摘要
目的 观察窄谱中波紫外线（NB-UVB）单独或联合干扰素治疗覃样肉芽肿（MF）的疗效,探讨外周血调节性T（Treg）细胞和辅助性T细胞17（Th17）细胞与疗效的相关性.方法 33例ⅠA期-ⅡA期MF患者按照治疗方法分为两组,分别应用NB-UVB单独照射（照射组）和NB-UVB照射联合重组人干扰素（INF）-α-2b肌内注射（联合组）治疗.于治疗前和治疗9个月后分别采集患者外周血,流式细胞仪检测Treg细胞和Th17细胞百分率.以10例健康人外周血为对照组（健康对照组）.结果 平均治疗时间9个月,照射组15例中,完全缓解6例,部分缓解3例,无效6例,联合组18例中,完全缓解12例,部分缓解5例,无效1例,联合治疗效果显著优于单独治疗（P=0.023）.治疗前两组患者外周血Treg和Th17细胞百分率均明显高于健康人（均P＜ 0.05）,两患者组间差异无统计学意义（P＞0.05）;治疗后两患者组Treg和Th17细胞百分率均显著下降,但仍高于健康对照组（均P＜ 0.05）.联合组Treg和Th17细胞降幅均大于照射组（均P＜0.05）.7例治疗无效患者治疗后外周血Treg细胞较治疗前亦有降低（P＜0.05）,Th17细胞无显著下降（P＞0.05）.结论 NB-UVB照射联合INF-α-2b肌内注射治疗MF临床疗效优于单独使用NB-UVB,疗效可能与外周血Treg和Th17细胞降幅有关.
Objective To evaluate the therapeutic effect of narrow band-ultraviolet B （NB-UVB） alone or in combination with interferon-alpha-2b （INF-alpha-2b） for mycosis fungoides （MF）,and to assess the correlation between the therapeutic effect and peripheral blood regulatory T （Treg）/T helper type 17 （Th 17） cells.Methods Thirty-three patients with stage ⅠA to ⅡA MF were randomly divided into two groups：NB-UVB group （n =15） receiving NB-UVB radiation alone,combined group （n =18） treated with NB-UVB radiation and intramuscular injection of INF-alpha-2b.Ten healthy volunteers were selected as the control group.Peripheral blood samples were collected before and 9 months after the start of treatment.Flow cytometry was performed to determine the percentages of Treg cells and Th17 cells.Statistical analysis was carried out by using t test,one-way analysis of variance,and Fisher＆#39;s exact test.Results The average treatment duration was 9 months among these patients.Therapeutic outcomes were significantly better in the combined group than in the NB-UVB group （P =0.023）.Among the 15 patients in the NB-UVB group,6 achieved complete remission,3 partial remission,6 showed no response;of the 18 patients in the combined group,12 experienced complete remission,5 partial remission,and 1 showed no response.Before the treatment,the percentages of both Treg and Th17 cells in peripheral blood were significantly higher in the NB-UVB group and combined group than in the control group （both P 〈 0.05）,but similar between the NB-UVB group and combined group （both P 〉 0.05）.After the treatment,the percentages of both Treg and Th17 cells in the NB-UVB group and combined group significantly decreased compared with those before the treatment,but were still higher than those in the control group （both P 〈 0.05）.Additionally,the degree of decrease in the percentages of Treg and Th17 cells was significantly greater in the combined group than in the NB-UVB group （both P〈 0.05）.The seven patients with no response also showed a significant decrease in the percentage of Treg cells （P 〈 0.05）,but no obvious changes in that of Th 17 cells （P 〉 0.05） after the treatment.Conclusions The therapeutic effect of NB-UVB radiation combined with intramuscular INF-alpha-2b is superior to that of NB-UVB radiation alone for MF,which may be associated with the degree of decrease in peripheral blood Treg and Th 17 cells.
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2015年第6期378-381,共4页
Chinese Journal of Dermatology
基金
浙江省医药卫生科技计划项目（2014KYB200）
杭州市医学重点专科专病项目（20L00733Q08、20140733Q19）
