摘要目的 观察窄谱中波紫外线(NB-UVB)治疗寻常性银屑病的疗效及其对外周血IL-23/Th17轴的影响,探讨NB-UVB治疗银屑病的作用机制.方法 对本院48例寻常性银屑病患者采用NB-UVB治疗20次,以皮损面积和严重程度(PASI)评分评价疗效;采用三色法流式细胞仪检测健康对照组及患者治疗前后的外周血Thl7细胞,同时采用ELISA法检测IL-17及IL-23的水平.结果 患者NB-UVB治疗前后评分明显下降[(8.12±4.05)分vs(3.98±2.03)分,P＜0.01];与健康对照组比较,Th17细胞百分比[(2.78±1.93)％vs(0.98±0.56)％]、IL-17[(23.85±7.98)pg/ml vs(6.53±4.26) pg/ml]及IL-23[( 29.73±12.08) pg/mM vs (16.73±8.91) pg/ml]的水平明显增高(P＜0.01),NB-UVB治疗后外周血Th17细胞的百分比[(1.13±0.51)％],血清IL-17的水平[(8.03±5.01)pg/ml]及IL-23的水平[(17.03±9.85)pg/ml]较治疗前显著下降(P＜0.01),其水平高低与PASI评分呈正相关(P＜0.05).结论 NB-UVB照射可能通过调节患者IL-23/Th17轴而发挥治疗银屑病的作用.

abstractsObjective To investigate the therapeutic effect of narrow band ultraviolet B ( NB VUB)and its influence on the expression of IL23/Th17 axis in peripheral blood of patients with Psoriasis vulgaris,and to further explore the mechanism of action of NB UVB.Methods Forty - eight cases of Psoriasis vulgaris were treated with NB-UVB irradiation for 20 times,the therapeutic effect was evaluated by the Psoriasis Area and Severity Index (PASI) scores.Peripheral blood was obtained from normal healthy controls and patients with Psoriasis vulgaris before and after NB-UVB irradiation.Three color flow cytometry was carried out to quantify Thl7 cells,and ELISA was used to examine the levels of serum IL17 and IL23.Results The mean PASI scores were significantly decreased after treatment with NB UVB irradiation[ (8.12±4.05)score vs (3.98±2.03) score,P＜0.01 ].Levels of Th17[ (2.78 ± 1.93)％ vs (0.98±0.56)％ ],IL-17[ (23.85±7.98) pg/ml vs (6.53±4.26) pg/ml] and IL-23 [ (29.73 ± 12.08)pg/ml vs ( 16.73±8.91 )pg/ml] were significantly higher in patients with Psoriasis vulgaris than that in healthy controls ( P ＜0.01 ).After treatment with NB-UVB irradiation,levels of Th17 [ ( 1.13 ± 0.51 ) ％ ],IL-17 [ ( 8.03±5.01 )pg/ml ],and IL-23 [ ( 17.03 ± 9.85 )pg/ml ] were significantly decreased than before ( P ＜ 0.01 ),and were positively correlated with PASI ( P ＜0.05).Conclusions NB-UVB may affect IL23/IL17 to achieve its therapeutic effect on patients with Psoriasis vulgaris.