【摘要】： 目的:銀屑病是一種由多基因遺傳決定的、多環(huán)境因素刺激誘導(dǎo)的免疫異常性慢性炎癥性增生性皮膚病,其病理過程十分復(fù)雜,涉及諸多細(xì)胞因子及免疫分子形成的網(wǎng)絡(luò),趨化因子及其受體在其中是至關(guān)重要的一環(huán)。本文旨在觀察UVB窄波治療儀治療前后患者血清單核細(xì)胞趨化蛋白4(MCP-4)及外周血T細(xì)胞上趨化因子受體6(CCR6)表達(dá)率水平的影響,并分別與正常人群對(duì)比,探討它們?cè)阢y屑病發(fā)病機(jī)制中可能發(fā)揮的作用。 材料和方法:選取尋常型銀屑病患者及正常人群各24例,分別于治療前采集血樣標(biāo)本,以?shī)A心酶聯(lián)免疫吸附法測(cè)定其血清中MCP-4的含量,以流式細(xì)胞儀測(cè)定其外周血T細(xì)胞上中CCR6的表達(dá)率。 NB-UVB治療:采用UV100L(TL01)(德國(guó)沃曼公司制造,波長(zhǎng)310-315nm,峰值為311nm)進(jìn)行NB-UVB照射。首次劑量取最小有效量0.3焦耳/cm2,以后每次增加0.1焦耳/cm2,最終劑量不超過3焦耳/cm2,每周照射3次,總療程平均36次。照射過程中囑患者戴上遮光眼睛,避免傷及眼睛。治療過程中,出現(xiàn)紅斑+(3-7天,淡粉或淡棕色,無(wú)壓痛無(wú)水腫)為最理想反應(yīng),出現(xiàn)紅斑++(明確紅斑,無(wú)水腫無(wú)壓痛)應(yīng)停止治療,臨床可按日光性灼傷處理。 經(jīng)過12周NB-UVB治療后,再次采集銀屑病患者血樣標(biāo)本檢測(cè)其血清中MCP-4的含量及外周血T細(xì)胞上CCR6的表達(dá)率,并以銀屑病嚴(yán)重程度PASI評(píng)分標(biāo)準(zhǔn)評(píng)分,分析尋常型銀屑病患者在治療前后及與正常人群血清MCP-4的含量及外周血T細(xì)胞CCR6的表達(dá)率對(duì)比,以SPSS17.0軟件包分析統(tǒng)計(jì)學(xué)結(jié)果。 結(jié)果:24例尋常型銀屑病患者患者血清MCP-4水平為255.35±79.31 pg/ml,正常人對(duì)照組血清MCP-4水平為32.43±10.41pg/ml,兩組差異有統(tǒng)計(jì)學(xué)意義(t= 13.145,P㩳0.05)。經(jīng)NB-UVB治療12周后,銀屑病患者M(jìn)CP-4水平明顯下降88.19±23.97 pg/ml,差異有統(tǒng)計(jì)學(xué)意義(t=9.229,P 0.05)。24例尋常型銀屑病患者患者外周血T細(xì)胞CCR-6表達(dá)率為(42.10±11.08)%,正常人對(duì)照組外周血T細(xì)胞CCR-6表達(dá)率為(11.03±1.01)%,兩組差異有統(tǒng)計(jì)學(xué)意義(t=13.02,P㩳0.05)。經(jīng)NB-UVB治療12周后,銀屑病患者外周血T細(xì)胞CCR-6表達(dá)率無(wú)明顯下降,為(40.05±4.52)%差異有無(wú)統(tǒng)計(jì)學(xué)意義(t= 1.43,P㧐0.05)。 結(jié)論:趨化因子通過其相應(yīng)受體對(duì)多種細(xì)胞如淋巴細(xì)胞、單核細(xì)胞、中性粒細(xì)胞、樹突狀細(xì)胞等的趨化作用而在多種疾病的免疫反應(yīng)及炎癥損傷中發(fā)揮著重要作用。銀屑病是一種慢性炎癥性自身免疫性疾病,涉及諸多細(xì)胞因子及免疫分子。本實(shí)驗(yàn)提示,尋常型銀屑病患者外周血中MCP-4較正常人群高表達(dá),且隨病情的變化而變化,可能與尋常型銀屑病的發(fā)病機(jī)制有著密切關(guān)系,促使了銀屑病的發(fā)生發(fā)展,可以作為銀屑病病情變化的參考指標(biāo)。另外,尋常型銀屑病患者外周血PBMC中T細(xì)胞上CCR6的表達(dá)率明顯高于正常人群,可能與銀屑病的發(fā)病機(jī)制有著密切關(guān)系,但其不隨病情的變化而變化,故不能作為銀屑病病情變化的參考指標(biāo)。
[Abstract]:Objective: psoriasis is a kind of chronic inflammatory hyperplastic dermatosis induced by polygenetic and multi-environmental stimuli. The pathological process of psoriasis is very complex, involving a network of cytokines and immune molecules. Chemokines and their receptors are a vital part of them. The purpose of this study was to observe the effect of UVB narrow wave therapeutic apparatus on the expression of serum monocyte chemoattractant protein 4 (MCP-4) and chemokine receptor 6 (CCR6) on peripheral blood T cells before and after treatment, and to compare it with that of normal population. To explore the possible role of them in the pathogenesis of psoriasis. Materials and methods: blood samples were collected from 24 patients with psoriasis vulgaris and 24 normal people before treatment, and the content of MCP-4 in serum was determined by sandwich enzyme-linked immunosorbent assay (Elisa). The expression rate of CCR6 in peripheral blood T cells was measured by flow cytometry. NB-UVB treatment: NB-UVB was irradiated with UV100L (TL01) (made by Warman, Germany, wavelength 310-315 nm, peak 311nm). After the minimum effective dose of 0.3joule / cm2, was taken for the first time, the final dose of 0.1joule / cm2, was not more than 3 joules / cm2, three times a week, and the total course of treatment was 36 times on average. In the process of irradiation, patients are told to wear shaded eyes to avoid injury to the eyes. In the course of treatment, erythema (3 鈮，

本文編號(hào)：2478951