卡介菌多糖核酸对特应性皮炎患者PBMC中TARC与CCR4表达的影响

目的检测卡介菌多糖核酸治疗前后特应性皮炎(AD)患者外周血胸腺和活化调节的趋化因子(TARC)与其相应受体CCR4的表达,以探讨其治疗特应性皮炎的相关机制。方法采用酶联免疫吸附试验检测45例AD患者卡介菌多糖核酸治疗前后血清中TARC水平;同时用流式细胞仪分析外周血中CCR4的表达。结果与治疗前(1169.1±106.5pg/mL)相比,卡介菌多糖核酸治疗后AD患者血清TARC(810.1±77.6pg/mL)显著降低(P<0.01);与治疗前(60.1±2.4)%相比,卡介菌多糖核酸治疗后AD患者外周血CCR4表达水平(54.6±2.2)%显著降低(P<0.01)。结论卡介菌多糖核酸可能通过降低TARC与CCR4,从而减少Th2细胞的募集、活化而发挥其治疗特应性皮炎的作用。     

窄谱中波紫外线联合卡介菌多糖核酸治疗白癜风疗效观察

目的：观察窄谱中波紫外线联合卡介菌多糖核酸治疗白癜风的临床疗效。方法：选择80例白癜风患者,随机分成两组,治疗组40例患者窄谱中波紫外线照射联合肌肉注射卡介菌多糖核酸,对照组40例单独肌肉注射卡介菌多糖核酸。观察治疗20、50、120天后的临床疗效。结果：经过120天的治疗,治疗组有效率62.5%,对照组30.0%,两组疗效差异有统计学意义（P〈0.01）。结论：311nm窄谱中波紫外线照射联合肌肉注射卡介菌多糖核酸治疗白癜风安全、有效,能显著提高临床治愈率。     

消银颗粒、卡介菌多糖核酸联合窄谱中波紫外线治疗玫瑰糠疹56例疗效观察

目的探讨消银颗粒、卡介菌多糖核酸联合窄谱中波紫外线治疗玫瑰糠疹的临床效果。方法86例玫瑰糠疹患者随机分为治疗组56例和对照组30例，均口服消银颗粒，肌注卡介菌多糖核酸。治疗组加用窄谱中波紫外线照射治疗。结果治疗1周、2周后与对照组总有效率比较均有显著差异，均P〈0．05，治疗组疗效明显优于对照组。结论消银颗粒、卡介菌多糖核酸联合窄谱中波紫外线照射治疗玫瑰糠疹能缩短疗程，提高疗效。     

卡介菌多糖核酸等治疗嗜酸性粒细胞增多性皮炎2例

2例嗜酸性粒细胞增多性皮炎患者予肌注卡介菌多糖核酸注射液2ml/d,同时口服抗胺药物,3～6周后皮损基本消退,外周血嗜酸性粒细胞计数恢复正常,无明显不良反应。     

窄谱中波紫外线联合吡美莫司乳膏对成人型特应性皮炎患者PBMC产生eotaxin和CCR3表达的影响

 目的:检测窄谱中波紫外线（NB-UVB)联合吡美莫司乳膏治疗前后,特应性皮炎 (AD) 患者外周血嗜酸性粒细胞活化趋化因子(eotaxin)与其相应受体CCR3的表达，以探讨其治疗特应性皮炎的相关机制。方法: 采用窄谱中波紫外线联合吡美莫司乳膏治疗30例成人型AD患者,酶联免疫吸附试验检测治疗前后血清中eotaxin水平; 同时用流式细胞仪分析外周血中CCR3的表达。结果: 治疗前，AD患者血清eotaxin水平为(133.86±42.23) pg/mL，CCR3表达水平为(23.10±6.31)%；治疗后，AD患者血清eotaxin水平为(101.54±35.63) pg/mL，较治疗前明显降低(t=3.20,P＜0.01);外周血 CCR3表达水平为(16.52±6.59)%，较治疗前亦明显降低(t=3.59,P＜0.01)。结论: 窄谱中波紫外线联合吡美莫司乳膏可能通过降低eotaxin、CCR3表达，从而减少嗜酸性粒细胞的募集、活化,发挥其治疗特应性皮炎的作用。     

