本文選題：銀屑病 + 紫外線療法　； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的研究窄譜中波紫外線(NB-UVB)治療對(duì)尋常性銀屑病患者外周血血漿中纖溶酶及CC趨化因子配體20(CCL20)水平的影響,探討纖溶酶和CCL20在銀屑病發(fā)病機(jī)制中的作用。方法60例進(jìn)行期尋常性銀屑病患者作為治療組均采用NB-UVB照射治療,每周照射3次,共治療8周,另外選擇50例同期健康體檢者作為健康對(duì)照組,治療組和健康對(duì)照組人員在性別、年齡及體重上的差異無統(tǒng)計(jì)學(xué)意義。采用ELISA法檢測(cè)60例進(jìn)行期尋常性銀屑病患者經(jīng)NB-UVB照射治療前、后及50例健康體檢者外周血血漿中纖溶酶和CCL20的水平。結(jié)果60例進(jìn)行期尋常性銀屑病患者經(jīng)過NB-UVB照射治療,隨著光療次數(shù)的增加銀屑病皮損面積和嚴(yán)重程度指數(shù)(PASI)評(píng)分逐漸降低,光療前、光療12次及光療24次PASI評(píng)分值之間的差異有統(tǒng)計(jì)學(xué)意義(F=238.85,P0.05),光療24次后的PASI評(píng)分值(2.54±1.64)顯著低于光療前(10.26±3.14),差異有統(tǒng)計(jì)學(xué)意義(t=17.40,P0.05)。光療24次時(shí),治愈24例,顯效28例,好轉(zhuǎn)8例,無效0例,有效率達(dá)87%。NB-UVB照射治療過程中沒有患者因?yàn)椴涣挤磻?yīng)而退出治療。尋常性銀屑病患者在治療前與健康對(duì)照組相比,外周血中纖溶酶[(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]的表達(dá)量均顯著升高(t=15.45、11.15,均P0.05)),尋常性銀屑病患者經(jīng)NB-UVB治療后與治療前相比,外周血中纖溶酶及CCL20的表達(dá)量均顯著降低[纖溶酶:(148.22±40.05)μg/L,t=4.97,P0.05;CCL20:(329.67±100.73)pg/L,t=6.44,P0.05],但治療后纖溶酶及CCL20水平仍顯著高于健康對(duì)照組(t=10.82、7.95,均P0.05)。治療前,尋常性銀屑病患者外周血中纖溶酶與CCL20水平呈正相關(guān)(r=0.57,P0.05),且治療前外周血中纖溶酶、CCL20水平均與PASI評(píng)分呈正相關(guān)(r=0.49、0.62,均P0.05)。結(jié)論纖溶酶和CCL20可能在銀屑病的發(fā)病機(jī)制中起一定的促炎癥作用,而NB-UVB照射可能通過降低銀屑病患者外周血血漿中纖溶酶及CCL20的水平發(fā)揮治療作用。意義本文通過采用NB-UVB照射的方法治療進(jìn)行期尋常性銀屑病患者,并對(duì)患者治療前后外周血血漿中纖溶酶和CCL20的水平進(jìn)行檢測(cè)比較,初步探討纖溶酶和CCL20在銀屑病發(fā)病機(jī)制中的作用,期待能為今后銀屑病的治療提供新思路。
[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 鹵1.64, which was significantly lower than that before phototherapy (10.26 鹵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 鹵40.62) 渭 g / L vs 76.30 鹵26.92 渭 g / L] and CCL20 [422.41 鹵129.87)pg/L vs 205.33 鹵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 鹵40.05) 渭 g / L ~ (4.97) 渭 g / L ~ (-1) (P ~ (0.05) CCL20: 20: M ~ (329.67 鹵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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R758.63

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本文編號(hào)：1973068