本文選題：銀屑病 + 濕疹　； 參考：《山東大學》2011年碩士論文

【摘要】：研究背景： 1.花生四烯酸(Arachidonic acid, AA)是人體內必需脂肪酸,近年來,AA及其代謝產物在疾病發(fā)病中的作用日益受到重視。AA主要通過環(huán)氧化酶(Cycloxygenase, COX)和脂氧合酶(Lipoxygenase, LO)途徑代謝,白三烯(Leukotrienes, LTs)是人體內花生四烯酸5-脂氧合酶途徑的代謝產物,是一種重要的炎癥介質,參與疾病的炎癥反應。銀屑病(Psoriasis, Ps)是一種皮膚科常見病,病因復雜,其發(fā)病機制一直是研究的熱點。研究表明正常皮膚局部注射LTB4可產生銀屑病樣皮膚損害,白三烯及其受體在銀屑病患者體內異常表達,提示白三烯在銀屑病患者體內代謝異常。但是白三烯如何參與銀屑病的發(fā)病目前尚無研究,白三烯是否參與銀屑病的炎癥反應需要我們進一步證實。 2.查閱大量文獻發(fā)現(xiàn),雖然花生四烯酸在銀屑病和濕疹(Eczema, Ec)患者體內均有代謝異常,但在臨床研究中,抗白三烯藥物和抑制前列腺素合成的藥物在濕疹治療中取得了較好療效,而抗白三烯藥物在銀屑病治療中療效尚不明確,甚至有報道抑制前列腺素合成藥物會加重銀屑病患者病情,鐘華等的研究表明半胱胺酰白三烯受體雖然在二者皮損中表達均增強,但在銀屑病患者中的表達明顯強于濕疹患者組,提示AA代謝產物在二者發(fā)病中可能有不同機理,需要我們進一步證實。 研究目的： 1.探討白三烯(LTs)與炎癥的關系及在銀屑病發(fā)病中的作用。 2.比較花生四烯酸(AA)在銀屑病(Ps)和濕疹(Ec)患者體內代謝特點異同。 研究方法： 1.采用酶聯(lián)免疫吸附方法(Enzyme-Linked Immunosorbent Assay, ELISA)分別檢測32例銀屑病患者血清、尿液和皮損中LTB4、LTE4水平及血清、皮損中IL-8、TNF-α水平,并與20例整形外科健康人員作對照。 2.采用ELISA方法分別檢測30例銀屑病患者(包括進行期、靜止期和退行期Ps患者各10例)、30例濕疹患者(包括急性、亞急性和慢性Ec患者各10例)皮損和10例對照者正常皮膚中LTB4、LTE4、TXB2、6-k-PGFla和PGE2水平。 結果： 1.銀屑病患者血清、皮損中IL-8、TNF-α和血清、尿液、皮損中LTE4水平均明顯高于對照組(均為P0.01),皮損中LTB4水平明顯升高(P0.01),但血清和尿液中LTB4水平與對照組相比差異無顯著性(P0.05)。皮損中LTB4、LTE4和IL-8水平與PASI評分變化趨勢一致,均有顯著相關性。皮損IL-8、TNF-α與LTB4變化趨勢一致,均有顯著相關性。 2.Ps患者LTB4、LTE4水平進行期組靜止期組退行期組對照組。進行期Ps患者組TXB2水平輕度升高(P0.05),6-k-PGFlα、PGE2水平在Ps患者3組中均無明顯升高。Ec患者LTE4、PGE2水平急性組亞急性組慢性組對照組,急性和亞急性Ec患者組LTB4、TXB2、6-k-PGF1α水平高于對照組,慢性Ec患者組LTB4、TXB2、6-k-PGF1α水平與對照組相比差異無顯著性。 結論： 1.白三烯通過參與局部炎癥反應在銀屑病發(fā)病中起重要作用。 2.Ps患者AA代謝紊亂以5-脂氧合酶(5-LO)途徑為主,Ec患者AA代謝5-脂氧合酶途徑和環(huán)氧化酶(COX)途徑均明顯增強。
[Abstract]:Research background:
1. Arachidonic acid (AA) is essential fatty acids in the human body. In recent years, the role of AA and its metabolites in the pathogenesis of the disease has been paid more attention to.AA mainly through the pathway of Cycloxygenase (COX) and lipoxygenase (Lipoxygenase, LO), and leukotrienes (Leukotrienes, LTs) are the lipoxygenes of the human peanut four arachidic acid. The metabolites of the synthase pathway, an important inflammatory mediator, participate in the inflammatory response of the disease. Psoriasis (Ps) is a common disease in the Department of dermatology. The etiology is complex and its pathogenesis has always been a hot spot. The study shows that local injection of LTB4 in normal skin can produce psoriatic skin damage, and leukotrienes and their receptors are in psoriasis. The abnormal expression in the patient's body suggests that leukotrienes have abnormal metabolism in the patients with psoriasis, but how leukotrienes are involved in the pathogenesis of psoriasis has not yet been studied. It is necessary to further confirm whether leukotrienes are involved in the inflammatory reaction of psoriasis.
2. a large number of literature found that although peanut four eNIC acid has metabolic abnormalities in patients with psoriasis and Eczema (Ec), in clinical studies, anti leukotrienes and prostaglandin synthetic drugs have achieved good efficacy in the treatment of eczema, and the efficacy of anti leukoenes in the treatment of psoriasis is not clear, even in the treatment of psoriasis. It is reported that inhibition of prostaglandin synthesis can aggravate the condition of patients with psoriasis. Zhong Hua and other studies have shown that although the expression of cysteamine receptor in the two skin lesions is enhanced, the expression in patients with psoriasis is stronger than that of the eczema patients, suggesting that the AA metabolites may have different mechanisms in the two cases, and we need to go in. Step by step.
The purpose of the study is:
1. to explore the relationship between leukotriene (LTs) and inflammation and the role of leukotriene in the pathogenesis of psoriasis.
2. to compare the metabolic characteristics of peanut four enoic acid (AA) in patients with psoriasis (Ps) and eczema (Ec).
Research methods:
1. Enzyme-Linked Immunosorbent Assay (ELISA) was used to detect the serum, urine and skin lesions of 32 patients with psoriasis, the level of LTB4, LTE4 and serum, and the level of IL-8, TNF- a in skin lesions, and compared with 20 cases of plastic surgery health.
2. the ELISA method was used to detect 30 cases of psoriasis (including 10 cases in the stage of progression, static period and degenerative Ps), 30 cases of eczema (including 10 cases of acute, subacute and chronic Ec) and 10 cases of normal skin, LTB4, LTE4, TXB2,6-k-PGFla and PGE2.
Result錛，

本文編號：1900103