窄谱UVB联合阿维A酸治疗红皮病型银屑病

Efficacy of narrowband ultraviolet B phototherapy combined with acitretin in erythrodermic psoriasis

目的:观察311nm窄谱中波紫外线(NB-UVB)联合阿维A酸治疗红皮病型银屑病的疗效。方法:单独采用NB-UVB照射、单独应用阿维A酸治疗及NB-UVB联合阿维A酸治疗红皮病型银屑病95例,并以银屑病面积和严重度指数(PASI)评价疗效。结果:在(27.15±4.28)d、(28.52±5.31)d、(18.75±3.24)d治疗后,窄谱UVB照射组、阿维A酸治疗组、窄谱UVB联合阿维A酸治疗组治疗前后PASI评分改善率分别为(78.54±23.65)%、(79.16±22.89)%、(89.48±25.34)%;与阿维A酸治疗组比较,窄谱UVB照射组与其疗效相当(P>0.05),而窄谱UVB联合阿维A酸治疗组则在更短的治疗时间(P<0.05)取得了更好的疗效(P<0.05)。结论:窄谱UVB联合阿维A酸治疗红皮病型银屑病疗效好,不良反应少。我们于2004年1月至2004年10月单独应用窄谱中波紫外线(narrow-bandultravioletB,NB-UVB)照射、单独应用阿维A酸治疗及窄谱UVB联合阿维A酸治疗了95例红皮病型银屑病,现将观察和分析结果报告如下。1资料与方法1.1病例选择95例接受治疗的患者均为2004年1月至2004年10月在我科门诊及住院治疗的红皮病型银屑病患者,其中门诊患者60例,住院患者35例。仅采用NB-UVB照射治疗的30例患者,男16例,女14例,年龄(32.64±7.36)岁,病程(6.78±4.57)年;皮肤类型(根据Filzpalrick分类法,中国人的皮肤大多为Ⅲ型或Ⅳ型):Ⅲ型19例,Ⅳ型11例;仅应用阿维A酸口服治疗的30例患者,男15例,女15例,年龄(33.12±4.23)岁,病程(6.18±4.23)年;皮肤类型:Ⅲ型21例,Ⅳ型9例;采用NB-UVB联合阿维A酸治疗的35例患者,男17例,女18例,年龄(34.21±3.26)岁,病程(7.15±4.35)年;皮肤类型:Ⅲ型21例,Ⅳ型14例。3组患者的性别、年龄、病程、病型。

Objective To observe the efficacy of narrowband ultraviolet B(NBUVB) in the treatment of patients with erythrodermic psoriasisMethods Ninetyfive patients were treated by 311nm narrowband ultraviolet B radiation only(NBVUB group,n=30),acitretin only (ACI group,n=30) or narrowband ultraviolet B radiation combined with acitretin(NBVUB/ACI,n=35)Results The efficacy was evaluated by psoriasis area and severity index(PASI)After (2715±428)d,(2852±531)d and (1875±324)d therapies,the improved rates of PASI of NBUVB group,ACI group and NBUVB/ACI group were (7854±2365%)、(7916±2289)%and (8948±2534)%,respectivelyCompared with ACI group,the efficacy of NBUVB group showed no difference(P >005),but NBUVB/ACI group got better efficacy(P< 005) in shorter time(P< 005)Conclusion NBUVB radiation combined with acitretin was safe and could improve the efficacy significantly for erythrodermic psoriasis