NB-UVB治疗白癜风疗效观察及探讨影响疗效的相关因素
发布时间：2018-09-08 16:57
【摘要】：背景白癜风是一种色素脱失疾病,NB-UVB治疗白癜风疗效好、副作用小、操作简单而被广泛应用。在既往的研究中显示NB-UVB治疗白癜风与多种因素有关,如:分型、部位、年龄、肤色、病程等,目前研究表明细胞因子和趋化因子与白癜风的发病和治疗疗效有关。虽然NB-UVB治疗白癜风获得较好的疗效,但是部分稳定期白癜风患者治疗效果差,具体原因未见相关报道;NB-UVB治疗白癜风一段时间后疗效停止,出现平台期,平台期出现的早晚与复色出现的早晚、疗效是否有关未见相关报道;光疗一段时间后白斑处会出现光不敏感现象,停止光疗后多久白斑恢复到最初治疗时的光敏感度未见相关报道。本研究就这几个问题作出探索。目的观察NB-UVB治疗白癜风平台期出现时光疗次数、初次复色时光疗次数、疗效三者之间的关系;停止光疗后多久,白斑恢复到最初治疗时光敏感度所需时间;筛查光疗效差者白斑处疱液中部分细胞因子及趋化因子水平较效优者差异,初步探索光疗效差者可能存在的原因。方法选取符合本研究要求的患者66名,以拍照的方式记录光疗期间患者的复色情况,比较有效和无效的患者初次复色时光疗次数、有效复色期间光疗总次数、平台期出现时光疗次数间的差异;进入平台期后以患者白斑处初始最小红斑量对剩余白斑定期进行2cm×2cm面积的照射,出现淡红斑时则认为光耐受结束,记录光耐受结束的时间;选取完成一个疗程光疗且复色小于10%和大于75%的患者各十名,以负压吸疱的方式收集白斑处疱液,用Luminex检测疱液中GM-CSF、IL-4、IL-6、IL-10、TNF-α、INF-γ、IP-10的水平。结果初次复色出现在第9次光疗前患者疗优于9次(包括9次)后的患者(P0.05);有效复色期间光疗总次数17次的患者疗效优于≤17次的患者(P0.05);平台期出现在第25次光疗前的患者与第25次(包括25次)光疗后的患者疗效比较,差异无统计学意义(P0.05);光耐受白斑恢复光敏感所需要的时间集中在45-75天之间;光疗效优者对比效差者白斑处TNF-α、IFN-γ、IL-10、IP-10水平有差异。结论1.NB-UVB治疗白癜风初次复色出现在9次前的患者,有效复色期间光疗总次数多,疗效好。2.光疗到一定次数后平台期均会出现,平台期与初次复色出现的早晚、疗效的好坏无关。3.进入平台期停止光疗后临床上建议至少休息75天再进行下一个疗程光疗,以期在小的累积能量下进行有效治疗。4.IL-10、TNF-α、IFN-γ水平可能与光疗治疗白癜风疗效有关。
[Abstract]:Background Vitiligo is a pigment loss disease. NB-UVB is widely used in the treatment of vitiligo. Previous studies have shown that NB-UVB treatment of vitiligo is related to a variety of factors, such as typing, location, age, skin color, course of disease and so on. Current studies have shown that cytokines and chemokines are associated with the pathogenesis and therapeutic efficacy of vitiligo. Although NB-UVB is effective in the treatment of vitiligo, the treatment effect of some stable vitiligo patients is poor. There is no related report that the curative effect of NB-UVB on vitiligo stopped after a period of time, and the stage of vitiligo appeared. There is no report on whether the therapeutic effect is related to the occurrence of the terrace in the morning and evening, and the light insensitivity will appear in the white spot after phototherapy for a period of time. How long the white spot returned to the initial treatment after stopping phototherapy was not reported. This study explores these issues. Objective to observe the relationship between the number of times of phototherapy in the plateau stage of NB-UVB treatment of vitiligo, the number of times of phototherapy in the first time of phototherapy, and the time required to recover the sensitivity of the initial treatment time after stopping phototherapy. The levels of some cytokines and chemokines in the leucoplast fluid of the patients with poor light effect were different, and the possible reasons for the poor light effect were explored. Methods Sixty-six patients who met the requirements of this study were selected to record the photochromic status of the patients during phototherapy by taking pictures. The effective and ineffective patients were treated with phototherapy for the first time and the total times of phototherapy during the effective phototherapy. After entering the platform stage, the residual white spot was irradiated with the initial minimum erythema at the white spot of the patient by 2cm 脳 2cm area, and the light tolerance was considered to be over and the time of the end of the light tolerance was recorded when the light erythema appeared. Ten patients with phototherapy less than 10% and more than 75% were selected for a course of phototherapy. The blister fluid of white spot was collected by suction blister under negative pressure, and the level of GM-CSF,IL-4,IL-6,IL-10,TNF- 伪 -INF- 纬 IP-10 in blister fluid was detected by Luminex. Results the primary phototherapy was better than 9 times (including 9 times) before the ninth phototherapy (P0.05), the curative effect of the patients with 17 times of phototherapy was better than that of 鈮，
本文编号：2231125
[Abstract]:Background Vitiligo is a pigment loss disease. NB-UVB is widely used in the treatment of vitiligo. Previous studies have shown that NB-UVB treatment of vitiligo is related to a variety of factors, such as typing, location, age, skin color, course of disease and so on. Current studies have shown that cytokines and chemokines are associated with the pathogenesis and therapeutic efficacy of vitiligo. Although NB-UVB is effective in the treatment of vitiligo, the treatment effect of some stable vitiligo patients is poor. There is no related report that the curative effect of NB-UVB on vitiligo stopped after a period of time, and the stage of vitiligo appeared. There is no report on whether the therapeutic effect is related to the occurrence of the terrace in the morning and evening, and the light insensitivity will appear in the white spot after phototherapy for a period of time. How long the white spot returned to the initial treatment after stopping phototherapy was not reported. This study explores these issues. Objective to observe the relationship between the number of times of phototherapy in the plateau stage of NB-UVB treatment of vitiligo, the number of times of phototherapy in the first time of phototherapy, and the time required to recover the sensitivity of the initial treatment time after stopping phototherapy. The levels of some cytokines and chemokines in the leucoplast fluid of the patients with poor light effect were different, and the possible reasons for the poor light effect were explored. Methods Sixty-six patients who met the requirements of this study were selected to record the photochromic status of the patients during phototherapy by taking pictures. The effective and ineffective patients were treated with phototherapy for the first time and the total times of phototherapy during the effective phototherapy. After entering the platform stage, the residual white spot was irradiated with the initial minimum erythema at the white spot of the patient by 2cm 脳 2cm area, and the light tolerance was considered to be over and the time of the end of the light tolerance was recorded when the light erythema appeared. Ten patients with phototherapy less than 10% and more than 75% were selected for a course of phototherapy. The blister fluid of white spot was collected by suction blister under negative pressure, and the level of GM-CSF,IL-4,IL-6,IL-10,TNF- 伪 -INF- 纬 IP-10 in blister fluid was detected by Luminex. Results the primary phototherapy was better than 9 times (including 9 times) before the ninth phototherapy (P0.05), the curative effect of the patients with 17 times of phototherapy was better than that of 鈮，
本文编号：2231125
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