特应性皮炎患者PBMC产生eotaxin和CCR3表达的影响

目的:检测窄谱中波紫外线(NB-UVB)联合吡美莫司乳膏治疗前后,特应性皮炎(AD)患者外周血嗜酸性粒细胞活化趋化因子(eotaxin)与其相应受体CCR3的表达,以探讨其治疗特应性皮炎的相关机制。方法:采用窄谱中波紫外线联合吡美莫司乳膏治疗30例成人型AD患者,酶联免疫吸附试验检测治疗前后血清中eotaxin水平;同时用流式细胞仪分析外周血中CCR3的表达。结果:治疗前,AD患者血清eotaxin水平为(133. 86±42. 23) pg/m L,CCR3表达水平为(23. 10±6. 31)%;治疗后,AD患者血清eotaxin水平为(101. 54±35. 63) pg/m L,较治疗前明显降低(t=3. 20,P 0. 01);外周血CCR3表达水平为(16. 52±6. 59)%,较治疗前亦明显降低(t=3. 59,P 0. 01)。结论:窄谱中波紫外线联合吡美莫司乳膏可能通过降低eotaxin、CCR3表达,从而减少嗜酸性粒细胞的募集、活化,发挥其治疗特应性皮炎的作用。     

卡介菌多糖核酸注射液联合咪唑斯汀治疗特应性皮炎疗效评价

目的:评价卡介菌多糖核酸注射液联合咪唑斯汀治疗特应性皮炎(AD)的疗效。方法:治疗组AD患者70例,给予卡介菌多糖核酸注射液联合咪唑斯汀治疗;对照组50例给予咪唑斯汀治疗,治疗12周。通过治疗前后SCORAD积分和血清总IgE水平变化评价疗效。结果:治疗组有效率(61.4%)高于对照组(34.0%)。治疗组SCORAD积分和血清总IgE值下降水平明显大于对照组(P0.05)。结论:卡介菌多糖核酸联合咪唑斯汀治疗中轻度特应性皮炎疗效显著。     

卡介菌多糖核酸对生殖器疱疹患者单核细胞功能的影响

目的探讨卡介菌多糖核酸对生殖器疱疹患者单核细胞功能的影响。方法采用ELISA和APAAP法,检测卡介菌多糖核酸治疗前、后生殖器疱疹患者单核细胞产生肿瘤坏死因子α(TNF-α)、白介素6(IL-6)水平和单核细胞人白细胞Ⅱ类抗原(HLA-II类抗原)水平。结果卡介菌多糖核酸治疗后生殖器疱疹患者外周血单核细胞分泌TNF-α,IL-6水平分别为(5.64±0.22)ng/mL和(6.24±0.67)ng/mL,较治疗前(4.73±0.36)ng/mL和(3.92±0.56)ng/mL明显升高,差异有显著性意义(P<0.05);治疗后生殖器疱疹患者外周血单核细胞HLA-DR,HLA-DQ表达水平分别为(80.30%±2.08%)和(39.8%±39.8%),较治疗前(69.13%±2.83%)和(29.90%±1.68%)明显升高,差异有显著性意义(P<0.01)。结论卡介菌多糖核酸能提高生殖器疱疹患者单核细胞产生TNF-α,IL-6及HLA-II类抗原表达水平,其可作为生殖器疱疹的辅助治疗手段之一。     

卡介菌多糖核酸注射液肌注联合窄谱中波紫外线照射治疗玫瑰糠疹疗效观察

目的观察卡介菌多糖核酸注射液肌注联合窄谱中波紫外线(NB-UVB)照射治疗玫瑰糠疹的临床疗效。方法将98例玫瑰糠疹患者随机分为两组,治疗组(48例)予卡介菌多糖核酸注射液1mg隔日1次肌注,同时行NB-UVB隔日1次照射;对照组(50例)单用NB-UVB照射,隔日1次。两组均治疗10次后判定疗效。结果治疗组有效率为91.67%(44/48),对照组为76。00%(38/50),两组有效率差异有统计学意义(P<0.05);治疗组平均痊愈时间为10.00±2.53天,对照组为15.00±3.65天,治疗组平均痊愈时间短于对照组(P<0.05)。结论卡介菌多糖核酸注射液联合NB-UVB治疗玫瑰糠疹较单用NB-UVB照射疗效好,可缩短痊愈时间。     

卡介菌多糖核酸治疗特应性皮炎38例

1998年以来，我们应用卡介菌多糖核酸注射液治疗特应性皮炎未见明显的毒副作用，现将结果报告如下。 组别例数止疱(d)止痛(d)痊愈(d) 万乃洛韦682.39±1.065.31±2.837.06±4.21 阿昔洛韦434.70±1.456.86±3.148.79±4.92 t值－8.1512.4313.30 P值－ 表1口服万乃洛韦、阿昔洛韦治疗带状疱疹患者症状消失时间及痊愈时间(x±s) 组别例数治愈显效好转无效有效率 万乃洛韦6850(73.53)12(17.65) 5(7.35)1(1.47)91.18％ 阿昔洛韦4323(53.49) 9(20.93)7(16.28)4(9.30)74.42％ 表2万乃洛韦、阿昔洛韦治疗带状疱疹疗效比较例(％) 卡介菌多糖核酸治…     

