单频准分子激光联合卤米松乳膏治疗斑块型银屑病疗效及对炎性因子影响

Single Frequency Excimer Laser Combined with Halometasone Cream in the Treatment of Plaque Psoriasis and Its Effects on Inflammatory Factors

目的探讨激光联合卤米松乳膏治疗斑块型银屑病的临床观察及对银屑病皮损面积和严重程度指数(PASI)评分法、皮肤病学生活质量指数(DLQI)评分和炎性因子的影响。方法回顾性选择2017年9月—2019年9月我院皮肤科收治的89例斑块型银屑病患者的一般资料。根据患者治疗方法分为2组,其中B组44例患者予外涂抹卤米松乳膏,A组45例患者在B组基础上予激光治疗。对比2组患者临床观察、PASI评分、DLQI评分和瘦素、人β-防御素(hBD)-2及炎性因子。结果治疗前,2组患者肿瘤坏死因子(TNF)-α、白细胞介素(IL)-17、IL-23、瘦素和hBD-2表达水平、PASI和DLQI评分及皮质含量、角质层水分含量、经表皮水分丢失情况差异无统计学意义(P>0.05),经治疗后2组TNF-α、IL-17、IL-23、PASI和DLQI评分、瘦素和hBD-2表达水平及经表皮水分丢失情况均较前下降,且A组低于B组,差异有统计学意义(P<0.05),2组皮质含量、角质层水分含量情况均较前上升,且A组高于B组,差异有统计学意义(P<0.05),A组42例(93.3%)治疗有效率明显高于B组34例(77.3%),差异有统计学意义(χ2=4.600,P=0.032)。结论激光联合卤米松乳膏治疗银屑病可降低PASI评分、DLQI评分和炎性因子表达水平,提高治疗效果。

Objective In order to investigate the clinical effects of laser combined with halometasone cream in the treatment of patchiness psoriasis and its influence on psoriasis area and severity index(PASI)score,dermatology life quality index(DLQI)score and cytokines.Methods The general data of 89 patients with plaque psoriasis treated in the dermatology department of our hospital from September 2017 to September 2019 were retrospectively selected.According to the therapeutic method,the patients were divided into two groups.Fourty-four patients in group B were treated with Halometasone cream,and 45 patients in group A were treated with laser on the basis of group B.PASI score,DLQI score,leptin,human-defensin 2(hBD-2)and cytokines were compared between the two groups.Results Before treatment,there were no significant differences in the expression levels of tumor necrosis factor(TNF)-α,interleukin(IL)-17,IL-23,leptin and hBD-2,PASI and DLQI scores,cortical water content,cuticular water content and transdermal water loss between the two groups(P>0.05).After treatment,the scores of TNF-α,IL-17,IL-23,PSAI and DLQI,the expression of Leptin and hBD-2 and the loss of epidermal water in the two groups were significantly lower than those in group A(P<0.05).The content of cortex and cuticle water in both groups were higher than before,and the differences were statistically significant(P>0.05).The effective rate of group A[42 cases(93.3%)]was significantly higher than that of group B[34 cases(77.3%)].The differences were statistically significant(χ2=4.600,P=0.032).Conclusion Laser combined with halometasone cream can decrease PASI score,DLQI score and the expression of cytokines,and improve the therapeutic effects.