共聚焦激光扫描显微镜观察白癜风外用药物疗效

发布时间：2018-06-24 05:13

本文选题：共聚焦激光扫描显微镜 + 面部白癜风　；参考：《浙江中医药大学》2012年硕士论文

【摘要】：目的①应用共聚焦激光扫描显微镜(CLSM)观察0.1%他克莫司软膏治疗面部白癜风的药物疗效。②应用CLSM观察维阿露溶液治疗面部白癜风的药物疗效。方法①收集我院皮肤科门诊35例面部白癜风患者,给予0.1%他克莫司软膏,每日2次,连续用药12个月,每1-2月随访1次,(随机选取20例患者,前4个月,每1-2周随访1次)；进行CLSM扫描和数码相机拍照,并及时记录扫描结果。②收集我院皮肤科门诊20例面部白癜风患者,给予外用维阿露溶液,每天2次,并在用药后30分钟局部日光浴10分钟。连续用药4个月,每1-2周随访1次,进行CLSM扫描和数码相机拍照,并及时记录扫描结果。结果①他克莫司中,痊愈11例,显效7例,好转6例,无效11例,有效率为68.57%显效率为51.43%。35例患者中,肉眼评估皮损出现大面积复色的患者中,CLSM下白斑区基底层都可见大量树突状、折光明亮的黑素细胞或大量色素颗粒、色素环。肉眼评估皮损无任何复色的患者中,部分患者CLSM下白斑区基底层未见树突状、折光明亮的黑素细胞；然部分患者CLSM下可见数量不定的树突状黑素细胞。在选取的20例患者中,CLSM评估的平均起效时间为(4.29±2.84)周,明显优于肉眼评估的平均起效时间为(7.40±3.24)周,两者有统计学差异(t=2.50,P0.05)。根据CLSM所观察的结果,总结了黑素细胞三种分布模式,边缘型：白斑边缘区域基底层可见少许树突状黑素细胞；毛囊周围型：白斑区基底层毛囊周围可见数量不定的树突状黑素细胞；弥漫型：白斑区基底层多个毛囊及其毛囊间可见大量树突状黑素细胞或色素颗粒、色素环出现。②维阿露中,CLSM的平均起效效时间为(4.53±2.47)周,也明显优于肉眼评估的平均起效时间为(9.83±2.76)周,两者有统计学差异(t=5.26,P0.05)。结论CLSM可以作为白癜风外用药物疗效观察的有效手段,有助于增强患者用药信心,更适合科学研究。CLSM下白癜风复色时期存在边缘型、毛囊周围型、弥漫型三种黑素细胞的分布模式。
[Abstract]:Objective 1 to observe the therapeutic effect of 0.1% tacrolimus ointment on facial vitiligo by confocal laser scanning microscope (CLSM). Methods (1) 35 patients with vitiligo were treated with 0.1% tacrolimus ointment twice a day for 12 months and followed up once every 1-2 months. (20 patients were randomly selected for the first 4 months and followed up once every 1-2 weeks). CLSM scanning and digital camera were performed, and the scanning results were recorded in time. 2. Twenty patients with vitiligo were collected from our dermatology outpatient department. The patients were given vitiligo solution twice a day, and after 30 minutes local sunbathing for 10 minutes. The patients were followed up once every 1-2 weeks for 4 months. CLSM scan and digital camera were taken and the scan results were recorded in time. Results (1) in tacrolimus, 11 cases were cured, 7 cases were markedly effective, 6 cases were improved, 11 cases were ineffective, the effective rate was 68.57% and the effective rate was 51.43.35 cases. A large number of dendritic cells or a large number of pigment granules and pigment rings were found in the basal layer of the leukoplakia area under CLSM in patients whose lesions were evaluated by naked eye. No dendritic cells were found in the basal layer of leukoplakia in some of the patients who were not stained by the naked eye, while in some patients, the number of dendritic melanocytes in the subbasal layer of the leukoplakia was not seen. The mean onset time of CLSM evaluation was (4.29 卤2.84) weeks, which was significantly better than that of naked eye assessment (7.40 卤3.24) weeks. There was statistical difference between the two groups (t 2.50 P 0.05). According to the results observed by CLSM, three distribution patterns of melanocytes were summarized: a few dendritic melanocytes were found in the basal layer of the marginal region of leukoplakia; Perifollicular type: a large number of dendritic melanocytes are seen around the basal follicle of the white spot area, and a large number of dendritic melanocytes or pigment particles are found between the multiple hair follicles of the basal layer of the white spot area and their hair follicles. The average effective time of CLSM was (4.53 卤2.47) weeks, which was significantly better than that of naked eye evaluation (9.83 卤2.76) weeks. There was statistical difference between the two groups (t 5.26P). Conclusion CLSM can be used as an effective method to observe the curative effect of external medicine for vitiligo, which is helpful to enhance patients' confidence in medication, and is more suitable for the scientific study of marginal type and perifollicular type of vitiligo in the period of color recovery of vitiligo under CLSM. Distribution patterns of diffuse melanocytes.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R758.41

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