寻常性银屑病患者光疗后血清内皮细胞特异性分子及nesfatin-1水平变化

Changes in serum endocan and nesfatin-1 levels in patients with psoriasis vulgaris after phototherapy

目的 :探究窄谱中波紫外线(NB-UVB)光疗后寻常性银屑病患者外周血中性粒细胞与淋巴细胞比值(NLR)、血清内皮细胞特异性分子及nesfatin-1水平。方法:共选取100例研究对象,其中患者组选取银屑病患者52例,对照组选取健康志愿者48例。患者组NB-UVB光疗3个月后,计算患者组皮损面积及严重程度指数(PASI)。测定患者组治疗前、后和对照组的NLR、血清内皮细胞特异性分子及nesfatin-1水平。结果 :光疗3个月后,患者组临床有效率为92.3%。与治疗前相比,患者组治疗后皮损PASI评分显著减低,差异具有统计学意义(P<0.05)。与对照组相比,治疗前患者组中性粒细胞计数、NLR显著增高(P<0.05)。同时,治疗前患者组血清内皮细胞特异性分子水平与疾病严重程度呈显著相关性。患者组患者NB-UVB光疗前、后,NLR、血清内皮细胞特异性分子及nesfatin-1水平存在显著差异,其中NLR和血清内皮细胞特异性分子显著降低,nesfatin-1水平显著增高(P<0.05)。结论:NB-UVB光疗治疗寻常性银屑病临床疗效显著,上述3个指标水平存在显著差异,因此,三者能够反映寻常性银屑病患者光疗临床疗效,具有一定临床意义。

Objective： The aim of the present study was to evaluate neutrophil-to-lymphocyte ratio（NLR）, serum endocan and nesfatin-1 levels in psoriasis vulgaris before and after narrow-band ultraviolet B（NB-UVB） phototherapy. Methods： This study included 52 subjects with psoriasis vulgaris and 48 healthy controls. Psoriatic patients were given NB-UVB photothera- py for 3 months. Psoriasis Area and Severity Index（PASI） was used to assess disease severity. NLR, serum endocan and nesfatin-1 levels were measured in psoriatic patients before and after NB-UVB phototherapy, and in the controls. Results： Phototherapy for 3 months induced effective rate of 92.3%, and a significant reduction in PASI（P〈0.0 vs. pretreatment）. Prior to the phototherapy, both neutrophil counts and NLR were significantly higher in psoriatic patients than in normal controls（P〈 0.05）, Moreover, serum endoean levels were significantly correlated with disease severity. Following phototherapy, NLR and endocan levels markedly declined in psoriatic patients while nesfatin-1 levels were significantly elevated （P〈0.05）. Conclu- sions： NB-UVB phototherapy is effective for psoriasis vulgaris. NB-UVB phototherapy dramatically changes the circulation levels of these three parameters, suggesting the importance of these parameters in assessing the therapeutic efficacy of pho- totherapy for psoriasis vulgaris.