他克莫司治疗白癜风对病人血清CXCL9、CXCL10水平的影响

Effect of tacrolimus on the serum levels of CXCL9 and CXCL10 in patients with vitiligo

目的:探讨他克莫司对白癜风病人血清CXC趋化因子配体9(CXCL9)、CXCL10水平的影响。方法:选取白癜风病人240例,按随机数字表法分为对照组和观察组,各120例。对照组采用常规治疗,观察组在常规治疗基础上加用他克莫司,2组均治疗2个月。比较2组治疗效果,分别在治疗前、治疗2个月后采血检测2组血清CXCL9、CXCL10水平以及肿瘤坏死因子-α(TNF-α)水平,Pearson线性相关分析血清CXCL9、CXCL10与TNF-α的相关性。记录2组不良反应情况。结果:观察组总有效率高于对照组(P<0.05)。治疗后2组血清CXCL9、CXCL10、TNF-α水平均显著低于治疗前,且观察组显著低于对照组(P<0.01)。Pearson线性相关分析提示血清CXCL9、CXCL10与TNF-α均呈正相关关系(r=0.713、r=0.672,P<0.01)。2组灼痛、红斑、皮疹、瘙痒发生率比较差异无统计学意义(P>0.05)。结论:与单纯常规治疗相比,加用他克莫司能进一步下调白癜风病人的血清CXCL9、CXCL10水平,这可能是其提高临床疗效的重要机制,且二者与TNF-α呈正相关。

Objective:To investigate the effects of tacrolimus on the serum levels of CXC chemokine ligand 9(CXCL9)and CXC chemokine ligand 10(CXCL10)in patients with vitiligo.Methods:Two hundred and forty patients with vitiligo were divided into the control group(n=120)and observation group(n=120)according to the random number table method.The control group was treated with routine treatment,while the observation group was additionally treated with tacrolimus on the basis of routine treatment for 2 months.The therapeutic effects between two groups were compared.The serum levels of CXCL9,CXCL10 and tumor necrosis factor-α(TNF-α)in two groups were measured before treatment and after 2 months of treatment.The correlations between serum levels of CXCL9 and CXCL10,and TNF-αwere analyzed using Pearson linear correlation analysis.The adverse reactions in two groups were recorded.Results:The total effective rate in observation group was higher than that in control group(P<0.05).After treatment,the serum levels of CXCL9,CXCL10 and TNF-αin two groups were significantly lower than those before treatment,and which in observation group was significantly lower than that in control group(P<0.01).The results of Pearson linear correlation analysis showed that the serum levels of CXCL9 and CXCL10 were positively correlated with TNF-α(r=0.713,0.672,P<0.01).The differences of the incidence rates of burning,erythema,rash and pruritus between two groups were not statistically significant(P>0.05).Conclusions:Compared with conventional therapy alone,tacrolimus can further reduce the serum levels of CXCL9 and CXCL10 in patients with vitiligo,which may be an important mechanism in improving clinical efficacy,and both of them are positively correlated with TNF-α.