他克莫司软膏联合激光治疗对寻常型白癜风疗效及细胞免疫的影响

The effect of tacrolimus ointment combined with laser on the psoriasis vulgaris and the influence of cellular immunity

目的观察他克莫司软膏联合激光治疗寻常型白癜风的效果及对T细胞亚群、趋化因子9(C-X-C motif9,CXCL9)表达的影响。方法选取我院2014年1月至2017年1月期间收治的150例寻常型白癜风患者,依据随机数字表法分为对照组1和对照组2,以及观察组,每组各50例,其中对照组1采用他克莫司软膏治疗,对照组2采用激光治疗,观察组联合采用他克莫司软膏、激光治疗。比较三组患者临床疗效,以及血清CXCL9水平、T细胞亚群。结果观察组总有效率(89.8%)显著高于对照组1(43.8%)和对照组2(56.3%),差异均具有统计学意义(P <0.05)。观察组治疗后的血清CXCL9水平、T总、CD8+T显著低于对照组1和对照组2,CD4+T/CD8+T显著高于对照组1和对照组2(P <0.05)。三组患者不良反应发生率不存在显著差异(P <0.05)。结论他克莫司软膏联合激光治疗可有效降低寻常型白癜风患者CXCL9表达,改善T细胞亚群比例,提高治疗效果。

Objective To study the effect of tacrolimus ointment combined with laser on the psoriasis vulgaris, and the expression of CXCL9 and T cell subsets. Methods 150 patients with psoriasis vulgaris admitted in our hospital from January 2014 to January 2017 were divided into observation group and control group 1 and 2 according to random digital table, 50 cases per group. The control group 1 was treated with tacrolimus ointment, and the control group 2 was treated with laser, while the observation group were treated with tacrolimus ointment and laser. The clinical efficacy, the serum CXCL9 levels and T cell subsets were compared between the three groups. Results The total effective rate in observation group(89.8%)was significantly higher than that in control group 1(43.8%)and 2(56.3%), with statistical significance(P<0.05). The serum CXCL9 levels and the total number of T cells and CD8+T in observation group were significantly lower than that in control group 1 and 2 after treatment(P<0.05), CD4+T/CD8+T was significantly higher than that in control group 1 and 2(P<0.05).There was no significant difference in the incidence of adverse reactions between the three groups(P<0.05). Conclusion Tacrolimus ointment combined with laser therapy can effectively reduce CXCL9 expression in patients with psoriasis vulgaris, and improve the proportion of T cell subsets and the therapeutic effect.