窄谱中波紫外线对寻常型银屑病患者血清维生素D及内皮细胞特异性分子的影响
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摘要
目的探究窄谱中波紫外线(NB-UVB)对寻常型银屑病患者血清维生素D及内皮细胞特异性分子的影响与意义。方法选取本院2017年1月—2018年3月期间在我院进行治疗的寻常型银屑病患者70例为观察组,同期进行体检的健康人群70例为对照组。观察组给予NB-UVB光疗照射8周,比较2组血清维生素D、内皮细胞特异性分子、炎症反应因子水平及生活质量。结果光疗前,观察组血清维生素D水平为(14.26±1.38)ng/mL、显著低于对照组(P<0.05),内皮细胞特异性分子分别为(2.71±0.68)ng/mL,显著高于对照组(P<0.05);光疗后,观察组维生素D、内皮细胞特异性分子水平与光疗前比较有统计学意义(P<0.05),趋于正常但是与对照组比较仍差异有统计学意义(P<0.05)。光疗前,观察组肿瘤坏死因子(TNF)-α为(2.53±0.31)μg/mL、C反应蛋白(CRP)为(7.42±1.10)mg/L、白细胞介素(IL)-6为(315.03±21.5)μg/mL、IL-17为(216.59±19.83)pg/mL,均显著高于对照组(P<0.05);光疗后,观察组炎症反应因子水平与光疗前比较差异有统计学意义(P<0.05),趋于正常与对照组比较差异有统计学意义(P<0.05)。连续治疗8周后,观察组基本痊愈12例,好转45例,无效13例,有效率为81.4%。光疗前,观察组生活质量水平显著低于对照组(P<0.05);光疗后,观察组生活质量水平与光疗前比较差异有统计学意义(P<0.05),与对照组比较差异无统计学意义(P>0.05)。结论光疗可能通过提高血清维生素D、内皮细胞特异性分子水平发挥治疗作用。
Objective In order to explore the effects and significance of narrow band ultraviolet B(NB-UVB) on vitamin D and endothelial cell specific molecules in serum in patients with psoriasis vulgaris. Methods Seventy patients with psoriasis vulgaris treated in our hospital from January 2017 to March 2018 were selected as the observation group,and another 70 healthy people examined for physical examination in the same period were selected as the control group. The patients in the observation group were treated with NB-UVB phototherapy for eight weeks. Serum vitamin D,endothelial cell specific molecules,inflammatory response factors and quality of life were compared between the two groups. Results Before phototherapy,the serum vitamin D level of the observation group was(14.26±1.38) ng/mL,which was significantly lower than that of the control group(P<0.05),and endothelial cell specific molecules were(2.71±0.68) ng/mL,which was significantly higher than those in the control group(P<0.05). And after phototherapy,the levels of vitamin D and endothelial cell specific molecules in the observation group were significantly different from those before phototherapy(P<0.05). After phototherapy,the levels of vitamin D and endothelial cell specific molecules in the observation group were significantly different from those before phototherapy(P<0.05),and tended to be normal,but there was a significant difference compared with the control group(P<0.05). Before phototherapy,the TNF-a in the observation group was(2.53±0.31) μg/mL,CRP was(7.42±1.10) mg/L,IL-6 was(315.03±21.5) μg/mL and IL-17(216.59±19.83) pg/mL,which were significantly higher than those of the control group(P<0.05). After phototherapy,the level of inflammatory reaction factor in the observation group was significantly different from that before phototherapy(P<0.05),and tended to be normal,but there were significant differences compared with the control group(P<0.05). After eight weeks of continuous treatment,in the observation group,12 cases were basically cured,45 cases were effective,13 cases were invalid,and the effective rate was 81.4%. Before phototherapy,the quality of life of the observation group was significantly lower than that of the control group(P<0.05). But after phototherapy,the quality of life of the observation group was significantly different from that before the phototherapy(P<0.05),and there was no significant difference compared with the control group(P>0.05). Conclusion The treatment of phototherapy may play a therapeutic role by increasing serum vitamin D and endothelial cell specific molecular level.
Objective In order to explore the effects and significance of narrow band ultraviolet B(NB-UVB) on vitamin D and endothelial cell specific molecules in serum in patients with psoriasis vulgaris. Methods Seventy patients with psoriasis vulgaris treated in our hospital from January 2017 to March 2018 were selected as the observation group,and another 70 healthy people examined for physical examination in the same period were selected as the control group. The patients in the observation group were treated with NB-UVB phototherapy for eight weeks. Serum vitamin D,endothelial cell specific molecules,inflammatory response factors and quality of life were compared between the two groups. Results Before phototherapy,the serum vitamin D level of the observation group was(14.26±1.38) ng/mL,which was significantly lower than that of the control group(P<0.05),and endothelial cell specific molecules were(2.71±0.68) ng/mL,which was significantly higher than those in the control group(P<0.05). And after phototherapy,the levels of vitamin D and endothelial cell specific molecules in the observation group were significantly different from those before phototherapy(P<0.05). After phototherapy,the levels of vitamin D and endothelial cell specific molecules in the observation group were significantly different from those before phototherapy(P<0.05),and tended to be normal,but there was a significant difference compared with the control group(P<0.05). Before phototherapy,the TNF-a in the observation group was(2.53±0.31) μg/mL,CRP was(7.42±1.10) mg/L,IL-6 was(315.03±21.5) μg/mL and IL-17(216.59±19.83) pg/mL,which were significantly higher than those of the control group(P<0.05). After phototherapy,the level of inflammatory reaction factor in the observation group was significantly different from that before phototherapy(P<0.05),and tended to be normal,but there were significant differences compared with the control group(P<0.05). After eight weeks of continuous treatment,in the observation group,12 cases were basically cured,45 cases were effective,13 cases were invalid,and the effective rate was 81.4%. Before phototherapy,the quality of life of the observation group was significantly lower than that of the control group(P<0.05). But after phototherapy,the quality of life of the observation group was significantly different from that before the phototherapy(P<0.05),and there was no significant difference compared with the control group(P>0.05). Conclusion The treatment of phototherapy may play a therapeutic role by increasing serum vitamin D and endothelial cell specific molecular level.
