IA免疫吸附疗法对银屑病患者的临床疗效和作用机制分析

Clinical Efficacy and Mechanism of IA Immunoadsorption Therapy in Patients with Psoriasis

目的探讨IA免疫吸附疗法对银屑病患者的临床疗效,以及对炎症免疫反应和微循环状态的改善作用。方法选择2017年1月至2020年1月在我院就诊的银屑病患者75例,将其中符合IA免疫吸附疗法适应证且自愿接受该疗法的患者25例纳入观察组,将其中不愿接受合IA免疫吸附疗法的患者50例纳入对照组。对照组给予常规药物治疗,观察组患者则在对照组基础上接受IA免疫吸附治疗。比较两组患者治疗前和治疗2个疗程后皮损面积和严重程度指数(PASI)、皮肤病生命质量量表(DLQI)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、CD4+、CD8+、CD4+/CD8+、全血粘度(低切、中切、高切)、血浆粘度和红细胞压积的变化。结果两组患者治疗后PASI、DLQI、hs-CRP、TNF-α、CD4+、CD8+、CD4+/CD8+、全血粘度(低切、中切、高切)、血浆粘度和红细胞压积水平均较治疗前显著改善(P <0.05,P<0.01),且观察组治疗后均显著优于对照组(P<0.01)。结论 IA免疫吸附疗法可有效改善银屑病患者的炎症免疫反应和微循环状态,从而减轻临床症状,提高生命质量。

Objective To explore clinical efficacy of IA immunoadsorption therapy in patients with psoriasis,and to improve inflammatory immune response and microcirculation.Methods From January 2017 to January 2020,75 patients with psoriasis who were treated in our hospital were selected.Among them,25 patients who met indications of IA immunoadsorption therapy and accepted therapy voluntarily were included in observation group,50 patients who were unwilling to receive it were included in control group.Control group was given conventional medication,and observation group received IA immunoadsorption therapy on the basis of control group.Skin lesion area and severity index(PASI)before treatment and after 2 courses of treatment,,dermatological quality of life scale(DLQI),high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),CD4+,CD8+,CD4+/CD8+,changes in whole blood viscosity(low cut,mid cut,high cut),plasma viscosity and hematocrit were compared.Results After treatment,PASI,DLQI,hs-CRP,TNF-α,CD4+,CD8+,CD4+/CD8+,whole blood viscosity(low-cut,mid-cut,high-cut),plasma viscosity,and hematocrit level were higher in two groups after treatment.Significant improvement before(P<0.05,P<0.01),and these of observation group were significantly better than of control group after treatment(P<0.01).Conclusion IA immunoadsorption therapy could effectively improve inflammatory immune response and microcirculation of patients with psoriasis,so that it could reduce clinical symptoms and improve life quality.