谷晓广 刁云珍 刘永生 续言凤 高丹旭

[摘要]目的：探討自体培养组织工程表皮移植治疗稳定期白癜风的临床疗效。方法：收集皮肤科10～48岁稳定期白癜风患者42例，切取患者正常皮肤（约2cm×3cm），通过酶解、消化并培养形成自体培养组织工程表皮。然后将培养的组织工程皮肤移植到患者白斑处，并进行缝合固定、加压包扎。1周后缝合处拆线、2周后拆除油纱。术后对患者进行随访，并用临床照片、辅以Wood灯分析色素恢复情况，记录复色情况，评价治疗效果。结果：2014年10月-2019年4月通过自体培养组织工程表皮移植治疗稳定期白癜风患者42例，随访12个月，结果显示自体培养组织工程表皮移植治疗稳定期白癜风整体有效率为83.3%，其中头面部有效率最高为94.7%，其次为躯干部皮损为90.9%、四肢的有效率最低为76.2%。头面部治疗有效率明显高于四肢，差异有统计学意义（P<0.05）。结论：自体培养组织工程表皮移植治疗稳定期白癜风效果明显，疗效确切，安全性高。

[关键词]白癜风;稳定期白癜风;黑素细胞;组织工程表皮;皮肤移植;自体移植

[中图分类号]R758.4+1    [文献标志码]A    [文章编号]1008-6455（2021）04-0106-04

Preliminary Clinical Study of Autologous Culture Tissue Engineering Epidermal Grafting in the Treatment of Stable Vitiligo

GU Xiao-guang1，2，DIAO Yun-zhen3，LIU Yong-sheng1，2，XU Yan-feng1，2，GAO Dan-xu1，2

（1.Department of Dermatology，  Aviation General Hospital，Beijing 100021，China;2.Beijing Translational Medicine Research Institute of Chinese Academy of Sciences，Beijing 100021，China;3.Beijing Airmet Biotechnology Co.，Ltd.Beijing 100094，China）

Abstract： Objective  To investigate the clinical efficacy of autologous culture tissue engineering epidermal grafting in the treatment of stable vitiligo. Methods  A total of 42 patients with stable vitiligo of 10-48 years old were enrolled in the dermatology department. Cutted the patients normal skin （approximately 2cm×3cm）， and form autologous culture tissue engineering epidermis through enzymolysis， digestion and culture. Then the cultured tissue engineered skin is transplanted to the patient's leukoplakia， sutured， fixed， and pressure bandaged. after 1 week， the stitches were removed from the suture， and the oil gauze was removed after 2 weeks. After the operation， the patients were followed up， and the clinical photos were used to analyze the recovery of the pigment with the aid of the Wood lamp， and the recolor situation was recorded to evaluate the treatment effect. Results  From October 2014 to April 2019， our department treated 42 patients with stable vitiligo through autologous culture tissue engineering epidermal grafting， and followed up for 12 months. The results showed that the overall effective rate of vitiligo in the stable period of autologous cultured tissue engineering was 83.3%， with the highest head and face efficiency of 94.7%， followed by the trunk lesions of 90.9% and the limbs with the lowest efficiency of 76.2%. The effective rate of head and face was significantly higher than that of limbs， and the difference was statistically significant（P<0.05）. Conclusion  Autologous cultured tissue engineering epidermal transplantation has obvious effects in the treatment of stable vitiligo， with definite curative effect and high safety.

Key words： vitiligo; stable vitiligo; melanocytes; tissue engineering epidermis; skin grafting; autotransplantation

白癜风是一种常见的后天性色素脱失性皮肤黏膜疾病，临床表现为身体局部出现白斑，随着病情进展白斑面积逐渐扩大，部分患者可逐渐进展为全身弥漫白斑[1]。白癜风的发病机制目前不十分清楚，治疗比较困难，虽然治疗方法多样，但有时疗效不尽人意。而利用自体培养组织工程表皮治疗稳定期白癜风，可以为患者表皮移植提供供体，成为白斑面积较大的白癜风患者治疗的新选择。从2014年开始，笔者科室开展自体培养组织工程表皮移植治疗稳定期白癜风的研究，取得了非常满意的临床效果，现将结果报道如下。……