奥马珠单抗对慢性自发性荨麻疹患者的临床疗效和安全性分析

目的:观察奥马珠单抗治疗慢性自发性荨麻疹（CSU）的临床疗效和安全性。方法:回顾性分析2020年3-9月在中国医学科学院皮肤病医院诊断为CSU并接受奥马珠单抗（300 mg/4周,皮下注射）治疗3次的60例患者的临床资料。分别在第0、2、4、6、8、10、12周使用7 d荨麻疹活动评分（UAS7）和慢性荨麻疹生活质量评...     

挪威疥误诊为泛发性湿疹一例

患者男,78岁。全身红斑、丘疹、脱屑伴痒10个月来中国医学科学院皮肤病医院过敏与风湿免疫科就诊。患者10个月前无明显诱因手背及指间出现红斑、丘疹,逐渐加重,泛发全身,伴剧烈瘙痒,影响睡眠。曾于当地医院考虑湿疹,予甲泼尼龙静脉滴注、抗组胺药口服及糖皮质激素药膏外用等治疗,病情无明显好转,我科以泛发性湿疹收入院……     

寻常性银屑病患者外周血单一核细胞IFN-γ受体和TNF-α受体mRNA表达的研究

Objective To investigate the mRNA expressions of IFN-gamma receptor and TNF-alpha receptor in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris and their role in the pathogenesis of psoriasis. Methods Fifty patients with psoriasis vulgaris (37 cases of active psoriasis and 13 cases of stable psoriasis) and 24 healthy human controls were included in this study. PBMCs were isolated from blood samples obtained from all patients and controls. The mRNA expressions of IFN-gamma receptor and TNF-aipha receptor in PBMCs were detected by RT-PCR. The disease severity in patients was evaluated by psoriasis area and severity index (PASI). Results The mRNA expressions of IFN-gamma receptor and TNF-alpha receptor were observed in the PBMCs of all subjects. The mRNA expression levels of IFN-gamma receptor were 0.72 ± 0.17 in healthy controls, 1.11 ± 0.55 in all patients with psoriasis, 1.13 ±0.57 in patients with active psoriasis and 1.03 ± 0.52 in patients with stable psoriasis, respectively. A signifi-cant increase was observed in the expression levels of IFN-gamma receptor mRNA in all psoriatic patients and in patients with active psoriasis compared with those in healthy controls (both P < 0.05), but there was no significant difference between the healthy controls and patients with stable psoriasis (P ＞ 0.05). The expres-sion levels of TNF-alpha receptor mRNA were 2.05 ± 1.34 in healthy controls, 2.70 ± 3.80 in all psoriatic patients, 2.90 ± 4.40 in patients with active psoriasis, 2.14 ± 1.05 in patients with stable psoriasis, respectively;there was no significant difference between psoriatic patients and healthy controls (P ＞ 0.05). However, no correlation was found between the mRNA expression of IFN-gamma receptor, that of TNF-alpha receptor,and disease severity in psoriatic patients. Conclusions The mRNA expression of IFN-gamma receptor in PBMCs is up-regulated in patients with psoriasis vulgaris, which is unrelated to the activity of psoriasis.     

寻常性银屑病患者外周血单一核细胞IFN-γ受体和TNF-α受体mRNA表达的研究

Objective To investigate the mRNA expressions of IFN-gamma receptor and TNF-alpha receptor in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris and their role in the pathogenesis of psoriasis. Methods Fifty patients with psoriasis vulgaris (37 cases of active psoriasis and 13 cases of stable psoriasis) and 24 healthy human controls were included in this study. PBMCs were isolated from blood samples obtained from all patients and controls. The mRNA expressions of IFN-gamma receptor and TNF-aipha receptor in PBMCs were detected by RT-PCR. The disease severity in patients was evaluated by psoriasis area and severity index (PASI). Results The mRNA expressions of IFN-gamma receptor and TNF-alpha receptor were observed in the PBMCs of all subjects. The mRNA expression levels of IFN-gamma receptor were 0.72 ± 0.17 in healthy controls, 1.11 ± 0.55 in all patients with psoriasis, 1.13 ±0.57 in patients with active psoriasis and 1.03 ± 0.52 in patients with stable psoriasis, respectively. A signifi-cant increase was observed in the expression levels of IFN-gamma receptor mRNA in all psoriatic patients and in patients with active psoriasis compared with those in healthy controls (both P < 0.05), but there was no significant difference between the healthy controls and patients with stable psoriasis (P ＞ 0.05). The expres-sion levels of TNF-alpha receptor mRNA were 2.05 ± 1.34 in healthy controls, 2.70 ± 3.80 in all psoriatic patients, 2.90 ± 4.40 in patients with active psoriasis, 2.14 ± 1.05 in patients with stable psoriasis, respectively;there was no significant difference between psoriatic patients and healthy controls (P ＞ 0.05). However, no correlation was found between the mRNA expression of IFN-gamma receptor, that of TNF-alpha receptor,and disease severity in psoriatic patients. Conclusions The mRNA expression of IFN-gamma receptor in PBMCs is up-regulated in patients with psoriasis vulgaris, which is unrelated to the activity of psoriasis.     

