[1]高 涛,武瑞霞. 超脉冲CO2点阵激光及高能紫外线联合他克莫司治疗不同类型白癜风皮损的疗效及相关影响因素分析[J].中国美容医学,2019,(12):59-62.
　GAO Tao,WU Rui-xia. Effect of Ultrapulsed CO2 Lattice Laser and High Energy Ultraviolet Ray Combinedwith Tacrolimus on the Treatment of Different Types of Vitiligo Skin Lesions and Related Influencing Factors[J].Medical Aesthetics and Beauty,2019,(12):59-62.
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 超脉冲CO2点阵激光及高能紫外线联合他克莫司治疗不同类型白癜风皮损的疗效及相关影响因素分析
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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:
期数:
2019年12期
页码:
59-62
栏目:
出版日期:
2019-12-05

文章信息/Info

Title:
 Effect of Ultrapulsed CO2 Lattice Laser and High Energy Ultraviolet Ray Combined
with Tacrolimus on the Treatment of Different Types of Vitiligo Skin Lesions and Related Influencing Factors
文章编号:
1008-6455(2019)12-0059-04
作者:
 高 涛; 武瑞霞
Author(s):
 GAO Tao;  WU Rui-xia
关键词:
 ; [关键词]白癜风; 超脉冲CO2点阵激光; 高能紫外线; 他克莫司; 皮损; 影响因素
Keywords:
 ; Key words: different types of vitiligo;  ultra-pulsed CO2 dot matrix laser;  high-energy ultraviolet light; tacrolimus; skin lesions; related influencing factors
分类号:
R758.4+1
文献标志码:
A
摘要:
[摘要]目的：探讨超脉冲CO2点阵激光、高能紫外线联合他克莫司治疗不同类型白癜风皮损的效果，并探讨相关影响因素。
方法：选取2016年1月-2018年1月笔者医院收治的255例白癜风患者为治疗组研究对象，根据临床类型不同将治疗组分为节段
型组、局限型组、散发型组、泛发型组和肢端型组，分别为40例、57例、85例、25例和48例，同时选取同期性别及年龄与之
匹配的300例健康体检人群作为对照组。入组前采用免疫透射比浊法检测所有研究对象血清免疫球蛋白(IgG、IgA、IgM)和
补体（C3、C4）水平；入组后白癜风患者即开始接受超脉冲CO2点阵激光、高能紫外线联合治疗，前者是每2周治疗1次，4次
为1个疗程，后者是每周2次，16次为1个疗程；此外还需加用0.1%他克莫司软膏封包，每次1h，每日2次，以上治疗共3个疗
程并评估其疗效。比较不同组别疗效及不同疗效患者入组前血清免疫球蛋白和补体水平；并用Logistic回归分析探讨影响
白癜风疗效的关键因素。结果：与对照组比较，白癜风患者血清IgG、IgA和IgM水平升高，C3和C4水平降低，差异均有统计
学意义（P ＜0.05）。四组总有效率比较差异有统计学意义（P ＜0.05），由高到低分别为局限型组（89.47%）、散发型组
（67.06%）、节段型组（52.50%）、肢端型组（31.25%）和泛发型组（16.00%）。治疗后经评估得知，255例患者中有效148
例，无效107例，其中无效者血清IgG、IgA、IgM、C3、C4水平明显低于有效者，且差异均有统计学意义（P ＜0.05）。疗效
不同，其病程、临床分期及临床分型差异明显，且具有统计学意义（P ＜0.05）。经Logistic回归分析得知，临床分期（进
展期）和临床分型（泛发型）是影响白癜风疗效的独立危险因素（P ＜0.05）。结论：超脉冲CO2点阵激光、高能紫外线联合
他克莫司治疗不同类型白癜风差异明显，以局限型白癜风效果最佳，与血清免疫蛋白和补体密切相关，其中泛发型是影响白
癜风疗效的独立危险因素。

Abstract:
Abstract: Objective To compare the effects of ultra-pulsed CO2 lattice laser combined with high-energy ultraviolet light and
tacrolimus in different types of vitiligo, and to explore related influencing factors. Methods A total of 255 patients with vitiligo
admitted to our hospital from January 2016 to January 2018 were enrolled in the study. They were divided into segmental,
localized, sporadic, and generalized groups according to different clinical types,The end group was 40, 57, 85, 25 and 48,
respectively,At the same time, 300 healthy people matched by sex and age in the same period were selected as the control group.
The levels of serum immunoglobulin (IgG, IgA, IgM) and complement (C3, C4) were measured by immunoturbidimetric assay
before enrollment. After the enrollment, ultra-pulsed CO2 laser-high-energy ultraviolet therapy was started. The former is treated
once every 2 weeks, 4 times for 1 course, the latter is 2 times a week, 16 times for one course of treatment; in addition, 0.1%
tacrolimus ointment package must be added, each time 1 h, each 2 times a day, the above treatments have a total of 3 courses,
and the efficacy is evaluated. The efficacy of different groups was compared. The serum immunoglobulin and complement
levels were compared before treatment. The clinical data of patients with different curative effects were compared. Logistic
regression analysis was used to explore the key factors affecting the efficacy of vitiligo. Results Compared with the control
group,the levels of serum IgG, IgA and IgM increased and C3 and C4 decreased in patients with vitiligo (P ＜0.05).The total
effective rate of the four groups was statistically significant (P ＜0.05). The high to low were limited (89.47%), sporadic (67.06%),
segmental (52.50%), and limbs. End group (31.25%) and general hair group (16.00%). After treatment, it was estimated that
148 patients were effective in 255 patients, and 107 patients were ineffective. Among them, serum IgG, IgA, IgM, C3, and C4
levels were significantly lower than those in the effective group, and the differences were statistically significant ( P ＜0.05).
The curative effect was different, and the disease course, clinical stage and clinical classification were significantly different,
and statistically significant (P ＜0.05). Logistic regression analysis showed that clinical stage (progressive stage) and clinical
classification (pan-type) were independent risk factors for the efficacy of vitiligo (P ＜0.05). Conclusion Ultra-pulsed CO2
dot-matrix laser combined with high-energy ultraviolet light has different treatments for different types of vitiligo. The effect
of localized vitiligo is the best, which is closely related to serum immune protein and complement. The pan-hair style is an
independent risk factor affecting the efficacy of vitiligo.

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更新日期/Last Update: 2020-01-06