糖皮质激素对甲状腺抗体升高的进展期白癜风患者的疗效及抗体水平的影响

Effects of glucocorticoids on serum thyroid antibody levels in patients with progressive vitiligo

目的:探讨糖皮质激素对并发甲状腺抗体升高的进展期白癜风患者血清中甲状腺过氧化物酶抗体(TPOAB)和甲状腺球蛋白抗体(TGAB)的影响及疗效。方法:将并发甲状腺抗体升高的进展期白癜风患者60例患者,分为试验组和对照组,每组各30例,试验组采用复方倍他米松(得宝松)肌内注射,每个月1次,连续3个月;对照组采用局部照射308 nm准分子激光,每周2次,连续3个月,两组患者均外用他克莫司乳膏,每日2次。治疗1个月和3个月后检测血清中TPOAB和TGAB的水平,同时观察两组患者的皮损情况。结果:试验组有效率为70%,对照组有效率为36.7%。试验组中24例(80%)患者皮损由进展变为稳定,对照组患者12例(40%)皮损稳定。3个月后,试验组患者血清中TPOAB和TGAB的水平均降低,与治疗前相比,差异具有统计学意义,而对照组患者TPOAB和TGAB的水平变化差异无统计学意义。结论:并发甲状腺抗体升高的进展期白癜风,糖皮质激素的疗效优于308 nm准分子激光,且糖皮质激素可以降低患者血清中TPOAB和TGAB的水平。

Objective:To study the effect of glucocorticoids on thyroid peroxidase antibody(TPOAB)and thyroglobulin antibody(TGAB)in the serum of patients with progressive vitiligo with elevated thyroid antibodies levels.Methods:60 patients of progressive vitiligo with elevated thyroid antibody level were divided into experimental group and control group with 30 cases in each group.The experimental group received intramuscular injection of compound betamethasone once a month for 3 consecutive months,and the control group received local irradiation of 308 nm excimer laser twice a week for 3 consecutive months.Both groups were given tacrolimus topically twice a day.Serum levels of TPOAB and TGAB were measured after 1 and 3 months of treatment,and the skin lesions of both groups were observed.Results:In the experimental group,the progressive skin lesions became stabilized in 24(80%)patients,while 12 patients(40%)in the control group had stable skin lesions.After 3 months of treatment,the levels of TPOAB and TGAB in the serum of patients in the experimental group decreased,and the difference was statistically significant compared with that before treatment.There was no significant difference in the levels of TPOAB and TGAB before and after the treatment in the control group.Conclusion:For progressive vitiligo complicated by elevated thyroid antibodies,the effect of glucocorticoids is better than that of 308 nm excimer laser,and glucocorticoids can reduce the levels of TPOAB and TGAB in serum.