摘要
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）×10。个／cm2，303例接种量为（5．0—7．9）×10^4个／cm2，82例接种量为（8．0～9．9）×10^4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，Hul6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／cm：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。
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 melanoeytes at 4 different seeding densities respectively, i.e., （3.0 - 4.9）x 104/em2 （n = 201 ）, （5.0 - 7.9） x 10^4/cm2 （n = 303）, （8.0 - 9.9） x 10^4/cm2 （n = 82）, （10.0 - 12.0） x 10Vcm2 （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） x 10^4/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） x 10^4cm2, and the color matching appears to improve with time.
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2013年第4期235-238,共4页
Chinese Journal of Dermatology
基金
浙江省科技厅2008年重大科技专项（2008C14029）
杭州市科技局医学重点专科专病专项科技计划（20070433Q01）
关键词
白癜风
黑素细胞
细胞移植
细胞计数
Vitiligo
Melanocytes
Cell transplantation
Cell count
