CO₂点阵激光联合他克莫司治疗白癜风患者的效果

苏婧 孙君儒

[摘 要]目的 探讨CO2点阵激光联合他克莫司治疗白癜风的临床效果。方法 选择2020年1月-2023年10月我院收治的白癜风患者94例为研究对象，采用简单抽样法分为对照组和观察组，各47例。对照组采用他克莫司软膏治疗，观察组在对照组基础上联合CO2点阵激光治疗，比较两组白癜风皮损面积与严重指数评分（VASI）、白癜风活动性评分（VIDA）、皮损分布评分、炎症因子水平（TNF-α、ICAM-1、IL-17、TGF-β1）及不良反应发生率。结果 观察组干预4周后VASI、VIDA及皮损分布评分低于对照组（P<0.05）；观察组干预4周后TNF-α、ICAM-1、IL-17及TGF-β1水平低于对照组（P<0.05）；两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论 CO2点阵激光联合他克莫司治疗白癜风的效果较好，能减轻临床症状及皮损分布情况，降低体内炎症反应，且治疗安全性较高。

[关键词] CO2点阵激光；他克莫司；白癜风；炎症因子；白癜风活动性评分；白癜风皮损面积与严重指数评分

[中图分类号] R758.5+4 [文献标识码] A [文章编号] 1004-4949（2024）05-0073-04

Effect of CO2 Fractional Laser Combined with Tacrolimus in the Treatment of Vitiligo

SU Jing， SUN Jun-ru

（Department of Dermatology， Qinghai Red Cross Hospital， Xining 810000， Qinghai， China）

[Abstract]Objective To investigate the clinical effect of CO2 fractional laser combined with tacrolimus in the treatment of vitiligo. Methods A total of 94 patients with vitiligo admitted to our hospital from January 2020 to October 2023 were selected as the research objects. They were divided into control group and observation group by simple sampling method， with 47 patients in each group. The control group was treated with tacrolimus ointment， and the observation group was treated with CO2 fractional laser on the basis of the control group. The vitiligo area severity index （VASI）， vitiligo disease activity score （VIDA）， skin lesion distribution score， inflammatory factor levels （TNF-α， ICAM-1， IL-17， TGF-β1） and the incidence of adverse reactions were compared between the two groups. Results After 4 weeks of intervention， the VASI， VIDA and skin lesion distribution scores of the observation group were lower than those of the control group （P<0.05）. The levels of TNF-α， ICAM-1， IL-17 and TGF-β1 in the observation group were lower than those in the control group after 4 weeks of intervention （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion CO2 fractional laser combined with tacrolimus is effective in the treatment of vitiligo， which can reduce the clinical symptoms and skin lesion distribution， reduce the inflammatory response in vivo， and has high safety.

[Key words] CO2 fractional laser； Tacrolimus； Vitiligo； Inflammatory factors； Safety； Vitiligo disease activity score； Vitiligo area severity index

白癜風（vitiligo）是一种因皮肤黑素细胞破坏，导致皮肤由于黑色素缺乏引起白斑的疾病[1]。研究表明[2]，白癜风可发生于人体不同部位，其机制尚未阐明，普遍认为与自身免疫系统疾病、神经化学物质和遗传因素有关，不仅影响患者美观，还影响生活质量。白癜风易诊、难治，且病情发展相对较慢，治疗周期较长，存在诸多不可预测性。常用的治疗方法以手术治疗、药物治疗及物理治疗为主，不同治疗方法各有优缺点，但多以控制病情发展为主，难以彻底治愈白癜风[3]。他克莫司作为白癜风首选西药，能抑制局部T淋巴细胞活性，降低炎症反应，提高酪氨酸酶活性，增加黑色素生成量，促进皮损恢复。……