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目的 探讨儿童白癜风与免疫的关系.方法 采用统一设计的儿童白癜风临床特点调查表对本院门诊的14岁以下患儿及其家属进行调查.对270例患儿检测外周血免疫球蛋白、补体水平和T细胞亚群.结果 白癜风患儿620例中男302例(48.71%),女318例(51.29%),平均就诊年龄8.81岁,平均发病年龄7.57岁,平均病程8.14个月.累及头颈部453例,占73.06%.节段型160例,占25.81%.发病季节和疾病进展均以春夏季为多.73例患儿伴有晕痣,占11.77%,以散发型者居多.有家族史者84例,占13.55%.节段型患儿中,进展期的患儿血C3、c4水平明显低于稳定期患儿(P<0.05).寻常型患儿中,进展期的患儿血CD3+,CD4+细胞水平和CD4+/CD8+比值明显低于稳定期患儿(P<0.01).结论 白癜风患儿体内存在某些免疫指标的异常,可能与免疫紊乱有关.

Objective To discuss the relationship between immunity and childhood vitiligo. Methods A questionnaire was designed to investigate the clinical characteristic of patients younger than 14 years with vi-tiligo and their relatives. The serum levels of immunoglobulin, complement and T-lymphocyte subsets were de-tected in 270 cases of pediatric vitiligo. Results A total of 620 patients were investigated. Of them, 302(48.71%) were boys and 318 (51.29% ) were girls, with a mean age of 8.81 years and mean onset age at 7.57years. The mean disease duration was 8.14 months. The involvement of head and neck was observed in 453(73.06%) children. Segmental vitiligo was diagnosed in 160 (25.81%) children. Spring and summer are predilected seasons of pediatric vitiligo. Halo nevi were found in 73 (11.77%) children,and most in those with scattered vitiligo. Family history was observed in 84 (13.55%) children. A significant decrease of serum C3 and C4 was observed in patients with segmental vitiligo in active phase compared with those in stable phase (P < 0.05). Similarly, the count of CD4+ and CD3+ lymphocytes in peripheral blood as well as the CD4+/CD8+ ratio were decreased in patients with vitiligo vulgaris in active phase compared with those in stable phase (P<0.01).Conclusion There is an abnormality in some immune parameters in children with vitiligo, which may be relat-ed to the immunologic derangement.