寻常性银屑病患者外周血单一核细胞IFN-γ受体和TNF-α受体mRNA表达的研究

Objective To investigate the mRNA expressions of IFN-gamma receptor and TNF-alpha receptor in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris and their role in the pathogenesis of psoriasis. Methods Fifty patients with psoriasis vulgaris (37 cases of active psoriasis and 13 cases of stable psoriasis) and 24 healthy human controls were included in this study. PBMCs were isolated from blood samples obtained from all patients and controls. The mRNA expressions of IFN-gamma receptor and TNF-aipha receptor in PBMCs were detected by RT-PCR. The disease severity in patients was evaluated by psoriasis area and severity index (PASI). Results The mRNA expressions of IFN-gamma receptor and TNF-alpha receptor were observed in the PBMCs of all subjects. The mRNA expression levels of IFN-gamma receptor were 0.72 ± 0.17 in healthy controls, 1.11 ± 0.55 in all patients with psoriasis, 1.13 ±0.57 in patients with active psoriasis and 1.03 ± 0.52 in patients with stable psoriasis, respectively. A signifi-cant increase was observed in the expression levels of IFN-gamma receptor mRNA in all psoriatic patients and in patients with active psoriasis compared with those in healthy controls (both P < 0.05), but there was no significant difference between the healthy controls and patients with stable psoriasis (P ＞ 0.05). The expres-sion levels of TNF-alpha receptor mRNA were 2.05 ± 1.34 in healthy controls, 2.70 ± 3.80 in all psoriatic patients, 2.90 ± 4.40 in patients with active psoriasis, 2.14 ± 1.05 in patients with stable psoriasis, respectively;there was no significant difference between psoriatic patients and healthy controls (P ＞ 0.05). However, no correlation was found between the mRNA expression of IFN-gamma receptor, that of TNF-alpha receptor,and disease severity in psoriatic patients. Conclusions The mRNA expression of IFN-gamma receptor in PBMCs is up-regulated in patients with psoriasis vulgaris, which is unrelated to the activity of psoriasis.     

汉族寻常性银屑病患者IFN-γ受体2基因多态性研究

目的 探讨IFN-γ受体2(IFN-γR2)基因氨基酸位点Gln64Arg多态性与中国汉族寻常性银屑病的相关性.方法 采用PCR-限制性片段长度多态性(RFLP)方法及DNA测序方法,检测苏皖地区182例汉族寻常性银屑病患者和114例正常人对照IFN-γR2基因Gln64Arg位点多态性.结果 寻常性银屑病患者与正常人对照组IFN-γR2基因Gln64Arg多态性位点各基因型及等位基因频率分布差异无统计学意义(P>0.05).伴甲损害银屑病组与无甲损害银屑病组之间Gln64/Gln64基因型分布频率分别为57.5%和38.1%.差异有统计学意义(X~3=5.33,P=0.02);Arg4等位基因(Gin64等位基因)分布频率分别为19.3%(80.7%)和30%(70%),差异也有统计学意义(X~2=5.03,P=0.02).伴甲损害的银屑病患者组Gln64/Arg64基因型分布频率为29.8%,正常人对照组为49.1%,两组间分布差异有统计学意义(X~2=5.48,P=0.01);Gln64/Gln64基因型分布频率在两组间分别为57.5%和35.1%,差异有统计学意义(X~2=6.23,P=0.01);无甲损害组与正常人对照组之间差异则无统计学意义.在以上呼吸道感染为诱因或加重因素的银屑病组与非上呼吸道感染银屑病组之间Arg64/Arg64基凶型分布频率分别为33.3%和15.5%,差异有统计学意义(X~2=4.94,P=0.03);Arg64等位基因(Gin64等位基因)分布频率为51.9%(48.1%)和35.2%(64.8%),差异也有统计学意义(X~2=5.46,P=0.02).结论 IFN-γR2基因Gln64Arg多态性位点可能与寻常性银屑病患者是否伴有甲损害有关,也可能与以上呼吸道感染为诱因或加重因素的寻常性银屑病有关.     

