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402富血小板血浆治疗轻中度斑秃有效性和安全性的系统评价临床皮肤科杂志2025年54卷第7期JClinDermatol,July2025,Vol.54,No.7论著宋黎，陆茂，唐懿，刘彦麟成都医学院第一附属医院皮肤科，四川成都610500[摘要]］目的：评价富血小板血浆治疗轻中度斑秃的有效性和安全性。方法：计算机检索截至2024年6月The Cochrane Li-brary、PubM ed、Webof Science、EM base、中国知网（CNKI）、万方数据知识服务平台、维普中文期刊服务平台、中国生物医学文献服务系统(SinoMed)中关于富血小板血浆治疗斑秃的随机对照试验(RCT)，手工检索补全可能的研究。经2名独立研究人员筛选出纳入的研究并进行文献质量评价，最后对纳人研究采用RevMan5.3软件进行Meta分析，不能Meta分析的资料采用描述性分析。结果：共纳入9项RCT研究,413例患者。Meta分析结果显示：①富血小板血浆组与曲安奈德组治疗斑秃有效率的差异无统计学意义(OR=1.22,95%CI=0.43~3.50,n=247,P>0.05);②富血小板血浆组斑秀复发风险低于曲安奈德组(OR=0.18，95%CI=0.08~0.39,n=125,P<0.05)；③富血小板血浆组主要不良反应是疼痛，其发生率与曲安奈德组比较差异无统计学意义(0R=1.80,95%CI=0.28~11.72,n=202,P>0.05),2组均无严重不良反应发生。结论：目前证据显示富血小板血浆可有效促进轻中度斑秃患者的毛发生长，可能出现疼痛等不良反应，但总体较安全。[关键词】富血小板血浆；斑秃；系统评价；Meta分析；毛发镜[中图分类号] R758.71doi:10.16761/j.cnki.1000-4963.2025.07.005A systemic review of the effectiveness and safety of platelet-rich plasma injection in thetreatment of mild to moderate alopecia areataSONG Li, LUMao, TANG Yi, LIUYanlinDepartment of Dermatology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China[Abstract] Objective: This study systematically evaluated the effectiveness and safety of platelet-rich plasma in the treatmentof mild to moderate alopecia areata. Methods: Related studies were retrieved through Cochrane central register of controlledtrials(CENTRAL) and others. Meta-analyses were performed for the results of homogeneous studies by RevMan 5.3 software.Results: A total of 9 RCTs involving 413 patients were included. Meta-analyses showed that the total effective rate ofplatelet-rich plasma group had no significant difference, compared with the triamcinolone acetonide group(OR=1.22,95%CI-0.43~3.50,n=247,P>0.05). The recurrence rate of platelet-rich plasma group was lower than the triamcinolone acetonidegroup(OR=0.18,95%CI=0.08~0.39,n=125,P<0.05). The adverse events rate of both groups were similar(OR=1.80,95%CI=0.28~11.72,n=202,P>0.05). Pain was the main adverse event, but temporary and mild. No serious adverse events appeared inboth groups. Conclusion: Platelet-rich plasma may be safe and effective for mild to moderate alopecia areata. Adverse reac-tions such as pain may occur, but it is generally safe.[Key words] platelet-rich plasma; alopecia areata; systematic review; Meta analysis; trichoscopy[文献标识码]A [文章编号]1000-4963(2025)07-0402-06[J Clin Dermatol, 2025, 54(7) :402-407]斑秃(alopecia areata,AA)是皮肤科常见的脱发类型，发生率仅次于雄激素性秃发，主要特征是突发性的非：坌酝逊。AA对患者个人形象、社交和精神方面的负面影响远大于雄激素性秃发。一项关于AA疾病负担的流行病学研究结果显示,1990—2019年全球AA患者新增了1068余万人，增幅> 49.41%。世界各地区AA 的疾病负担仍在逐年增加,已成为一个重要的全球收稿日期：2024-12-31；修回日期：2025-03-22公共卫生问题[2。AA是由T淋巴细胞介导的复杂的炎症性疾病,其发病机制尚不完全明确3-4]。目前本病尚无确切的治愈或预防复发的方法。传统接触免疫法易发生局部刺激等不良反应，患者依从性差；皮损内注射糖皮质激素可能引起疼痛、头皮萎缩、色素减退和毛细血管扩张等[;系统使用糖皮质激素或免疫抑制剂安全性欠佳，需定期监测，且停药后复发率较高；而新的免疫治疗如 Janus 激酶(Janus kinase,JAK)抑制剂也存在费用较高、易合并感染和血液系统异常等