308nm准分子激光治疗207例稳定期白癜风的疗效及影响因素

Efficacy and influential factors for 308 nm excimer laser in treatment of 207 stable vitiligo patients

目的:分析308 nm准分子激光治疗稳定期白癜风的疗效,并评估影响其疗效的因素。方法:207例稳定期白癜风患者的1 763片皮损经308 nm准分子激光治疗后,分析其疗效及安全性,然后按性别、年龄、病程、皮损部位及皮损处毛发颜色进行亚组分类,分析影响308 nm准分子激光疗效的关键因素。结果:经308 nm准分子激光治疗后,560片(31.8%)皮损痊愈,650片(36.9%)复色75%~99%,189片(10.7%)复色50%~75%,231片(13.1%)复色25%~49%,108片(6.1%)复色1%~24%,25片(1.4%)无复色。<18岁患者的总显效率明显高于≥18岁患者的(86.9%vS 63.4%,p<0.001);病程<2年患者的总显效率明显高于病程≥2年患者的(90.6%vS 40.7%,p<0.001)。面颈部皮损的总显效率为95.4%,明显高于躯干(70.3%)和四肢(41.7%)的(p<0.001)。皮损伴毛发变白的总显效率低于皮损不伴毛发变白患者的(54.9%vS 84.5%,p<0.001)。不同性别白癜风患者的总显效率差异无统计学意义(p>0.05)。结论:308 nm准分子激光治疗白癜风疗效好,安全性高。年龄、病程、皮损部位、皮损毛色是影响308 nm准分子激光疗效的重要因素。

Objective: To evaluate the efficacy and influential factors for 308 nm excimer laser in the treatment of stable vitiligo patients.Methods: A total of 207 stable vitiligo patients with 1 763 patches were treated with 308 nm excimer laser. Open-label study was carried out to investigate the efficacy and safety regarding the treatment with 308 nm excimer laser, and to compare the response under different conditions including gender, age, duration, lesion location, and hair color.Results: After treatment, 560(31.8%) patches achieved 100% repigmentation, 650(36.9%) lesions showed 75%-99% repigmentation, 189(10.7%) showed 50%-75% repigmentation,231(13.1%) showed 25%-49% repigmentation, 108(6.1%) showed 1%-24% repigmentation, 25(1.4%) displayed no response. The rates of total excellent response(50%-100% repigmentation) in underage patients was 86.9%, much higher than that in adult patients(P<0.001). Total excellent response rates was 90.6% in disease duration <2 years, and 40.7% in disease duration ≥2 years. Lesions on the faciocervical region responded better than trunk and limbs, showing 95.4%, 70.3%, and 41.7% total excellent response, respectively. Patients with poliosis showed 54.9% in total excellent response rate, much lower than 84.5% in patients without poliosis(P<0.001). No significant response differences in gender were found. Conclusion: 308 nm excimer laser is effective and safe in treatment of vitiligo. Aging, disease duration, lesion location, and hair color in lesion may be the influential factors for 308 nm excimer laser in treatment of vitiligo patients.