中国血液净化

›› 2007, Vol. 6 ›› Issue (3): 142-144.

• 论著 • 上一篇    下一篇

血液灌流对银屑病治疗作用的临床观察

孙丽君1 朱嘉琦3 戎 殳1 叶朝阳1 汪晓军 2 梅长林1   

  1. 1. 200003 上海，第二军医大学附属长征医院肾内科，2. 皮肤科， 3. 854000 昌都，解放军75医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-03-12 发布日期:2007-03-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2007-03-12 Published:2007-03-12

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摘要： 目的 体外观察血液灌流对严重银屑病患者临床疗效及对血浆中可能的毒性物质的清除作用。方法 选择上海第二军医大学附属长征医院12例严重银屑病患者，随机分为常规治疗组和血液灌流组各6例。常规治疗组以阿维A酸+还原型谷胱甘肽治疗，血液灌流组在常规治疗组的基础上，予以血液灌流2～4次，每次间隔2～4天。治疗前及血液灌流末次治疗后，分别收集患者血清，测定免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、肿瘤坏死因子α(TNF-α)、白细胞介素β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)，并观察记录临床表现情况。结果 血液灌流治疗后，IgA、IgG、TNF-α、IL-1β、IL-6、IL-8均显著下降(P＜0.05）；?TNF-α、?IL-8和 ?PASI直线相关分析r值分别为 0.663、0.422，呈正相关(P＜0.05）；血液灌流组患者临床治愈率显著提高。结论 血液灌流能吸附银屑病患者血浆中的TNF-α、IL-1β、IL-6、IL-8，不同程度降低IgA、IgG、IgM，能明显改善临床症状，可能成为银屑病新的治疗手段。

关键词: 血液灌流, 银屑病, 免疫球蛋白, 细胞因子

Abstract: Objective To evaluate the clinical effect of hemoperfusion on eliminating possible toxic substances in psoriasis patients. Methods Twelve severe psoriasis patients were randomly divided into two groups, routine therapy group and hemoperfusion group. The psoriasis patients in routine therapy group were treated with retinoids and transfer factor, and those in hemoperfusion group were additionally treated with hemoperfusion for two or three times. serum IgA, IgG, IgM, TNF- , IL-1 , IL-6, and IL-8 were tested and the clinical indices were recorded at the beginning and the end of the study. Results After hemoperfusion, symptoms of these patients were improved. The serum parameters such as IgA, IgG, TNF- , IL-1 , IL-6 and IL-8 in hemoperfusion group decreased significantly (P＜0.05), and TNF- , IL-8 were correlated positively with PASI. Conclusion Hemoperfusion can improve the clinical presentation of psoriasis by eliminating some possible toxic substances and may be a therapeutic tool for psoriasis in future.

Key words: Psoriasis, Immuneglobulin, Cytokine