本文選題：銀屑病 + 沙利度胺　； 參考：《廣西醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的：研究沙利度胺對(duì)銀屑病患者外周血免疫細(xì)胞因子水平的影響及治療效果,為臨床應(yīng)用沙利度胺治療銀屑病提供實(shí)驗(yàn)依據(jù)。 方法：收集60例尋常型銀屑病患者,按照隨機(jī)分配原則隨機(jī)分為對(duì)照組33例和實(shí)驗(yàn)組27例,分別使用甲氨蝶呤(MTX)和沙利度胺(THD)干預(yù)治療；分別采用雙抗體夾心ELISA法和流式細(xì)胞術(shù)檢測(cè)并比較實(shí)驗(yàn)組與對(duì)照組治療前后外周血IL-2、TNF-α、CD4+T、CD8+T細(xì)胞水平變化,利用銀屑病皮損面積和嚴(yán)重程度指數(shù)比較實(shí)驗(yàn)組和對(duì)照組的療效差異,應(yīng)用SPSS13.0統(tǒng)計(jì)軟件,采用卡方檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)處理,取α=0.05為顯著性檢驗(yàn)水準(zhǔn)。 結(jié)果: ①治療前實(shí)驗(yàn)組與對(duì)照組IL-2、TNF-α、CD4+T細(xì)胞、CD8+T細(xì)胞水平及CD4+/CD8+T細(xì)胞比值的差異均無統(tǒng)計(jì)學(xué)意義(均P0.05)。 ②治療后實(shí)驗(yàn)組與對(duì)照組IL-2、TNF-α、CD4+T細(xì)胞水平及CD4+/CD8+T細(xì)胞比例均下降,實(shí)驗(yàn)組下降程度明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(均P0.05)。 ③實(shí)驗(yàn)組和對(duì)照組療效比較,實(shí)驗(yàn)組總有效率明顯高于對(duì)照組總有效率,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 ④不良反應(yīng)發(fā)生率比較,實(shí)驗(yàn)組明顯低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論： ①沙利度胺較MTX更能有效降低銀屑病患者的免疫狀態(tài),降低外周血免疫細(xì)胞因子(IL-2、TNF-α)水平,推測(cè)是THD發(fā)揮治療銀屑病療效的重要藥理學(xué)基礎(chǔ)。 ②與傳統(tǒng)治療銀屑病的免疫抑制劑甲氨蝶呤比較,沙利度胺對(duì)銀屑病有較好的療效、較少的副作用,為今后把THD作為治療銀屑病的常規(guī)方案提供了參考依據(jù)。
[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- 偽 TNF- 偽 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 偽 -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- 偽 TNF- 偽 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- 偽) 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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R758.63

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