他克莫司联合308 nm准分子激光治疗白癜风的效果和安全性

Clinical effect and safety of tacrolimus combined with 308 nm excimer laser on vitiligo

目的分析他克莫司联合308 nm准分子激光治疗白癜风的效果和安全性。方法抽取2019年1月至2020年4月开封市中心医院收治的白癜风患者110例,按随机数字表法分为他克莫司组和激光照射组,每组55例。激光照射组予以308 nm准分子激光,他克莫司组予以他克莫司联合308 nm准分子激光。比较两组疗效、色素与白斑消退时间、不良反应、复发率及治疗前后白癜风面积评分指数(VASI)、炎性因子水平。结果他克莫司组总有效率(94.55%,52/55)高于激光照射组(81.82%,45/55),P<0.05;他克莫司组色素消退时间、白斑消退时间均短于激光照射组(P均<0.05)。治疗后,他克莫司组VASI评分低于激光照射组(P<0.05);肿瘤坏死因子-α、白细胞介素-17水平均低于激光照射组(P均<0.05)。他克莫司组不良反应发生率(5.45%,3/55)及复发率(3.70%,2/54)与激光照射组(9.09%,5/55;13.46%,7/52)比较,差异均未见统计学意义(P均>0.05)。结论他克莫司联合308 nm准分子激光治疗白癜风患者,可提高疗效,调节炎性因子表达,改善临床症状,避免复发,且具有安全性。

Objective To analyze the clinical effect and safety of tacrolimus combined with 308 nm excimer laser in the treatment of vitiligo.Methods One hundred and ten patients with vitiligo treated in Kaifeng Central Hospital from January 2019 to April 2020 were selected and divided into tacrolimus group and laser irradiation group according to the random number table method,with 55 cases in each group.The laser irradiation group received 308 nm excimer laser,and the tacrolimus group received tacrolimus combined with 308 nm excimer laser.The curative effect,pigment and vitiligo fading time,adverse reactions,recurrence rate,preoperative and postoperative vitiligo area scoring index(VASI),and preoperative and postoperative inflammatory factors were compared between the two groups.Results The total effective rate in tacrolimus group(94.55%,52/55)was higher than that in laser irradiation group(81.82%,45/55),P<0.05.The fading times of pigment and vitiligo in tacrolimus group were shorter than those in laser irradiation group(all P<0.05).After treatment,VASI score of tacrolimus group was lower than that of laser irradiation group(P<0.05);the levels of tumor necrosis factor-αand interleukin-17 in tacrolimus group were lower than those in laser irradiation group(all P<0.05).There was no significant difference in adverse reactions and recurrence rate between tacrolimus group(5.45%,3/55;3.70%,2/54)and laser irradiation group(9.09%,5/55;13.46%,7/52),all P>0.05.Conclusions Tacrolimus combined with 308 nm excimer laser in the treatment of vitiligo patients can improve the efficacy,regulate the expression of inflammatory factors,improve clinical symptoms,and avoid recurrence,with safety.