海南医科大学学报

目的:探讨阿维A联合窄谱中波紫外线(UVB)对寻常型银屑病患者外周血T淋巴细胞亚群的影响。方法:选取本科收治的90例寻常型银屑病患者,随机分为观察组和对照组,对照组于餐后口服阿维A 10mg/次,一天二次,疗程为6周;观察组在对照组基础上联合UVB进行照射治疗,每次照射30min,每周三次,疗程为6周。观察两组治疗前后外周静脉血T淋巴细胞亚群(CD3+、CD4+、CD8+)变化情况,病损面积及严重程度指数(PASI)评分及临床疗效。结果:两组治疗后观察组CD3+、CD4+升高程度较对照组明显,CD8+下降程度较对照组明显,差异具有统计学意义(P<0.05);治疗后观察组PASI评分降低程度明显优于对照组,差异具有统计学意义(P<0.05);观察组总有效率明显优于对照组,差异具有统计学意义(P<0.05)。结论:寻常型银屑病患者采用阿维A联合UVB通过改变T淋巴细胞免疫功能的失衡状态而发挥作用,联合治疗可以提高治疗效果,值得临床推广。

Objective:To explore the effect of acitretin combined with NB-UVB on T lymphocyte subsets in the peripheral blood of patients with psoriasis vulgaris.Methods:A total of 90 patients with psoriasis vulgaris who were admitted in our department from May,2013 to May,2015 were included in the study and randomized into the observation group and the control group.The patients in the control group were given acitretin after dinner,10mg/time,twice each day,for 6weeks.The patients in the observation group were given acitretin in combined with UVB,each irradiation for 30 min,three times every week,for 6weeks.The changes of CD3+,CD4+,and CD8+in the peripheral blood,PASI score,and the clinical efficacy before and after treatment in the two groups were observed.Results:The elevation degree of CD3+and CD4+after treatment in the observation group was more significant than that in the control group,while the declining degree of CD8+was also more significant than that in the control group(P<0.05).The decreased degree of PASI score after treatment in the observation group was significantly superior to that in the control group(P<0.05).The total effective rate in the observation group(93.33%)was significantly superior to that in the control group(80.00%)(P<0.05).Conclusions:Acitretin in combined with UVB in the treatment of psoriasis vulgaris can alter the imbalance state of T lymphocyte immune function.The combined treatment can enhance the therapeutic effect,therefore,it deserves to be widely recommended in the clinic.