【摘要】 目的探讨维生素D辅助点阵激光治疗白癜风的疗效及对外周血CXC趋化因子配体(CXC chemokine ligand,CXCL)的影响。方法前瞻性研究2018年6月至2019年12月,白癜风患者116例,按随机数表法分为观察组和对照组,每组患者58例。对照组采用点阵激光治疗,每月治疗1次,共治疗3次,3个月为一个疗程。观察组在点阵激光基础上口服维生素D3,1粒/次、1次/d,连续服用3个月。比较两组治疗前和治疗后3个月的皮损色素评分和皮损面积改变;检测外周血CXCL10、CXCL16;并记录不良反应发生情况。结果观察组治疗后3个月总有效率(91.4%)明显高于对照组(77.6%)(P<0.05)。观察组治疗后3个月皮损色素评分(1.79±0.4)分高于治疗前(0.41±0.1)分;对照组治疗后3个月皮损色素评分(1.54±0.4)分高于治疗前(0.39±0.1)分,差异均具有统计学意义(P<0.05);同时观察组治疗后3个月的皮损色素评分高于对照组(P<0.05)。治疗后3个月,观察组皮损面积降低至(3.24±1.0)cm~2低于治疗前(7.48±1.9)cm~2;对照组皮损面积降低至(4.58±1.4)cm~2低于治疗前(7.36±1.8)cm~2,差异均具有统计学意义(P<0.05)。同时观察组治疗后3个月的皮损面积低于对照组(P<0.05)。观察组治疗后3个月血清CXCL10、CXCL16分别为(1 008.2±117.7)μg/mL、(2 316.6±221.7)μg/mL低于治疗前(1 232.7±176.9)μg/mL和(2 852.3±316.6)μg/mL;对照组血清CXCL10、CXCL16降低至(1 153.7±120.5)μg/mL、(2 547.7±253.1)μg/mL,低于治疗前(1 219.8±158.6)μg/mL和(2 818.0±278.8)μg/mL,差异均具有统计学意义(P<0.05)。同时观察组治疗3个月的血清CXCL10、CXCL16低于对照组(P<0.05)。观察组和对照组的不良反应总发生率分别为6.90%和10.3%,差异无统计学意义(P>0.05)。结论维生素D辅助点阵激光治疗白癜风可通过下调外周血CXCL10、CXCL16改善患者皮损情况、提高疗效,且安全可耐受。更多还原

【Abstract】 Objective To explore the efficacy of vitamin D-assisted fractional laser treatment of vitiligo and its influence on CXC chemokine ligand(CXCL) in peripheral blood.Methods A prospective study was made on 116 selected patients of vitiligo admitted from Jun.2018 to Dec.2019.They were divided into the observation group and control group with random number table method,58 patients in each group.The patients in the control group were treated with fractional laser once every 1 month for 3 times in total.The patients in the observation group were treated with vitamin D3 on the basis of fractional laser.The Vitamin D3 was given orally for 3 months,1 capsule/time,once/d.Skin lesion pigment scores,changes of lesion area,peripheral blood CXCL10,CXCL16 and adverse reactions were compared between the two groups.Results After 3 months breatment the total effective rate of the observation group(91.4%) was significantly higher than control group 77.6%(P<0.05).After the treatment,the skin lesion pigment score of the observation group rose from(0.41±0.1) to(1.79±0.4),and the score of the control group from(0.39±0.1) to(1.54±0.4).The difference were statistically significant(P<0.05).The skin lesion pigment score of the observation group was higher than that of the control group after the treatment(P<0.05).Upon the treatment,the area of skin lesions in the observation group decreased from(7.48±1.9) cm2 to(3.24±1.0) cm2 and the area of the control group from(7.36±1.8) cm2 to(4.58±1.4) cm2.The difference were statistically significant(P<0.05).At the same time,the area of skin lesions in the observation group after the treatment was smaller than that in the control group(P<0.05).Three months after the treatment,the serum CXCL10 and CXCL16 in the observation group dropped from(1 232.7±176.9) μg/mL and(2852.3±316.6) μg/mL to(1 008.2±117.7)μg/mL and(2 316.6±221.7) μg/mL respectively,and those in the control group from(1219.8±158.6) μg/mL and(2 818.0±278.8) μg/mL to(1 153.7±120.5) μg/mL and(2 547.7±253.1) μg/mL(P<0.05)respectively.At the same time,the serum CXCL10 and CXCL16 of the observation group were lower than those of the control group after the treatment(P<0.05).The total incidence of adverse reactions in the observation group and the control group were 6.90% and10.3% respectively,and the difference was not statistically significant(P>0.05).Conclusions Vitamin D-assisted fractional laser treatment of vitiligo will improve patients’ skin lesions and treating efficacy while being safely tolerated by down-regulating peripheral blood CXCL 10 and CXCL16.更多还原