NB-UVB对寻常性银屑病患者外周血纤溶酶及CC趋化因子配体20水平的影响

发布时间：2018-06-03 14:08

本文选题：银屑病 + 紫外线疗法　；参考：《青岛大学》2017年硕士论文

【摘要】：目的研究窄谱中波紫外线(NB-UVB)治疗对寻常性银屑病患者外周血血浆中纤溶酶及CC趋化因子配体20(CCL20)水平的影响,探讨纤溶酶和CCL20在银屑病发病机制中的作用。方法60例进行期寻常性银屑病患者作为治疗组均采用NB-UVB照射治疗,每周照射3次,共治疗8周,另外选择50例同期健康体检者作为健康对照组,治疗组和健康对照组人员在性别、年龄及体重上的差异无统计学意义。采用ELISA法检测60例进行期寻常性银屑病患者经NB-UVB照射治疗前、后及50例健康体检者外周血血浆中纤溶酶和CCL20的水平。结果60例进行期寻常性银屑病患者经过NB-UVB照射治疗,随着光疗次数的增加银屑病皮损面积和严重程度指数(PASI)评分逐渐降低,光疗前、光疗12次及光疗24次PASI评分值之间的差异有统计学意义(F=238.85,P0.05),光疗24次后的PASI评分值(2.54±1.64)显著低于光疗前(10.26±3.14),差异有统计学意义(t=17.40,P0.05)。光疗24次时,治愈24例,显效28例,好转8例,无效0例,有效率达87%。NB-UVB照射治疗过程中没有患者因为不良反应而退出治疗。寻常性银屑病患者在治疗前与健康对照组相比,外周血中纤溶酶[(180.07±40.62)μg/L比(76.30±26.92)μg/L]及CCL20[(422.41±129.87)pg/L比(205.33±49.89)pg/L]的表达量均显著升高(t=15.45、11.15,均P0.05)),寻常性银屑病患者经NB-UVB治疗后与治疗前相比,外周血中纤溶酶及CCL20的表达量均显著降低[纤溶酶:(148.22±40.05)μg/L,t=4.97,P0.05;CCL20:(329.67±100.73)pg/L,t=6.44,P0.05],但治疗后纤溶酶及CCL20水平仍显著高于健康对照组(t=10.82、7.95,均P0.05)。治疗前,寻常性银屑病患者外周血中纤溶酶与CCL20水平呈正相关(r=0.57,P0.05),且治疗前外周血中纤溶酶、CCL20水平均与PASI评分呈正相关(r=0.49、0.62,均P0.05)。结论纤溶酶和CCL20可能在银屑病的发病机制中起一定的促炎症作用,而NB-UVB照射可能通过降低银屑病患者外周血血浆中纤溶酶及CCL20的水平发挥治疗作用。意义本文通过采用NB-UVB照射的方法治疗进行期寻常性银屑病患者,并对患者治疗前后外周血血浆中纤溶酶和CCL20的水平进行检测比较,初步探讨纤溶酶和CCL20在银屑病发病机制中的作用,期待能为今后银屑病的治疗提供新思路。
[Abstract]:Objective to study the effects of NB-UVB on plasma plasminogen and CC chemokine ligand 20CCL20 in patients with psoriasis vulgaris, and to explore the role of plasminase and CCL20 in the pathogenesis of psoriasis. Methods 60 patients with psoriasis vulgaris were treated with NB-UVB three times a week for 8 weeks. There was no significant difference in sex, age and weight between the treatment group and the healthy control group. The levels of plasmin and CCL20 in peripheral blood plasma of 60 patients with psoriasis vulgaris before and after NB-UVB irradiation and 50 healthy controls were detected by ELISA method. Results 60 patients with psoriasis vulgaris were treated with NB-UVB irradiation. The PASI scores of psoriatic lesions decreased with the increase of phototherapy times. The difference of PASI score between 12 times of phototherapy and 24 times of phototherapy was statistically significant. The PASI score after 24 times of phototherapy was 2.54 卤1.64, which was significantly lower than that before phototherapy (10.26 卤3.14), and the difference was statistically significant (P 0.05). After 24 times of phototherapy, 24 cases were cured, 28 cases were markedly effective, 8 cases were improved, and 0 cases were ineffective. The effective rate was as high as that in the course of 87%.NB-UVB irradiation. No patient withdrew from the treatment because of adverse reactions. In patients with psoriasis vulgaris, the expression of plasminase [180.07 卤40.62) 渭 g / L vs 76.30 卤26.92 渭 g / L] and CCL20 [422.41 卤129.87)pg/L vs 205.33 卤49.89)pg/L] in peripheral blood of patients with psoriasis vulgaris were significantly higher than those in healthy controls before treatment (P0.0511.15, P0.0511.15). The expression of fibrinolytic enzyme in patients with psoriasis vulgaris was significantly higher than that in patients with psoriasis vulgaris after NB-UVB treatment. The expression of fibrinolytic enzyme and CCL20 in peripheral blood were significantly decreased [plasminogen 1: 1 148.22 卤40.05) 渭 g / L ~ (4.97) 渭 g / L ~ (-1) (P ~ (0.05) CCL20: 20: M ~ (329.67 卤100.73) g / L ~ (6.44) P 0.05], but the levels of plasminase and CCL20 were still significantly higher than those of healthy control group (P ~ (0.05) P ~ (0.05) after treatment. Before treatment, the levels of plasmin in peripheral blood of patients with psoriasis vulgaris were positively correlated with the level of CCL20, and the levels of CCL20 in peripheral blood of patients with psoriasis vulgaris were positively correlated with PASI score (P 0.05). Conclusion Plasminolytic enzyme and CCL20 may play a role in promoting inflammation in the pathogenesis of psoriasis, while NB-UVB irradiation may play a therapeutic role by reducing the level of plasminogen and CCL20 in peripheral blood of psoriatic patients. Objective to study the effects of NB-UVB irradiation on patients with psoriasis vulgaris, and to compare the levels of plasminogen and CCL20 in peripheral blood plasma before and after treatment in patients with psoriasis vulgaris. To explore the role of fibrinolytic enzyme and CCL20 in the pathogenesis of psoriasis and to provide new ideas for the treatment of psoriasis in the future.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.63

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