复方利多卡因乳膏对激素依赖性皮炎Th17类细胞因子表达水平的影响

Effect of Compound Lidocaine Cream on the Expression Levels of Th17 Cytokines in Patients with Hormone Dependent Dermatitis

目的评价复方利多卡因乳膏治疗激素依赖性皮炎(HDD)的疗效及对患者血清白细胞介素(IL)-17和IL-22、IL-23表达水平的影响与临床意义。方法治疗组34例HDD患者外涂复方利多卡因乳膏,对照组34例外涂肝素钠软膏,疗程均为8周,二组均于治疗前和治疗1,2,4,8周及治疗结束后2周观察病情并记分,疗程结束后评价临床疗效。以30例志愿者作为健康组,采用双抗体酶联免疫吸附法分别检测健康组和治疗组、对照组患者治疗前后及治疗结束后2周外周血中IL-17、IL-22、IL-23含量。结果治疗组治疗1周及治疗结束后2周症状积分明显降低,与治疗前比较均差异有统计学意义(P<0.05或P<0.01);治疗2周及治疗结束后2周症状积分与对照组比较均差异有统计学意义(P<0.05或P<0.01);治疗组有效率91.18%,明显优于对照组的61.76%(P<0.01)。治疗前:治疗组IL-17、IL-22、IL-23与对照组比较均差异无统计学意义(P>0.05),但均较健康组显著升高(P<0.01)。治疗后及治疗结束后2周:治疗组3个指标较治疗前显著降低[IL-17:(19.61±3.85),(20.05±3.63)pg·m L-1比(41.36±6.19)pg·m L-1,P<0.01;IL-22:(33.07±4.67),(33.18±4.36)pg·m L-1比(35.64±5.78)pg·m L-1,P<0.05;IL-23:(24.56±3.71),(24.95±3.45)pg·m L-1比(54.97±8.19)pg·m L-1,P<0.01];对照组2个指标较治疗前显著降低[IL-17:(37.83±5.07),(38.32±5.21)pg·m L-1)比(40.77±6.45)pg·m L-1,P<0.05;IL-23:(51.86±6.22),(52.14±6.70)pg·m L-1比(55.46±7.81)pg·m L-1,P<0.05];治疗组3个指标与对照组比较均差异有统计学意义(P<0.05或P<0.01);治疗组IL-17、IL-22、IL-23和对照组IL-17、IL-23与症状积分均呈显著正相关。结论复方利多卡因乳膏治疗HDD疗效显著,可能是通过下调患者血清中Th17细胞相关因子IL-17、IL-22、IL-23的表达水平来发挥治疗HDD的作用。

Objective To evaluate the clinical efficacy of compound lidocaine cream in the treatment of hormone dependent dermatitis(HDD) and the effect on serum IL-17,IL-22 and IL-23 expression levels and its clinical significance.Methods Treatment group(34 cases) of HDD were coated with compound lidocaine cream,and control group(34 cases) were coated with heparin sodium ointment.The two groups were both treated for 8 weeks,and the illness scores before the treatment,and after 1,2,4,8 weeks of the treatment and 2 weeks after the 8-week-long treatment were recorded respectively,and then the clinical efficacy was evaluated.In addition,30 healthy volunteers were chosen as health control group,IL-17,IL-22 and IL-23 levels in the peripheral blood of healthy control group and two groups of patients before and after the treatment and 2 weeks after the treatment were detected by double antibody enzyme linked immunosorbent assay(ELISA).Results After 1 week of the treatment and 2 weeks after the treatment,the illness scores of patients were significantly decreased,and the difference was statistically significant as compared with that before treatment(P < 0.05 or P < 0.01).After 2 weeks of the treatment and 2weeks after the treatment,as compared with the illness scores of the control group,the difference was statistically significant(P < 0.05 or P < 0.01).The effective rate of the treatment group(91.18%) was significantly higher than that of the control group(61.76%,P < 0.01).Before treatment,the expression levels of IL-17,IL-22 and IL-23 were not statistically significantly different between the treatment group and the control group(P > 0.05),but they were significantly higher than those of the healthy control group(P < 0.01).After the treatment and 2 weeks after the treatment: 3 indexes of the treatment group were significantly lower than those before treatment [IL-17:(19.61 ± 3.85),(20.05 ± 3.63) pg·m L-1vs.(41.36 ± 6.19) pg·m L-1,P < 0.01; IL-22:(33.07 ± 4.67),(33.18 ± 4.36) pg·m L-1vs.(35.64 ± 5.78) pg·m L-1,P < 0.05; IL-23:(24.56 ± 3.71),(24.95 ± 3.45) pg·m L-1vs.(54.97 ± 8.19) pg·m L-1,P < 0.01]; 2 indexes of the control group were significantly lower than those before the treatment [IL-17:(37.83 ± 5.07),(38.32 ± 5.21) pg·m L-1vs.(40.77 ± 6.45) pg·m L-1,P < 0.05; IL-23:(51.86 ± 6.22),(52.14 ± 6.70) pg·m L-1vs.(55.46 ± 7.81) pg·m L-1,P < 0.05]; the 3indexes of the treatment group were significantly different as compared with the control group(P < 0.05 or P < 0.01); IL-17,IL-22,IL-23 levels of the treatment group and IL-17,IL-23 levels of the control group had a significant positive correlation with the disease scores.Conclusion Compound lidocaine cream is effective in treating HDD,perhaps by down-regulating the expression levels of Th17-related cytokines(IL-17,IL-22 and IL-23) in serum of patients.