沙利度胺对银屑病患者细胞免疫功能的影响以及疗效的初步评价

发布时间：2018-04-24 14:36

本文选题：银屑病 + 沙利度胺　；参考：《广西医科大学》2011年硕士论文

【摘要】：目的：研究沙利度胺对银屑病患者外周血免疫细胞因子水平的影响及治疗效果,为临床应用沙利度胺治疗银屑病提供实验依据。方法：收集60例寻常型银屑病患者,按照随机分配原则随机分为对照组33例和实验组27例,分别使用甲氨蝶呤(MTX)和沙利度胺(THD)干预治疗；分别采用双抗体夹心ELISA法和流式细胞术检测并比较实验组与对照组治疗前后外周血IL-2、TNF-α、CD4+T、CD8+T细胞水平变化,利用银屑病皮损面积和严重程度指数比较实验组和对照组的疗效差异,应用SPSS13.0统计软件,采用卡方检验进行统计学处理,取α=0.05为显著性检验水准。结果: ①治疗前实验组与对照组IL-2、TNF-α、CD4+T细胞、CD8+T细胞水平及CD4+/CD8+T细胞比值的差异均无统计学意义(均P0.05)。 ②治疗后实验组与对照组IL-2、TNF-α、CD4+T细胞水平及CD4+/CD8+T细胞比例均下降,实验组下降程度明显高于对照组,差异有统计学意义(均P0.05)。 ③实验组和对照组疗效比较,实验组总有效率明显高于对照组总有效率,差异有统计学意义(P0.05)。 ④不良反应发生率比较,实验组明显低于对照组,差异有统计学意义(P0.05)。结论： ①沙利度胺较MTX更能有效降低银屑病患者的免疫状态,降低外周血免疫细胞因子(IL-2、TNF-α)水平,推测是THD发挥治疗银屑病疗效的重要药理学基础。 ②与传统治疗银屑病的免疫抑制剂甲氨蝶呤比较,沙利度胺对银屑病有较好的疗效、较少的副作用,为今后把THD作为治疗银屑病的常规方案提供了参考依据。
[Abstract]:Objective: to study the effect of thalidomide on the level of peripheral blood immune cytokines in patients with psoriasis and to provide experimental evidence for the clinical application of thalidomide in the treatment of psoriasis. Methods: sixty patients with psoriasis vulgaris were randomly divided into control group (n = 33) and experimental group (n = 27). Double antibody sandwich ELISA and flow cytometry were used to detect and compare the changes of peripheral blood IL-2TNF- 伪 TNF- 伪 CD4 and CD8 T cells before and after treatment, and the therapeutic effects were compared between the experimental group and the control group by using the psoriasis lesion area and severity index. Using SPSS13.0 statistical software, chi-square test was used for statistical processing, and 伪 -0. 05 was taken as the significant test level. Results: 1 there was no significant difference in the level of CD8 T cells and the ratio of CD4 / CD8 T cells between the experimental group and the control group before treatment (P 0.05). 2After treatment, the levels of IL-2TNF- 伪 TNF- 伪 CD4 T cells and the ratio of CD4 / CD8 T cells in the experimental group and the control group were all decreased, and the degree of the decrease in the experimental group was significantly higher than that in the control group (P 0.05). 3Compared with the control group, the total effective rate of the experimental group was significantly higher than that of the control group, and the difference was statistically significant (P 0.05). 4 the incidence of adverse reactions in the experimental group was significantly lower than that in the control group (P 0.05). Conclusion: 1 thalidomide was more effective than MTX in reducing the immune state and the level of peripheral blood immunocyte factor (IL-2TNF- 伪) in patients with psoriasis. It is suggested that thalidomide is an important pharmacological basis for the treatment of psoriasis by THD. Compared with the traditional immunosuppressant methotrexate, thalidomide has a better curative effect and less side effects on psoriasis, which provides a reference for the treatment of psoriasis with THD as a routine regimen in the future.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R758.63

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