儿童白癜风临床及免疫学研究

Clinical and immtmologieal features of childhood vitiligo

目的探讨儿童白癜风与免疫的关系。方法采用统一设计的儿童白癜风临床特点调查表对本院门诊的14岁以下患儿及其家属进行调查。对270例患儿检测外周血免疫球蛋白、补体水平和T细胞亚群。结果白癜风患儿620例中男302例（48．71％），女318例（51．29％），平均就诊年龄8．81岁，平均发病年龄7．57岁，平均病程8．14个月。累及头颈部453例，占73．06％。节段型160例，占25．81％。发病季节和疾病进展均以春夏季为多。73例患儿伴有晕痣，占11．77％，以散发型者居多。有家族史者84例，占13．55％。节段型患儿中，进展期的患儿血C3、C4水平明显低于稳定期患儿（P〈0．05）。寻常型患儿中，进展期的患儿血CD3^＋,CD4^＋细胞水平和CD4^＋／CD8^＋比值明显低于稳定期患儿（P〈0．01）。结论白癜风患儿体内存在某些免疫指标的异常，可能与免疫紊乱有关。

Objective To discuss the relationship between immunily and childhood vitiligo. Methods A questionnaire was designed to investigate the clinical characteristic of patients younger than 14 years with vitiligo and their relatives. The serum levels of immunoglobulin, complement and T-lymphocyte subsets were detected in 270 cases of pediatric vitiligo. Results A total of 620 patients were investigated. Of them, 302 （48.71%） were boys and 318 （51.29%） were girls,with a mean age of 8.81 years and mean onset age at 7.57 years. The mean disease duration was 8.14 months. The involvement of head and neck was observed in 453 （73.06%） children. Segmental vitiligo was diagnosed in 160 （25.81%） children, Spring and summer are predilected seasons of pediatric vitiligo. Halo nevi were found in 73 （ 11.77%） children, and most in those with scattered vitiligo. Family history was observed in 84 （13.55%） children. A significant decrease of serum C3 and C4 was observed in patients with segmental vitiligo in active phase compared with those in stable phase （P 〈 0.05 ）. Similarly, the count of CD4^＋ and CD3^＋ lymphocytes in peripheral blood as well as the CD4^＋/CD8^＋ ratio were decreased in patients with vitiligo vulgaris in active phase compared with those in stable phase （P 〈 0.01 ）. Conclusion There is an abnormalily in some immune parameters in children with vitiligo, which may be related to the immunologic derangement.