Treatment of atopic dermatitis with the xenon chloride excimer laser

BACKGROUND: Narrow-band ultraviolet B phototherapy is an effictive and safe treatment for atopic dermatitis. We have previously found that the 308 nm xenon chloride excimer laser was more effective than the narrow-band ultraviolet B light for the treatment of psoriasis, suggesting that ultraviolet B laser might offer advantages over narrow-band ultraviolet B. OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy of the 308 nm excimer laser in atopic dermatitis. PATIENTS AND METHODS: Fifteen patients with atopic dermatitis (less than 20% body area involvement) were treated with a xenon chloride excimer laser (XTRAC laser, Photomedex Inc.) twice weekly. The severity of the atopic dermatitis was assessed via (i) a clinical score characterizing the intensity of erythema, infiltration, lichenification and excoriation; (ii) the quality of life, determined by means of a questionnaire; and (iii) a visual linear analogue scale, with which the patients scored the severity of their pruritus. RESULTS: After 1 month of laser therapy, the clinical scores were significantly lower than the initial values. Similar decreases were observed for the quality of life and pruritus scores. No serious or unpleasant side-effects were observed. CONCLUSION: These results suggest that the xenon chloride excimer laser is an effective and well-tolerated treatment for localized atopic dermatitis.     

窄谱中波紫外线治疗特应性皮炎疗效观察

目的：观察窄谱中波紫外线（NB—UVB）治疗特应性皮炎（AD）的疗效。方法：53例AD患者接受NB—UVB治疗仪照射治疗，每周治疗3次，连续治疗36次。采用欧洲AD评分标准（SCORAD）对AD的临床严重度进行评分，用视觉模拟尺度（VAS）评分法对瘙痒程度进行评分，同时记录SCORAD积分和VAS积分。疗程结束后评价疗效。结果：53例患者痊愈17例（32．08％），显效28例（52．83％），有效5例（9．43％），有效率为84．91％，SCORAD积分和VAS积分较治疗前明显下降（P〈0．01）。结论：NB—UVB治疗AD安全性高，近期疗效好，操作简便，患者依从性好。     

窄谱UVB联合阿维A治疗斑块型银屑病疗效观察

目的观察311 nm窄谱中波紫外线(NB-UVB)联合阿维A治疗斑块型银屑病的疗效。方法单独采用NB-UVB照射、单独应用阿维A治疗及NB-UVB联合阿维A治疗斑块型银屑病90例,以银屑病皮损面积和严重度指数(PASI)评价疗效。结果三组在(26.16±4.37)天、(28.24±5.27)天、(18.34±3.52)天治疗后,三组治疗前后PASI评分改善率分别为(77.65±24.77)%,(78.64±23.43)%,(89.44±25.57)%;与阿维A治疗组比较,NB-UVB照射组与其疗效相当(P>0.05),而NB-UVB联合阿维A治疗组则在更短的治疗时间(P<0.05)取得了更好的疗效(P<0.05)。结论NB-UVB联合阿维A治疗斑块型银屑病疗效好,不良反应少。     

Half-side comparison study on the efficacy of 8-methoxypsoralen bath-PUVA versus narrow-band ultraviolet B phototherapy in patients with severe chronic atopic dermatitis

In patients with severe chronic atopic dermatitis (AD), both photochemotherapy [psoralen ultraviolet A (PUVA)] and narrow-band (TL-01) UV B phototherapy have been reported to be very effective. As no data exist on the relative therapeutic efficacy of these two regimens, we performed a randomized investigator-blinded half-side comparison study on 12 patients with severe chronic AD. Half-side irradiation with threshold erythemogenic doses of 8-methoxypsoralen bath-PUVA and narrow-band UVB was performed three times weekly over a period of 6 weeks. The severity of the disease was assessed separately for the paired halves of the patients' bodies by a modified SCORAD score at baseline and after 2, 4 and 6 weeks of treatment. Ten of the 12 patients completed the trial. All but one showed marked improvement or complete remission with both treatments. The mean baseline SCORAD score decreased by 65.7% by the bath-PUVA treatment and by 64.1% by the narrow-band UVB treatment (P = 0.48). No serious adverse reactions to either of the two regimens were observed. Our data confirm the high efficacy of bath-PUVA and narrow-band UVB phototherapy in the treatment of patients with chronic severe AD. Both regimens appear to be equally effective when administered in equi-erythemogenic doses.     

