白癜风临床分析及实验研究

目的：了解白癜风的临床特点，探讨其发病机制。方法：回顾分析2008例白癜风患的临床资料；以酶联免疫吸附法检测283例白癜风患血清中的抗黑素细胞IgG抗体；以免疫组织化学染色法检测45例白癜风患血清中的抗黑素细胞IgG抗体和IgM抗体；观察25例活动期白癜风血清对补体介导的黑素细胞损伤的作用。结果：①2008例白癜风患中，男女患之比为1．06，平均就诊年龄23．2岁，平均发病年龄为20岁，6例出生时即患病，头面及颈部为最易受累部位。临床分型以双侧型最多见，82．2％的患就诊时处于进展期，303例（15．0％）患伴发其他疾病，其中有110例（5．5％）合并晕痣，156例（7．8％）患有家族史，337例（16．4％）有明确的促发因素。②25例活动期白癜风患血清中有19例（76％）检出IgG型抗体，21例（84％）检出IgM型抗体，明显高于非活动期白癜风患（35％，10％）和正常对照（10％，0）（P＜0．01）。③25例活动期白癜风患血清9例（36％）出现对黑素细胞的明显细胞毒作用，正常人血清及对照的成纤维细胞未出现明显的细胞毒作用。结论：白癜风可出生即患；自身抗体在白癜风的发病中起重要作用。

Clinical analysis and experimental study of vitiligo

AIM To probe into the clinical features and the cause of vitiligo. METHODS Clinical data of 2008 patients with vitiligo were reviewed; anti-pigment cell IgG antibodies in the sera of 283 patients with vitiligo was detected by ELISA; anti-pigment cell IgG antibodies and IgM antibodies in the sera of 45 patients with vitiligo were detected by Immunohistological methods; cytotoxic experiment mediated by complement was studied with the sera of 25 patients with active vitiligo. RESULTS ① Of the total 2008 vitiligo patients, the male -to -female ratio was 1.06. The average age of the patients at visit was 23.2 years old. The average of the onset age was 20 years old. There were 6 patients who fell ill when they were born. Head and neck were the most involved locations. Unilateral type was of the most. 82.2% patients were in advancing stage when they came to see the doctor. 303 patients (15.0%) were accompanied with other diseases. 110 (5.5%) of them were accompanied with halo nevi.156 (7.8%) patients have family history. 337 (16.4%) patients confirmed provocated factors. ② Of the sera of 25 patients with active vitiligo, IgG antibody was detected in 19 (76%) patients and IgM was detected in 21 (84%) patients, which was significantly higher than that in patients with inactive disease (35%, 10%) or controls (10%, 0) (P<0.01). ③ Of the sera of 25 patients with active vitiligo, cytotoxity mediated by the complement was observed in the sera of 9 (36%) patients. No cytotoxity was observed in the sera of the normal controls and in the fibroblasts. CONCLUSION Congenital vitiligo has been noticed in a few patients. Further more, we highlight the important role of autoantibodies in the pathogenesis of vitiligo.