阿维A联合窄谱UVB治疗银屑病的疗效及对血管紧张素转化酶与血管紧张素Ⅱ的影响

目的探讨阿维A联合窄谱UVB治疗银屑病的疗效及其对血管紧张素转化酶(ACE)及血管紧张素Ⅱ(Ang Ⅱ)表达的影响。方法临床观察采用随机对照方法,将80例银屑病患者分为A组和B组,A组单纯用窄谱UVB照射全身,B组口服阿维A联合窄谱UVB治疗,4周后评价疗效并测定患者治疗前后血清中ACE及Ang Ⅱ水平。结果治疗4周后,总有效率B组显著A组(χ2=10.313,P<0.01);B组PASI评分、血清ACE水平均低于治疗前和A组,而血清Ang Ⅱ水平低于治疗前和A组;PASI评分与银屑病患者ACE和Ang Ⅱ表达水平均呈正相关性(r=0.516,r=0.647,均P<0.01)。结论阿维A联合窄谱UVB治疗银屑病可显著提高疗效,不良反应少,其治疗机制可能与调节血清ACE和Ang Ⅱ水平有关。

Avi A Combined Narrow-spectrum UVB Treatment of Psoriasis and its Effect on Angiotensin-converting Enzyme and Angiotensin II

Objective To explore the therapeutic effect of acitretin combing with narrow-hand （NB） UVB phototherapy on psoriasis patients and the impacts on the expressions of ACE and Ang II. Methods The clinical observation of using randomized controled method, 80 cases of psoriasis patients were divided into A and B group. The group A was given mono-therapy of NB-UVB, The group B received oral acitretin combined NB-UVB. And the concentrations of ACE and Ang II in serum were detected before and after therapy. Results The total effective rate after four weeks of treatment on B group was significant higher thanA group （x2= 10.313, P 〈 0.01 ） ; The cores of PASI and serum level of ACE on B group after treatment were lower than those before treatment and A group after treatment （P 〈 0.05） , while the serum level of Ang II on B group after treatment was higher than those before treatment and A group after treatment （P 〈 0.05 ） . There was a positive correlation between PASI scores and expression level of ACE and Ang II in patients with psoriasis （r=0.516, r=0.647,all P〈0.01 ） . Conclusion It could improve the therapeutic efficacy significantly for psoriasis therapy to apply acitretin combined NB-UVB, and untoward reaction were lower. And the treatment mechanism may be related to regulating the serum level of ACE and Ang II on psoriasis patients.