白癜风临床分析及实验研究(英文)

Clinical analysis and experimental study of vitiligo

目的 了解白癜风的临床特点 ,探讨其发病机制 .方法 回顾分析 2 0 0 8例白癜风患者的临床资料 ;以酶联免疫吸附法检测 2 83例白癜风患者血清中的抗黑素细胞 Ig G抗体 ;以免疫组织化学染色法检测 45例白癜风患者血清中的抗黑素细胞 Ig G抗体和 Ig M抗体 ;观察 2 5例活动期白癜风血清对补体介导的黑素细胞损伤的作用 .结果 1 2 0 0 8例白癜风患者中 ,男女患者之比为 1 .0 6 .平均就诊年龄 2 3 .2岁 ,平均发病年龄为 2 0岁 ,6例出生时即患病 .头面及颈部为最易受累部位 .临床分型以双侧型最多见 ,82 .2 %的患者就诊时处于进展期 ,3 0 3例 (1 5 .0 % )患者伴发其他疾病 ,其中有1 1 0例 (5 .5 % )合并晕痣 ,1 5 6例 (7.8% )患者有家族史 ,3 3 7例 (1 6 .4% )有明确的促发因素 .2 2 5例活动期白癜风患者血清中有 1 9例 (76 % )检出 Ig G型抗体 ,2 1例 (84% )检出 Ig M型抗体 ,明显高于非活动期白癜风患者 (3 5 % ,1 0 % )和正常对照 (1 0 % ,0 ) (P<0 .0 1 ) .3 2 5例活动期白癜风患者血清 9例(3 6 % )出现对黑素细胞的明显细胞毒作用 ,正常人血清及对照的成纤维细胞未出现明显的细胞毒作用 .结论 白癜风可出生即患 ;

AIM To probe into the clinical features and the cause of vitiligo. METHODS Clinical data of 2008 patients with vitiligo were reviewed; anti pigment cell IgG antibodies in the sera of 283 patients with vitiligo was detected by ELISA; anti pigment cell IgG antibodies and IgM antibodies in the sera of 45 patients with vitiligo were detected by Immunohistological methods; cytotoxic experiment mediated by complement was studied with the sera of 25 patients with active vitiligo. RESULTS ① Of the total 2008 vitiligo patients, the male to female ratio was 1.06. The average age of the patients at visit was 23.2 years old. The average of the onset age was 20 years old. There were 6 patients who fell ill when they were born. Head and neck were the most involved locations. Unilateral type was of the most. 82.2% patients were in advancing stage when they came to see the doctor. 303 patients (15.0%) were accompanied with other diseases. 110 (5.5%) of them were accompanied with halo nevi.156 (7.8%) patients have family history. 337 (16.4%) patients confirmed provocated factors. ② Of the sera of 25 patients with active vitiligo, IgG antibody was detected in 19 (76%) patients and IgM was detected in 21 (84%) patients, which was significantly higher than that in patients with inactive disease (35%, 10%) or controls (10%, 0) ( P < 0.01). ③ Of the sera of 25 patients with active vitiligo, cytotoxity mediated by the complement was observed in the sera of 9 (36%) patients. No cytotoxity was observed in the sera of the normal controls and in the fibroblasts. CONCLUSION Congenital vitiligo has been noticed in a few patients. Further more, we highlight the important role of autoantibodies in the pathogenesis of vitiligo.