窄谱中波紫外线联合他克莫司软膏对白癜风的疗效及对外周血白细胞介素17和白细胞介素22水平的影响

Effects of narrow-band UVB combined with tacrolimus ointment in the treatment of vitiligo and its influence on IL-17 and IL-22 in peripheral blood

目的 探讨窄谱中波紫外线联合他克莫司软膏对白癜风的疗效及对外周血白细胞介素17（IL-17）和白细胞介素22（IL-22）水平的影响.方法 选择100例白癜风患者为研究对象,按照随机数字表法分为对照组和观察组,每组50例.对照组给予0.1%他克莫司软膏治疗,观察组给予窄谱中波紫外线联合0.1%他克莫司软膏治疗.治疗6个月后观察两组临床治疗效果,采用ELISA法检测血清IL-17、IL-22含量,比较两组患者治疗前后的差异.结果 观察组治愈率、有效率分别为74.0%、96.0%,明显高于对照组的62.0%、84.0%,差异均有统计学意义（x2=4.125、4.897,均P〈0.05）.治疗前两组IL-17、IL-22含量比较差异均无统计学意义（均P〉0.05）.两组治疗后IL-17、IL-22含量较前均明显降低（t=3.454、3.032,均P〈0.05）,治疗后观察组IL-17、IL-22含量均低于对照组,两组差异均有统计学意义（t=3.867、2.665,均P〈0.05）.结论 窄谱中波紫外线联合他克莫司软膏对白癜风具有较好的临床疗效,且能提高患者的局部免疫反应,值得推广应用.

Objective To investigate the effect of narrow-band UVB combined with tacrolimus ointment in the treatment of vitiligo,and its influence on IL-17 and IL-22 in peripheral blood.Methods 100 patients with vitiligo were selected as study subjects,and they were divided into the control group and observation group according to the random number table method,50 cases in each group.The control group was given 0.1% tacrolimus ointment,the observation group was treated with narrow-band UVB combined with 0.1% tacrolimus ointment.After 6 months of treatment,the clinical treatment effect of the two groups was observed.The levels of serum IL-17 and IL-22 were detected by ELISA,the differences between before and after treatment were compared between the two groups.Results The cure rate,effective rate of the observation group were 74.0%,96.0%,respectively,which were significantly higher than 62.0%,84.0% of the control group,the differences were statistically significant（x2=3.125,2.897,all P〈0.05）.The levels of IL-17 and IL-22 in the two groups before treatment had no statistically significant differences（all P〉0.05）.After treatment,the levels of IL-17 and IL-22 in the two groups significantly decreased（t=3.454,3.032,all P〈0.05）,which in the observation group were lower thanthose in the control group（t=3.867,2.665,all P〈0.05）.Conclusion Narrow-spectrum UVB combined with tacrolimus ointment has good clinical effect on vitiligo,which can effectively improve the local immune response.