窄谱中波紫外线不同照射方法对寻常性银屑病疗效的影响

Influence of irradiation regimens on the efficacy of narrow-band ultraviolet B for psoriasis vulgaris

目的探讨窄谱中波紫外线（NB—UVB）不同照射方法对寻常性银屑病疗效的影响。方法将69例寻常性银屑病患者分为A组（起始量为70％最小红斑量＋20％增量组）、B组（0．4J／emz传统起始量＋固定增量组）和c组（非照射组）3组，每组各23例。对各组患者治疗前、治疗4周、8周进行PASI评分，根据PASI评分的改变计算有效率。结果A、B、C3组患者经治疗4周有效率分别为78．26％、26．09％、8．70％；8周有效率为95．65％、69．57％、13．05％，A组疗效均明显优于B组和c组（P〈0．01）。结论根据患者最小红斑量值确定NB—UVB的起始剂量并采用渐进性增量法治疗寻常性银屑病，可较快控制病情，减轻疾病严重程度。

Objective To evaluate the influence of irradiation regimens on the efficacy of narrow-band ultraviolet B（NB-UVB） for psoriasis vulgaris. Methods Sixty-nine patients with psoriasis vulgaris were randomly and equally divided into 3 groups to receive NB-UVB irradiation （group A and group B） or remain untreated （group C）. The irradiation dose of NB-UVB was 70% of the minimal erythemal dose （MED） in group A and 0.4 J/cm2 in group B in the beginning, and increased by 20% in group A and by 0.1 J/cm2 in group B at each treatment thereafter. Irradiation was carried out 3 times per week for 8 weeks. Psoriasis area and severity index （PASI） score was evaluated at the baseline, 4 and 8 weeks after initiation of treatment. The response rate was calculated according to the reduction in PASI score. Results The response rate in group A, B and C was 78.26%, 26.09% and 8.70% respectively at 4 weeks, 95.65%, 69.57% and 13.05% respectively at 8 weeks. A better response was observed in the group A compared with group B and C at both time points （P 〈 0.01 or 0.05）. Conclusions NB-UVB phototherapy with the irradiation dose initially determined according to MED and gradually increasing thereafter may lead to a quick control and improvement of psoriasis vulgaris.