长期外用他克莫司软膏对特应性皮炎患者免疫力的影响

目的:探讨特应性皮炎患者长期外用他克莫司软膏治疗后血药浓度的变化以及对外周血淋巴细胞亚群的影响。方法:使用他克莫司软膏(0.1%)治疗12例特应性皮炎患者,疗程12个月,于治疗前和治疗结束后使用流式细胞术检测外周血中淋巴细胞亚群,治疗一周时和治疗结束后使用ELISA检测患者他克莫司血药浓度,比较治疗前后的变化。结果:淋巴细胞亚群的变化在治疗前后比较,差异均无统计学意义(P值均>0.05);治疗1周时,他克莫司血药浓度为(1.73±0.48)ng/mL,治疗12个月后浓度为(1.07±0.42)ng/mL,两者差异具有统计学意义(t=16.85,P<0.05);他克莫司软膏使用总量与Th/Ts比值变化量无相关性(r=-0.40,P>0.05)。结论:特应性皮炎长期外用他克莫司软膏存在低水平的系统吸收,他克莫司低水平系统暴露对特应性皮炎患者的外周血淋巴细胞亚群无影响。     

Elevated cyclic adenosine monophosphate phosphodiesterase activity in peripheral blood mononuclear leucocytes from children with atopic dermatitis

We examined peripheral blood mononuclear leucocyte cyclic adenosine monophosphate phosphodiesterase (cAMP-PDE) activity in 80 children (aged 2-12 years) with atopic dermatitis. The enzyme activity (35.1 ± 18.6U) in children with atopic dermatitis was significantly higher than that (19.1 ± 12.6U) in age-matched non-atopic controls. There was no significant difference in the cAMP-PDE activity between children with mild atopic dermatitis and children with severe atopic dermatitis. These findings support the view that elevation of peripheral mononuclear leucocyte cAMP-PDE actvity in patients with atopic dermatitis is a gene-associated abnormality.     

Bicentre experience in the treatment of severe generalised atopic dermatitis with extracorporeal photochemotherapy

Pilot studies have shown an improvement of atopic dermatitis in approximately 65% of patients during extracorporeal photopheresis (ExP) therapy. The purpose of the present clinical trial was to investigate the response to ExP by controlling clinical and laboratory parameters during short term ExP therapy in patients with severe generalised atopic dermatitis. Thirty-five patients with severe, therapy-resistant atopic dermatitis were treated with ExP in an open clinical trial at two week intervals over a period of 6 to 10 cycles. Disease activity was measured before each cycle by SCORAD index together with a standardized protocol for blood samples. ExP led to a significant decrease (p < 0.05) in SCORAD from 74.4 +/- 15.5 before to 36.8 +/- 16.8 after ExP therapy (mean 10 cycles). Approximately 70% (24/33 patients = responder) of patients had a favourable response to ExP requiring at least 6 cycles. The decrease in SCORAD was accompanied by a significant decrease of eosinophil cationic protein (27%), sE-selectin (37%) and sIL-2R (53%) levels in serum (p < 0.05). No significant correlation between a decrease in these levels and values of blood eosinophils or lymphocytes was found (p > 0.05). In comparison to responders, most non-responders were characterised by very high levels of total IgE before and during therapy (p < 0.05). The present clinical trial confirms that short term ExP is an effective treatment for certain patients with severe atopic dermatitis based on anti-inflammatory mechanisms. Total IgE could be a predictor of outcome in ExP treatment.     

窄谱中波紫外线对寻常性银屑病患者外周血MCP-4表达水平的影响

目的探讨窄谱中波紫外线(NB-UVB)对寻常性银屑病患者外周血中单核细胞趋化蛋白-4(MCP-4/CCL13)表达的影响。方法采用夹心酶联免疫吸附法检测24例寻常性银屑病患者NB-UVB治疗前后和24例健康人外周血血清MCP-4水平。结果 24例寻常性银屑病患者患者血清MCP-4水平为(255.35±79.31)pg/mL,正常人对照组血清MCP-4水平为32.43±10.41pg/mL,两组差异有显著性(t=13.145,P0.05)。经NB-UVB治疗12周后,银屑病患者MCP-4水平明显下降(88.19±23.97)pg/mL,与治疗前差异有显著性(t=9.229,P0.05)。结论 NB-UVB可以降低寻常性银屑病患者血清中MCP-4的表达水平,MCP-4可能参与了角质形成细胞的增殖,参与银屑病的发病过程。     

Does narrow‐band ultraviolet B phototherapy work in atopic dermatitis through a local or a systemic effect?

The likely mechanisms of action of narrow-band ultraviolet B (NB-UVB) in atopic dermatitis are several. We attempted, in a 12 patient prospective intraindividually controlled study, to determine whether the effect of NB-UVB in atopic dermatitis is primarily through systemic or local effects. Change in observer-assessed severity of patches of dermatitis covered during each whole-body NB-UVB treatment was compared with change in uncovered neighbouring patches. We found great variation between patients in responses. Only in two (of 12) patients was there a large difference between directly exposed and covered patch dermatitis severity. We suspect that the balance of local and systemic effects important in determining response to NB-UVB in atopic dermatitis varies from patient to patient. This study did not conclusively answer our original question, but did show that in some patients localized effects of NB-UVB are important.