摘要目的 研究窄谱中波紫外线(NB-UVB)治疗对寻常性银屑病患者外周血中纤溶酶及CC趋化因子配体20(CCL20)水平的影响.方法 60例进行期寻常性银屑病患者均采用NB-UVB照射治疗,每周3次,共治疗8周.采用酶联免疫吸附试验(ELISA)检测银屑病患者NB-UVB照射前后及50例健康体检者(对照组)外周血血浆中纤溶酶和CCL20水平.结果 60例患者治疗后银屑病皮损面积和严重程度指数(PASI)评分(2.54±1.64)显著低于治疗前(10.26±3.14),差异有统计学意义(t=17.40,P＜ 0.05),且NB-UVB治疗的有效率达87％ (52/60).治疗前,银屑病患者外周血中纤溶酶[(180.07±40.62) μg/L]及CCL20水平[(422.41±129.87) pg/L]均显著高于对照组[(76.30±26.92) μg/L,t=15.45;(205.33±49.89) pg/L,t=11.15;均P＜0.05].治疗后银屑病患者外周血纤溶酶[(148.22±40.05) μg/L]及CCL20的表达量[(329.67±100.73) pg/L]均显著低于治疗前(t=4.97、6.44,均P＜0.05),但仍显著高于对照组(t=10.82、7.95,均P＜0.05).治疗前,银屑病患者外周血纤溶酶与CCL20水平呈正相关(r=0.57,P＜0.05),纤溶酶、CCL20水平均与PASI评分呈正相关(r=0.49、0.62,均P＜ 0.05).结论 NB-UVB照射可能通过降低银屑病患者外周血纤溶酶及CCL20的水平发挥治疗作用.

abstractsObjective To investigate the effects of narrow-band ultraviolet B (NB-UVB) therapy on the levels of plasmin and CC chemokine ligand 20 (CCL20) in peripheral blood of patients with psoriasis vulgaris.Methods A total of 60 patients with psoriasis vulgaris in progressive stage were treated with NB-UVB radiation thrice a week for 8 weeks.Enzyme-linked immunosorbent assay (ELISA) was performed to detect the levels of plasmin and CCL20 in the peripheral blood of the patients before and after the treatment,as well as in the peripheral blood of 50 healthy controls.Results After the treatment,psoriasis area and severity index (PASI) scores in patients were significantly decreased compared with those before the treatment (2.54 ± 1.64 vs.10.26 ± 3.14,t =17.40,P ＜ 0.05),and the response rate was up to 87％ (52/60).Before the treatment,levels of plasmin and CCL20 were both significantly higher in the patient group than in the control group (plasmin:180.07 ± 40.62 μg/L vs.76.30 ± 26.92 μg/L,t =15.45,P ＜ 0.05;CCL20:422.41 ± 129.87 pg/L vs.205.33 ± 49.89 pg/L,t =11.15,P ＜ 0.05).After the treatment,levels of plasmin (148.22 ± 40.05 μg/L) and CCL20 (329.67 ± 100.73 pg/L) in patients were significantly decreased compared with those before the treatment (t =4.97,6.44,P ＜ 0.05),but still significantly higher than those in controls (t =10.82,7.95,P ＜ 0.05).Before the treatment,the level of plasmin was positively correlated with the level of CCL20 in peripheral blood of the patients (r =0.57,P ＜ 0.05),and the levels of plasmin and CCL20 were both positively correlated with the PASI score (r =0.49,0.62,respectively,both P ＜ 0.05).Conclusion NB-UVB radiation may exert a therapeutic effect on psoriasis vulgaris by reducing levels of plasmin and CCL20 in peripheral blood of patients.