引文
[1]何欢,龚瑜,史玉玲.银屑病住院患者380例临床分析[J].同济大学学报(医学版),2016,37(1):105-109.
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[10]马小娜,王爽,张辉,等.寻常性银屑病患者光疗后血清内皮细胞特异性分子及nesfatin-1水平变化[J].临床皮肤科杂志,2017,46(4):243-246.
[11]盛国荣,谢勇,刘海琴.退银汤联合窄谱中波紫外线治疗寻常型银屑病的疗效及对外周血相关细胞因子表达水平的影响[J].中国医院药学杂志,2014,34(7):576-580.
[12]Baumbach P,Weiss T,Giermann C,et al.Standardized quantitative sensory testing in patients with psoriasis vulgaris:evidence for altered largeand small fibre functioning[J].J Eur Acad Dermatol Venereol,2016,30:e137-140.
[13]Zhang L,Li Y,Yang X,et al.Characterization of Th17 and FoxP3(+)Treg cells in paediatric psoriasis patients[J].Scand J Immunol,2016,83:174-180.
[14]张力文,李艳嫦,刘冬先.寻常性银屑病患者皮损组织中RORγt,IL-17,FoxP3和IL-10的检测[J].中国皮肤性病学杂志,2014,28(7):681-683,689.
[15]章承中.不同照射频率的窄谱UVB治疗慢性斑状银屑病的疗效比较[J].实用医学杂志,2011,27(9):1 600-1 601.
[2]唐静,李惠,曾丹,等.维生素D与皮肤相关性疾病关系的研究进展[J].重庆医学,2016,45(31):4 443-4 445.
[3]杨小英,关坤,王慧,等.儿童银屑病患者血清25羟-维生素D水平检测及意义[J].实用医技杂志,2017,24(9):982-984.
[4]Erek TA,Emin O,Kevser UT,et al.Neutrophil/Lymphocyte ratio,serum endocan,and nesfatin-1 levels in patients with psoriasis vulgaris undergoing phototherapy treatment[J].Med Sci Monit,2016,22:1 232-1 237.
[5]单秀娟,于亮,郭文臣.窄谱中波紫外线对银屑病患者白细胞介素17、22水平的影响[J].中华皮肤科杂志,2015,48(8):575-577.
[6]张建中.银屑病的流行病学与危险因素[J].实用医院临床杂志,2013,10(1):4-6.
[7]周欣,毕新岭,顾军.维生素D受体基因CDX2多态性与阿达木单抗治疗中重度斑块型银屑病疗效相关性研究[J].中国中西医结合皮肤性病学杂志,2015,14(5):273-275.
[8]周欣,毕新岭,顾军.阿达木单抗治疗中重度斑块型银屑病疗效观察及血清维生素D水平变化[J].第二军医大学学报,2015,36(9):1 003-1 006.
[9]顾军,周欣.银屑病免疫机制及生物制剂治疗进展[J].皮肤病与性病,2013,35(5):260-261.
[10]马小娜,王爽,张辉,等.寻常性银屑病患者光疗后血清内皮细胞特异性分子及nesfatin-1水平变化[J].临床皮肤科杂志,2017,46(4):243-246.
[11]盛国荣,谢勇,刘海琴.退银汤联合窄谱中波紫外线治疗寻常型银屑病的疗效及对外周血相关细胞因子表达水平的影响[J].中国医院药学杂志,2014,34(7):576-580.
[12]Baumbach P,Weiss T,Giermann C,et al.Standardized quantitative sensory testing in patients with psoriasis vulgaris:evidence for altered largeand small fibre functioning[J].J Eur Acad Dermatol Venereol,2016,30:e137-140.
[13]Zhang L,Li Y,Yang X,et al.Characterization of Th17 and FoxP3(+)Treg cells in paediatric psoriasis patients[J].Scand J Immunol,2016,83:174-180.
[14]张力文,李艳嫦,刘冬先.寻常性银屑病患者皮损组织中RORγt,IL-17,FoxP3和IL-10的检测[J].中国皮肤性病学杂志,2014,28(7):681-683,689.
[15]章承中.不同照射频率的窄谱UVB治疗慢性斑状银屑病的疗效比较[J].实用医学杂志,2011,27(9):1 600-1 601.