CAJ | 학술논문

目的研究自体黑素细胞移植治疗白癜风细胞接种量与疗效的关系.方法共移植治疗632例稳定期白癜风患者,采用随机分组的方法分为4组,其中201例患者黑素细胞接种量为(3.0～4.9)×104个/cm2,303例接种量为(5.0～ 7.9)×104个/cm2,82例接种量为(8.0 ～ 9.9)×104个/cm2和46例接种量为(10.0～12.0)×104个/cm2.负压吸疱获取患者正常表皮片,Hu16培养基体外培养黑素细胞,经2～5代体外培养,受皮区应用超脉冲CO2激光磨削去表皮后,按照不同的黑素细胞密度进行移植.随访观察6、12和24个月患者色素恢复比率和色素匹配情况.结果共治疗632例稳定期白癜风患者.随访6个月时,52.85％患者皮损复色面积超过90％,82.28％患者皮损复色面积超过50％,4个组间痊愈率和有效率差异无统计学意义(均P＞ 0.05).随访6、12和24个月,黑素细胞接种量(5.0 ～ 7.9)×104个/cm2组色素匹配良好率明显高于其他3组(均P＜ 0.05).各组病例移植后6个月时与正常皮肤颜色色素匹配良好率均明显低于12和24个月时(均P＜ 0.05)；随访12个月与正常皮肤颜色色素匹配良好率与随访24个月差异均无统计学意义(均P＞0.05).结论自体纯培养黑素细胞移植是治疗稳定期白癜风的有效治疗手段,黑素细胞最优接种量为(5.0～7.9)×104个/cm2,皮肤颜色色素匹配度随时间升高.
목적 연구자체흑소세포이식치료백전풍세포접충량여료효적관계.방법 공이식치료632례은정기백전풍환자,채용수궤분조적방법분위4조,기중201례환자흑소세포접충량위(3.0～4.9)×104개/cm2,303례접충량위(5.0～ 7.9)×104개/cm2,82례접충량위(8.0 ～ 9.9)×104개/cm2화46례접충량위(10.0～12.0)×104개/cm2.부압흡포획취환자정상표피편,Hu16배양기체외배양흑소세포,경2～5대체외배양,수피구응용초맥충CO2격광마삭거표피후,안조불동적흑소세포밀도진행이식.수방관찰6、12화24개월환자색소회복비솔화색소필배정황.결과 공치료632례은정기백전풍환자.수방6개월시,52.85％환자피손복색면적초과90％,82.28％환자피손복색면적초과50％,4개조간전유솔화유효솔차이무통계학의의(균P＞ 0.05).수방6、12화24개월,흑소세포접충량(5.0 ～ 7.9)×104개/cm2조색소필배량호솔명현고우기타3조(균P＜ 0.05).각조병례이식후6개월시여정상피부안색색소필배량호솔균명현저우12화24개월시(균P＜ 0.05)；수방12개월여정상피부안색색소필배량호솔여수방24개월차이균무통계학의의(균P＞0.05).결론 자체순배양흑소세포이식시치료은정기백전풍적유효치료수단,흑소세포최우접충량위(5.0～7.9)×104개/cm2,피부안색색소필배도수시간승고.
Objective To evaluate the relationship between cell seeding density and clinical efficacy of autologous cultured melanocyte transplantation in the treatment of vitiligo.Methods A total of 632 patients with vitiligo were enrolled in this study,and randomly classified into 4 groups to be treated with transplantation of autologous cultured melanocytes at 4 different seeding densities respectively,i.e.,(3.0-4.9)× 104/cm2 (n =201),(5.0-7.9) × 104/cm2 (n =303),(8.0-9.9) × 104/m2 (n =82),(10.0-12.0) × 104/cm2 (n =46).Epidermal sheets were obtained by suction blister biopsy from the normal skin of the vitiligo patients,and subjected to the isolation and culture of melanocytes.After 2 to 5 passages,the cultured autologous melanocytes were transplanted at different seeding densities to vitiligous lesions,which were abraded previously by ultra-pulsed CO2 laser,of these patients.All the patients were followed for 6-12 months.Results At 6 months after the transplantation,52.85％of these patients achieved more than 90％ repigmentation,and 82.28％ more than 50％ repigmentation,with no differences in the cure rate and response rate between the 4 groups (both P ＜ 0.05).The percentage of patients obtaining excellent color matching was significantly higher in the group treated with transplantation of melanocytes at a seeding density of (5.0-7.9) × 104/cm2 than in the other 3 groups at 6,12 and 24 months after treatment (all P ＜ 0.05),and higher in all the 4 groups at 12-and 24-month points compared with the 6-month point (all P ＜ 0.05),but no statistical difference was observed between the 12-and 24-month point in any of these groups (all P ＞ 0.05).Conclusions The transplantation of autologous cultured pure melanocytes is effective for the treatment of stable vitiligo with the optimal cell seeding density of melanocytes being (5.0-7.9) × 104/cm2,and the color matching appears to improve with time.