窄谱中波紫外线联合阿维A对寻常型银屑病患者的炎症因子、免疫功能的影响探讨

Effects of narrow-spectrum UVB combined with acitretin on inflammatory factors and immune function in patients with psoriasis vulgaris

目的探讨窄谱中波紫外线联合阿维A对寻常型银屑病的炎症因子、免疫功能的影响。方法70例符合入选标准的寻常型银屑病患者,按随机数字表法分为对照组(35例)和观察组(35例)。对照组给予窄谱中波紫外线照射治疗,观察组在对照组基础上口服阿维A治疗。比较两组临床疗效、不良反应发生情况及治疗前后T淋巴细胞亚群(CD^3(+)、CD^4(+)、CD^8(+))、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平。结果观察组临床总有效率94.29%(33/35)明显高于对照组74.29%(26/35)(P<0.05)。与观察组治疗前CD^4(+)(30.06±4.21)%及对照组治疗后CD^4(+)(34.38±3.47)%比较,观察组治疗后CD^4(+)(39.39±3.60)%显著升高(P<0.05);与观察组治疗前CD^8(+)(29.53±2.88)%及对照组治疗后CD^8(+)(26.50±2.48)%比较,观察组治疗后CD^8(+)(21.50±2.25)%明显降低(P<0.05)。观察组治疗后TNF-α(7.1±2.0)ng/ml、IL-6(111.6±20.5)pg/L、CRP(4.4±2.0)mg/L明显低于治疗前(15.3±2.6)ng/ml、(179.3±25.8)pg/L、(9.8±2.8)mg/L及对照组治疗后(9.3±2.2)ng/ml、(138.6±21.2)pg/L、(6.7±2.3)mg/L(P<0.05)。观察组的不良反应发生率为51.43%(18/35),与对照组42.86%(15/35)比较,无显著性差异(χ^(2)=0.516,P=0.473>0.05)。结论窄谱中波紫外线联合阿维A治疗寻常型银屑病可提高临床疗效,调节T淋巴细胞功能失衡,降低炎症细胞因子,且安全性高,值得推广。

Objective To explore the effects of narrow-spectrum UVB combined with acitretin on inflammatory factors and immune function in patients with psoriasis vulgaris.Methods 70 patients with psoriasis vulgaris were divided into a control group(35 cases)and an observation group(35 cases)according to random number table method.The control group was treated with narrow-spectrum UVB rays irradiation,and the observation group was treated with oral acitretin based on the control group.Both groups were compare in terms of clinical efficacy,occurrence of adverse reactions,the levels of T lymphocyte subsets(CD^3(+),CD^4(+),CD^8(+))and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]before and after treatment.Results The total effective rate of the observation group was 94.29%(33/35),which was significantly higher than that of the control group 74.29%(26/35),P<0.05.Compared with observation++group before treatment CD4(30.06±4.21)%and the control group after treatment CD4(34.38±3.47)%+comparison,the observation group after treatment CD4(39.39±3.60)%increased significantly(P<0.05);+Compared with observation group before treatment CD8(29.53±2.88)%and the control group after treatment of++CD8(26.50±2.48)%comparison,the observation group after treatment of CD8(21.50±2.25)%significantly decreased(P<0.05).The TNF-α,IL-6 and CRP of the observation group after treatment(7.1±2.0)ng/ml,(111.6±20.5)pg/L,(4.4±2.0)mg/L were significantly lower than those before treatment(15.3±2.6)ng/ml,(179.3±25.8)pg/L,(9.8±2.8)mg/L and those of the control group after treatment(9.3±2.2)ng/ml,(138.6±21.2)pg/L,(6.7±2.3)mg/L(P<0.05).The incidence of adverse reactions of the observation group was 51.43%(18/35),which was not significantly different from that of the control group 42.86%(15/35)(χ^(2)=0.516,P=0.473>0.05).Conclusion In the treatment of psoriasis vulgaris,narrow-spectrum UVB combined with acitretin can improve clinical efficacy,regulate T lymphocyte function imbalance,reduce inflammatory cytokines,and have high safety,which is worthy of promotion.