Clinical Investigation Of Related Factors And Analysis Of T Cell Subsets In Peripheral Blood Of Patients With Vitiligo

Objective:Investigate the clinical information of patients with vitiligo and analyze the number of peripheral T-cell subsets.Explore the related factors and the immune function of patients with vitiligo,to provide scientific basis for the prevention and treatment of vitiligo.Methods:1.A case-control study was conducted in 268 patients with vitiligo from September2016 to September 2018 in the outpatient clinic of the Second affiliated Hospital of Dalian Medical University,as well as 240 healthy volunteers as the control group.The two groups completed questionnaires respectively,and analyzed the related factors of vitiligo.Single factor analysis was used?~2 test,multivariate logistic regression analysis was used.2.Analysis of T cell subsets in peripheral blood of patients with vitiligo:the proportions of CD3~+T cells,CD4~+T cells,CD8~+T cells in the peripheral blood of patients with vitiligo and healthy persons were measured by flow cytometry.The proportion of T cell subsets in peripheral blood of patients with vitiligo and its severity were analyzed by independent sample t test and single factor variance analysis.Result:1.Related factors of vitiligo:In this study,268 cases of vitiligo were analyzed.Univariate analysis showed that there were significant differences in family history,type II skin,type IV skin,thyroid disease,mental factors,overwork and trauma between the two groups(P<0.05).The statistically significant indexes in univariate analysis were replaced by multivariate Logistic regression model analysis.The results showed that family history of vitiligo,type IV skin,mental factors and thyroid disease were independent risk factors for vitiligo.2.T cell subsets in peripheral blood of patients with vitiligo:2.1 Analysis of T cell subsets in peripheral blood of vitiligo group and control group:The number of CD4~+T cells in peripheral blood of patients with vitiligo was significantly lower than that of healthy controls(p<0.01),the ratio of CD4~+/CD8~+was decreased(p<0.05),the number of CD8~+T cells was increased(p<0.05).the number of CD3~+T cells was decreased,but the difference was not statistically significant(p>0.05).2.2 Analysis of t cell subsets in peripheral blood of patients with vitiligo at different stages:Compared with the healthy control group,the number of CD3~+T cells in peripheral blood of patients with advanced vitiligo was decreased(p<0.05),the number of CD4~+T cells and the ratio of CD4~+/CD8~+decreased significantly(p<0.01),CD8~+T cells increased significantly(p<0.01).There was no significant difference in the number of CD3~+T cells,CD4~+T cells,CD8~+T cells and CD4~+/CD8~+ratio between patients with stable vitiligo and healthy controls(P>0.05).2.3 Analysis of T cell subsets in peripheral blood of patients with different types of vitiligo:The number of CD4~+T cells and the ratio of CD4~+/CD8~+in peripheral blood of patients with non-segmental vitiligo were lower than those of the control group,while the number of CD8~+T cells was significantly higher than that of the control group(P<0.05).Compared with the healthy control group,the number of CD4~+T cells and the ratio of CD4~+/CD8~+in patients with mixed vitiligo were decreased(p<0.05).The number of CD3~+T cells and CD8~+T cells was significantly different from that of the control group(p>0.05).The numbers of CD3~+T cells,CD4~+T cells,CD8~+T cells and CD4~+/CD8~+ratio in peripheral blood of patients with segmental and undetermined vitiligo were not significantly different from those of the control group(p>0.05).In non-segmented vitiligo,The number of CD3~+T cells,CD4~+T cells and CD4~+/CD8~+ratio in peripheral blood of sporadic vitiligo patients decreased(p<0.05),but the number of CD8~+T cells increased(p<0.05).There was no significant difference in the number of CD3~+T cells,CD4~+T cells,CD8~+T cells and the ratio of CD4~+/CD8~+between the patients with facial terminal vitiligo and the control group(P>0.05).2.4 The relationship between the severity of vitiligo and T cell subsets in peripheral blood:the proportion of CD4~+T cells and the ratio of CD4~+/CD8~+in peripheral blood of vitiligo patients increased with the severity of vitiligo.There was no significant difference in the proportion of CD3~+T cells and CD8~+T cells in patients with vitiligo of different severity(P>0.05).Conclusion:1.The incidence of vitiligo is the result of multiple factors.It is related to family history of vitiligo,skin type,mental factors before onset,overwork,history of skin injury,complicated with thyroid disease and halo nevus.Family history of vitiligo,skin type?,mental factors before onset,thyroid disease is the independent risk factor of vitiligo.2.Vitiligo patients have abnormal cellular immunity,and the degree of immune response in different types of vitiligo patients is different.3.The proportion of peripheral CD4~+T cells and CD4~+/CD8~+ratio in patients with vitiligo increased with the aggravation of the disease.