幼儿肛周扁平湿疣1例

早期先天梅毒的皮损呈现多样性和不典型性。与少数皮肤病皮损极易混淆，造成误诊或漏诊。笔者诊治1例初次误诊为尖锐湿疣的幼儿肛周扁平湿疣，现报告如下，[第一段]     

寻常性银屑病患者外周血单一核细胞IFN-γ受体和TNF-α受体mRNA表达的研究

Objective To investigate the mRNA expressions of IFN-gamma receptor and TNF-alpha receptor in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris and their role in the pathogenesis of psoriasis. Methods Fifty patients with psoriasis vulgaris (37 cases of active psoriasis and 13 cases of stable psoriasis) and 24 healthy human controls were included in this study. PBMCs were isolated from blood samples obtained from all patients and controls. The mRNA expressions of IFN-gamma receptor and TNF-aipha receptor in PBMCs were detected by RT-PCR. The disease severity in patients was evaluated by psoriasis area and severity index (PASI). Results The mRNA expressions of IFN-gamma receptor and TNF-alpha receptor were observed in the PBMCs of all subjects. The mRNA expression levels of IFN-gamma receptor were 0.72 ± 0.17 in healthy controls, 1.11 ± 0.55 in all patients with psoriasis, 1.13 ±0.57 in patients with active psoriasis and 1.03 ± 0.52 in patients with stable psoriasis, respectively. A signifi-cant increase was observed in the expression levels of IFN-gamma receptor mRNA in all psoriatic patients and in patients with active psoriasis compared with those in healthy controls (both P < 0.05), but there was no significant difference between the healthy controls and patients with stable psoriasis (P ＞ 0.05). The expres-sion levels of TNF-alpha receptor mRNA were 2.05 ± 1.34 in healthy controls, 2.70 ± 3.80 in all psoriatic patients, 2.90 ± 4.40 in patients with active psoriasis, 2.14 ± 1.05 in patients with stable psoriasis, respectively;there was no significant difference between psoriatic patients and healthy controls (P ＞ 0.05). However, no correlation was found between the mRNA expression of IFN-gamma receptor, that of TNF-alpha receptor,and disease severity in psoriatic patients. Conclusions The mRNA expression of IFN-gamma receptor in PBMCs is up-regulated in patients with psoriasis vulgaris, which is unrelated to the activity of psoriasis.     

寻常性银屑病患者外周血单一核细胞IFN-γ受体和TNF-α受体mRNA表达的研究

目的 探讨寻常性银屑病患者外周血单一核细胞IFN-γ受体mRNA和TNF-α仅受体mRNA的表达及其在银屑病发病机制中的作用.方法 采集50例寻常性银屑病患者外周静脉血,分离单一核细胞后,以RT-PCR法检测其IFN-γ受体mRNA和TNF-α受体mRNA的表达,PASI评分法评估银屑病的严重程度.以24例正常人作对照.结果 50例银屑病患者外周血单一核细胞IFN-γ受体mRNA的表达均值为1.11±0.55,其中37例进行期患者为1.13±0.57,13例静止期患者为1.03±0.52,正常人对照组为0.72±0.17,银屑病患者显著高于正常人对照组(P=0.0034),进行期显著高于正常人对照组(P=0.008),而静止期与正常人对照组差异无统计学意义.正常人对照组和银屑病患者外周血单一核细胞TNF-α受体mRNA的表达水平差异无统计学意义.银屑病患者外周血单一核细胞IFN-γ受体mRNA表达水平与TNF-α受体mRNA表达水平及PASI值均无相关性.结论 IFN-γ受体mRNA在寻常性银屑病患者外周血单一核细胞中异常高表达,但与疾病的活动性无关.     

寻常性银屑病患者外周血单一核细胞IFN-γ受体和TNF-α受体mRNA表达的研究

Objective To investigate the mRNA expressions of IFN-gamma receptor and TNF-alpha receptor in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris and their role in the pathogenesis of psoriasis. Methods Fifty patients with psoriasis vulgaris (37 cases of active psoriasis and 13 cases of stable psoriasis) and 24 healthy human controls were included in this study. PBMCs were isolated from blood samples obtained from all patients and controls. The mRNA expressions of IFN-gamma receptor and TNF-aipha receptor in PBMCs were detected by RT-PCR. The disease severity in patients was evaluated by psoriasis area and severity index (PASI). Results The mRNA expressions of IFN-gamma receptor and TNF-alpha receptor were observed in the PBMCs of all subjects. The mRNA expression levels of IFN-gamma receptor were 0.72 ± 0.17 in healthy controls, 1.11 ± 0.55 in all patients with psoriasis, 1.13 ±0.57 in patients with active psoriasis and 1.03 ± 0.52 in patients with stable psoriasis, respectively. A signifi-cant increase was observed in the expression levels of IFN-gamma receptor mRNA in all psoriatic patients and in patients with active psoriasis compared with those in healthy controls (both P < 0.05), but there was no significant difference between the healthy controls and patients with stable psoriasis (P ＞ 0.05). The expres-sion levels of TNF-alpha receptor mRNA were 2.05 ± 1.34 in healthy controls, 2.70 ± 3.80 in all psoriatic patients, 2.90 ± 4.40 in patients with active psoriasis, 2.14 ± 1.05 in patients with stable psoriasis, respectively;there was no significant difference between psoriatic patients and healthy controls (P ＞ 0.05). However, no correlation was found between the mRNA expression of IFN-gamma receptor, that of TNF-alpha receptor,and disease severity in psoriatic patients. Conclusions The mRNA expression of IFN-gamma receptor in PBMCs is up-regulated in patients with psoriasis vulgaris, which is unrelated to the activity of psoriasis.