红斑狼疮患者最小红斑量测定及其与病情相关性研究

Minimum erythema dose determination in lupus erythematosus and its relationship with the state of illness

目的探讨红斑狼疮患者的光生物学反应，了解红斑狼疮光敏感性与其病情的相关性。方法采用日光紫外线模拟器对41例红斑狼疮患者进行UVA最小红斑量（UVA—MED）及UVB最小红斑量（UVB—MED）测定，同时评估测定结果与光敏感病史、临床病情及血清学指标之间的相关性。结果41例红斑狼疮患者中，19例（46．34％）UVA—MED和／或UVB—MED降低。其中11例仅UVA—MED降低、5例仅UVB—MED降低，3例UVA—MED及UVB—MED同时降低。19例红斑狼疮患者接受2。4MED的UVA或UVB照射后产生的红斑持续2周及以上仍未消退。光敏试验阳性组及阴性组抗Ro／SSA抗体的发生率分别为52．63％及9．09％（P=0．001），但光敏试验结果与光敏感病史、临床病情及其他血清学检查之间无明显相关性。结论UVA及UVB可能同时参与红斑狼疮皮损的发生。MED的测定有助于红斑狼疮光敏感的判定。抗Ro／SSA抗体与红斑狼疮光敏感密切相关。

Objective To investigate the photobiologic reactivity in lupus erythematosus （LE） patients and to explore the relationship between photosensitivity and the state of the illness. Methods The minimal erythema dose （MED） for ultraviolet A （UVA） and ultraviolet B （UVB） was measured by SUV1000 type ultraviolet simulator in 41 LE patients. The relationship between phototesting results and the history of photosensitivity, state of illness and immunological parameters was also evaluated for these patients. Results A lowered UVA-MED and/or UVB-MED was found in 46.34% （ 19/41 ） of these patients. Of the 19 patients, 11 were sensitive to UVA, 5 to UVB, and 3 to both UVA and UVB. The erythema persisted for 2 weeks or more in 19 patients after the irradiation of 2 - 4 folds of MEDs of UVA or UVB. The incidence of anti- Ro/SSA antibody in phototesting-positive and negative patients was 52.63% and 9.09% respectively （P = 0.001 ）. No significant association was found between the phototesting results and history of photosensitivity, state of illness, incidence of anti-Ro/SSA antibody or other immunological parameters. Conclusions UVA and UVB may both participate in the development of LE. MED determination may benefit the judgement of photosensitivity in LE. There is a close association between anti-Ro/SSA antibody and photosensitivity in LE.