阿维A与环孢素A联合311nm窄谱紫外线治疗重度银屑病的疗效

Therapeutic effets and mechanism of Acitretin combined with cyclosporine A and311nm NB-UVB in severe psoriasis

目的观察A与环孢素A联合311nm窄谱紫外线(NB-UVB)治疗重度银屑病的疗效及讨论其治疗机制。方法采用平行随机方法，对照组口服阿维A胶囊0.6mg/(kg·d)，治疗组给予口服阿维A胶囊0.6mg/kg/d+环孢素A3mg/(kg·d)，同时给予311nmNB-UVB治疗。于治疗前、治疗后6周、12周PASI评分，治疗前、治疗后6周、12周监测血清T细胞及肿瘤坏死因子(TNF-α)水平及实验室检查，并记录不良反应。结果治疗组在治疗后6周、12周PASI评分较对照组明显降低，治疗组治疗有效率明显高于对照组。2组血清TNF-α在治疗前后变化不明显。结论阿维A胶囊联合环孢素A对重度银屑病的疗效明显，但是否通过调节TNF-α达到疗效还不明确，需更多的临床资料进一步证实。

Objective:To study the clinical effects of Acitretin combined with cyclosporine A and311nm NB-UVB in severe psoriasis,and to elucidate the clinical effects and mechanisms of action of this treatment.Methods:We conducted a random、contrast control,the treatment group was treated with cyclosporine A3mg/(kg·d)combined with Acitretin0.6mg/(kg·d)and311nm NB-UVB,and the control group was treated with Acitretin0.6mg/(kg·d).PASI scores、TNF-αas well as adverse effect were taken at baseline,then again at6weeks and12weeks post treatment.Results:The PASI scores in the treatment group were significantly lower than that of control group at6and12weeks post treatment.The efficacy rates in the treatment group were significantly higher than that of control group.we did not approach statistical significance of TNF-α.Conclusion:Cyclosporine A combined with Acitretin showed good efficacy in severe Psoriasis patients,whether could restitution the TNF-αthat may could take more approach.