窄谱中波紫外线联合阿维 A 对寻常型银屑病患者 T 淋巴细胞免疫功能影响的探讨

目的探讨窄谱中波紫外线联合阿维A对寻常型银屑病患者T淋巴细胞免疫功能的影响。方法选择2011年1月-2014年1月在潮州市潮安区庵埠华侨医院住院治疗的80例寻常型银屑病患者，分为观察组和对照组，每组各40例。对照组采用传统窄谱中波紫外线照射,观察组联合阿维A胶囊口服，比较两组治疗8周后的疗效以及两组患者治疗前后PASI评分、两组患者治疗前后外周血T淋巴细胞亚群（CD3＋、CD4＋、CD8＋、CD4＋/CD8＋）的变化情况。结果治疗8周后，观察组的总有效率达95．0％，明显高于对照组（77．5％），差异有统计学意义（P〈0．05）。观察组与对照组PASI评分均较治疗前降低，且观察组治疗后的PASI评分明显低于对照组，差异均有统计学意义（P〈0．05）。对照组患者的CD4＋水平治疗后较治疗前无明显变化．观察组患者的CD4＋水平治疗后较治疗前明显升高，且观察组患者治疗后的CD＋水平明显高于对照组，差异有统计学意义（P〈0．05）。对照组患者的CD8＋水平治疗后较治疗前无显著变化，观察组患者的CD8＋水平治疗后较治疗前明显降低。且观察组患者治疗后的CD8＋水平明显低于对照组，差异有统计学意义（P〈0．05）。观察组和对照组患者的CD4＋／CD8＋治疗后较治疗前明显提高，且治疗后观察组明显高于对照组，差异有统计学意义（P〈0．05）。结论窄谱中波紫外线联合阿维A可以提高寻常型银屑病的疗效，其作用机制可能与通过改变T淋巴细胞免疫功能的失衡状态而发挥作用密切相关。

Influence of narrow-band UVB combined with Avi A on psoriasis vul- garis T lymphocyte immune function

Objective To study the effect of narrow-band UVB combined with Avi A on psoriasis vulgaris T lympho- cyte immune function. Methods From January 2011 to January 2014, in Anbu Overseas Chinese Hospitals of Chaoan District in Chaozhou City 80 patiens with psoriasis vulgaris were randomly divided into observation group and control group, 40 cases in each group, the control group were given traditional narrow-hand UVB, the observeration group were given narrow-band UVB combined with Avi A capsule. After 8 weeks of treatment, the efficacy before and after treat- ment were compared, and the PASI score and peripheral blood T lymphocyte subsets （CD3＋, CD4＋, CD8＋, CD4＋/CD8＋） before and after treatment were observed. Results After 8 weeks treatment, the total effective rate of the observation group （95.0%） was significantly higher than that of the control group （77.5%）, the difference was statistically significant （P 〈 0.05）. PASI score of the observation group and control group after treatment were lowered than those before the treat- ment, and PASI score of the observation group after the treatment were significantly lower than those of the control group, the differences were statistically significant （P 〈 0.05）. CD4＋ levels of the control group had no difference be- tween before and after the treatment, CD4＋ levels of the observation group after the treatment were higher than those before and those of the control group, the difference was statistically significant （P 〈 0.05）. CD8＋ levels of the control group had no difference between before and after the treatment, CD8＋ levels of the observation group after the treatment were higher than those before and those of the control group, the difference was statistically significant （P 〈 0.05）. CD4＋ /CD8＋ levels of control group and observation group were higher than those before treatment, and after the treatment those of the observation group were higher than those of the control group, the differences were statistically significant （P 〈 0.05）. Conclusion Narrow-band UVB combined with Avi A can improve the efficacy on psoriasis vulgaris, its mechanism of action may be T lymphocytes play a role imbalance on immune function closely related .