CAJ | 학술논문

目的探讨自体培养黑素细胞移植治疗甲状腺功能异常白癜风的临床疗效.方法白癜风患者分为2组,甲状腺功能异常组30例和无甲状腺功能异常组30例.负压吸疱获取患者正常表皮片,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激光磨削去表皮后进行黑素细胞移植.所有患者均至少跟踪观察6个月.结果 30例甲状腺功能异常患者中,平均复色47％,7例复色面积超过90％,9例复色面积为50％～89％,53.3％达到＞50％的复色.无甲状腺功能异常组平均复色75％,13例达到＞90％的复色,11例有50％～89％的复色,痊愈率与有效率分别为43.3％、80％,均较甲状腺功能异常组疗效明显,两组间差异有统计学意义(均P＜ 0.05).移植部位位于面颈部、移植面积＞20 cm2时,组间有效率差异也有统计学意义(均P＜ 0.05).表皮吸疱于腰部皮肤的痊愈率与有效率均为最差.结论临床或亚临床的甲状腺异常会对白癜风的自体黑素细胞移植疗效产生负面影响.
목적 탐토자체배양흑소세포이식치료갑상선공능이상백전풍적림상료효.방법 백전풍환자분위2조,갑상선공능이상조30례화무갑상선공능이상조30례.부압흡포획취환자정상표피편,체외배양흑소세포,경2～5대체외배양,수피구응용초맥충CO2격광마삭거표피후진행흑소세포이식.소유환자균지소근종관찰6개월.결과 30례갑상선공능이상환자중,평균복색47％,7례복색면적초과90％,9례복색면적위50％～89％,53.3％체도＞50％적복색.무갑상선공능이상조평균복색75％,13례체도＞90％적복색,11례유50％～89％적복색,전유솔여유효솔분별위43.3％、80％,균교갑상선공능이상조료효명현,량조간차이유통계학의의(균P＜ 0.05).이식부위위우면경부、이식면적＞20 cm2시,조간유효솔차이야유통계학의의(균P＜ 0.05).표피흡포우요부피부적전유솔여유효솔균위최차.결론 림상혹아림상적갑상선이상회대백전풍적자체흑소세포이식료효산생부면영향.
Objective To evaluate the therapeutic efficacy of autologous melanocyte transplantation for the treatment of vitiligo in patients with abnormal thyroid function.Methods A total of 60 patients with vitiligo were enrolled in this study,including 30 with abnormal thyroid function and 30 without.Epidermal sheets were obtained by suction blister biopsy from the normal skin of all the patients followed by melanocyte isolation and culture.After 2-5 passages of subculture,the melanocytes were transplanted onto vitiliginous lesions,which were abraded previously by ultra-pulsed CO2 laser,in the corresponding patients.All the patients were followed for 6-12 months.Results Of the 30 patients with abnormal thyroid function,7 patients achieved more than 90％ repigmentation,9 patients 50％-89％ repigmentation,53.3％ more than 50％ repigmentation,with the average repigmentation rate being 47％ within 6 months after the transplantation.Meanwhile,13 out of the 30 patients without abnormal thyroid function showed more than 90％ repigmentation,11 showed 50％-89％ repigmentation,with the average repigmentation rate being 75％.Both the cure rate and response rate were significantly higher in the patients without abnormal thyroid function than in those with (cure rate,43.3％ vs.23.3％,P＜ 0.05; response rate,80％ vs.53.3％,P＜ 0.05).Significant differences were also found in the response rate for lesions on the face or neck and for those sized more than 20 cm2 between the two groups of patients (both P ＜ 0.05).The lesions transplanted with epidermal melanocytes from the waist exhibited the lowest cure rate and response rate.Conclusion Clinical or subclinical thyroid dysfunction may have a negative impact on the efficacy of autologous melanocyte transplantation in vitiligo.