窄波紫外线单用及联合干扰素等治疗Ⅰ、Ⅱ期蕈样肉芽肿64例疗效分析

Analysis of efficacy of NB—UVB alone or in combination with interferon in treating 64 cases of stages Ⅰ and Ⅱ mycosis fungoides

目的:分析窄波紫外线(NB-UVB)单用及联合干扰素等治疗Ⅰ、Ⅱ期蕈样肉芽肿的临床疗效。方法:回顾性分析北京大学第一医院皮肤科2009年1月—2013年12月诊治并随访的64例经临床和组织病理证实为Ⅰ、Ⅱ期蕈样肉芽肿并接受了NB-UVB,NB-UVB联合干扰素,NB-UVB联合干扰素、甲氨蝶呤(MTX)、小剂量糖皮质激素和(或)阿维A等方案治疗的患者临床资料。结果:64例蕈样肉芽肿(ⅠA期15例,ⅠB期33例,ⅡA期10例,ⅡB期6例),经NB-UVB,NB-UVB联合干扰素,NB-UVB联合干扰素、MTX、小剂量糖皮质激素和(或)阿维A治疗等方案治疗,有效率分别为:91.18%、86.67%和53.33%。其中ⅠA-ⅡA期中完全缓解(CR)19例(32.76%)、部分缓解(PR)30例(51.72),有效率84.48%。ⅡB期中CR1例(16.67%),PR1例(16.67%),有效率33.33%。结论:NB-UVB及NB-UVB联合干扰素治疗早期MF(ⅠA期、ⅠB-ⅡA期)效果优于ⅡB期,NB-UVB联合干扰素、MTX、小剂量糖皮质激素和(或)阿维A方案治疗ⅡB期MF有一定疗效。

Objective： To analyze the efficacy of NB-UVB alone or in combination with interferon in treating stage I and stage Ⅱ mycosis fungoides（MF）. Method： Clinical data of 64 MF patients were retrospectively analyzed. All patients were clinically and pathologically diagnosed with MF, and treated with either a. NB-UVB, b. NB-UVB＋interferon-alpha（IFN-α, or c. NB-UVB＋IFN-ot＋methotrexate（MTX）＋low dose of glucocorticoids＋acitretin. Results： The 64 patients consisted of 15 cases of stage I A, 33 cases of stage I B, 10 cases of stage ⅡA and 6 cases of stage ⅡB. The effective rates in patients treated with methods a, b and c were 91.18%, 86.67%, and 53.33%, respectively. Among stage I A, I B, and ⅡA patients, 19 patients（32.76%） were completely reheved and 30 patients（51.72%） were partially reheved. The total effective rate was 84.48%. Complete and partial relief were 1 each among stage ⅡB patients （total effective rate, 33.33%）. Conclusion： Treatment with NB-UVB alone or NB-UVB combined with IFN-α is more effective for early stage MF than for stage Ⅱ B MF. IFN combined with MTX. glueocorticoids, and aeitretin capsules displays some benefit for Ⅱ B.