白癜风二氧化碳点阵激光联合复方倍他米松疗程中免疫炎症因子动态观测及与复发相关性

doi:10.3969/j.issn.1007-3205.2023.12.016

摘要/Abstract

摘要： 目的观测白癜风二氧化碳（carbon dioxide，CO2）点阵激光联合复方倍他米松疗程中免疫炎症因子动态变化及与复发相关性。
方法选取我院收治的经CO2点阵激光联合复方倍他米松治疗后获得痊愈白癜风患者100例，根据痊愈后6个月病情复发情况分为复发组、未复发组。比较2组治疗前、治疗2次后、完成治疗后白细胞介素17（interleukin-17，IL-17）、干扰素-γ（interferon-γ，IFN-γ）及白细胞介素10（interleukin-10，IL-10）的水平，Logistic回归分析复发的相关影响因素，受试者工作特征曲线（receiver operating characteristic，ROC）分析治疗2次后、完成治疗后IL-17、IFN-γ、IL-10预测复发价值，并比较不同IL-17、IFN-γ、IL-10水平患者复发时间，Pearson检验分析IL-17、IFN-γ、IL-10与复发时间关系。
结果复发组有白癜风家族史患者多于未复发组，疾病严重程度重于未复发组（P＜0.05）；复发组治疗2次后、完成治疗后IL-17、IFN-γ水平高于未复发组，IL-10水平低于未复发组（P＜0.05）；Logistic回归分析显示，白癜风家族史、疾病严重程度、完成治疗后IL-17、IFN-γ均是复发的相关独立危险因素，IL-10是复发的相关保护因素（P＜0.05）；完成治疗后IL-17、IFN-γ、IL-10预测复发的AUC大于治疗2次后IL-17、IFN-γ、IL-10的AUC（Z=3.784、2.591、6.264，P＜0.05）；完成治疗后IL-17+IFN-γ+IL-10预测复发的AUC大于治疗2次后IL-17+IFN-γ+IL-10的AUC（Z=2.260，P＜0.05）；IL-17、IFN-γ高水平患者复发时间短于低水平患者，IL-10高水平患者复发时间长于低水平患者（P＜0.05）；完成治疗后IL-17、IFN-γ与复发时间呈负相关（r=-0.838、-0.773，P＜0.05），IL-10与复发时间呈正相关（r=0.814，P＜0.001）。
结论白癜风CO2点阵激光联合复方倍他米松疗程中IL-17、IFN-γ、IL-10水平呈动态变化，与痊愈后复发有关，联合检测完成治疗后三者水平可作为预测复发的一个方案，从而为临床防治复发提供重要参考信息。

关键词: 白癜风, 激光, 气体, 倍他米松

Abstract: Objective To observe the dynamic changes of immunoinflammatory factors during the course of carbon dioxide (CO2) fractional laser combined with compound betamethasone in vitiligo and their correlation with recurrence.
Methods One hundred patients with vitiligo who were treated with CO2 fractional laser combined with compound betamethasone in our hospital were selected and divided into recurrence group and non-recurrence group according to the recurrence of the disease at 6 months after healing. The levels of interleukin-17 (IL-17), interferon-γ (IFN-γ) and interleukin-10 (IL-10) were compared between two groups before treatment, after treatment for two times and after completion of treatment, and the factors associated with recurrence were analyzed by logistic regression. The receiver operating characteristic (ROC) curve was used to analyze the value of IL-17, IFN-γ and IL-10 in predicting recurrence after treatment for two times and after completion of treatment. The time to recurrence in patients with different IL-17, IFN-γ, and IL-10 levels was compared, and Pearson analysis was used to analyze the relationship between IL-17, IFN-γ, and IL-10 and time to recurrence.
Results There were more patients with family history of vitiligo in the recurrence group than in the non-recurrence group, and the severity of disease was greater than in the non-recurrence group (P＜0.05). IL-17 and IFN-γ levels were higher in the recurrence group than in the non-recurrence group after treatment for two times and after completion of treatment, and IL-10 level was lower than that in the non-recurrence group (P＜0.05). Logistic regression analysis showed that family history of vitiligo, severity of disease, and the levels of IL-17 and IFN-γ were all independent risk factors associated with recurrence, and the levels of IL-10 was a protective factor associated with recurrence (P＜0.05). The AUC of IL-17, IFN-γ, and IL-10 for predicting recurrence after completion of treatment was greater than that of IL-17, IFN-γ, and IL-10 after treatment for two times (Z=3.784, 2.591, 6.264, P＜0.05); the AUC of IL-17+IFN-γ+IL-10 for predicting recurrence after completion of treatment was greater than that of IL-17+IFN-γ+IL-10 after completion of treatment (Z=2.260, P＜0.05). Time to recurrence was shorter in patients with high levels of IL-17 and IFN-γ than in those with low levels, and longer in patients with high levels of IL-10 than in those with low levels (P＜0.05). IL-17 and IFN-γ were negatively correlated with time to recurrence after completion of treatment (r=-0.838, -0.773, P＜0.05), and IL-10 was positively correlated with time to recurrence (r=0.814, P＜0.001).
Conclusion The dynamic changes of IL-17, IFN-γ and IL-10 levels during the course of CO2 fractional laser combined with compound betamethasone in vitiligo are related to recurrence after healing, and the combined detection of the three levels after completion of treatment can be used as a scheme to predict recurrence, thus providing important reference information for clinical prevention and control of recurrence.

Key words: vitiligo, lasers, gas, betamethasone

张丽娜, 吕超, 王鑫, 申娟, 苗国英. 白癜风二氧化碳点阵激光联合复方倍他米松疗程中免疫炎症因子动态观测及与复发相关性 [J]. 河北医科大学学报, 2023, 44(12): 1460-1466.

ZHANG Li-na, LYU Chao, WANG Xin, SHEN Juan, MIAO Guo-ying. Dynamic observation of immunoinflammatory factors during the course of carbon dioxide fractional laser combined with compound betamethasone in vitiligo and their correlation with recurrence [J]. Journal of Hebei Medical University, 2023, 44(12): 1460-1466.

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白癜风二氧化碳点阵激光联合复方倍他米松疗程中免疫炎症因子动态观测及与复发相关性

Dynamic observation of immunoinflammatory factors during the course of carbon dioxide fractional laser combined with compound betamethasone in vitiligo and their correlation with recurrence

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