沙利度胺治疗银屑病的疗效及对血清TNF-α、VEGF和bFGF的影响  

Psoriasis: Efficacy of Thalidomide and Its Influence on Levels of Serum TNF-α, VEGF and bFGF

作　　者：文莉 周娇 金玉华 刘绪荣 汪萍 WEN Li; ZHOU Jiao; JIN Yu-hua; LIU Xu-ron; WANG Ping(Department of Science and Education, Suizhou Central Hospital of Hubei Province/Suizhou Hospital Affiliated to Hubei University of Medicine, Suizhou, Hubei, 441399, China; Department of Blood Supply, Suizhou Central Hospital of Hubei Province/Suizhou Hospital Affiliated to Hubei University of Medicine, Suizhou, Hubei, 441399, China; 3 Department of Dermatology, Suizhou Central Hospital of Hubei Province/Suizhou Hospital Affiliated to Hubei University of Medicine, Suizhou, Hubei, 441399, China)

机构地区：[1]湖北省随州市中心医院/湖北医药学院附属随州医院科教科,湖北随州441399 [2]湖北省随州市中心医院/湖北医药学院附属随州医院供血科,湖北随州441399 [3]湖北省随州市中心医院/湖北医药学院附属随州医院皮肤科,湖北随州441399

出　　处：《现代生物医学进展》2018年第17期3352-3355,共4页Progress in Modern Biomedicine

基　　金：湖北省教育厅科学研究计划项目(B2014063);湖北省科技厅科技计划青年基金项目(2014CFB364)

摘　　要：目的:探讨沙利度胺治疗银屑病的疗效及对患者血清肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)的影响。方法:选择2014年6月至2016年6月我院收治的80例中重度寻常型银屑病患者为研究对象,将其完全随机化分为实验组和对照组,各40例。实验组口服沙利度胺,对照组口服甲氨蝶呤,均治疗10周。采用银屑病皮损面积和严重指数评分标准(PASI评分)评价治疗效果,采用酶联免疫吸附试验(ELISA)测定血清TNF-α、VEGF和bFGF水平,并进行安全性评价。结果:实验组治疗有效率为72.50%,高于对照组的47.50%,而不良反应发生率为5.00%,低于对照组的20.00%,差异具有统计学意义(P<0.05)。两组治疗后血清TNF-α、VEGF和bFGF水平明显低于治疗前,且实验组治疗后血清TNF-α、VEGF和b FGF水平低于对照组,差异具有统计学意义(均P<0.05)。结论:沙利度胺治疗银屑病具有较好疗效,且不良反应发生率较低,其作用机制可能与抑制患者血清中TNF-α、VEGF和bFGF的表达有关。Objective： To investigate the efficacy of thalidomide in the treatment of psoriasis and its influence on the level of serum tumor necrosis factor-α（TNF-α）, vascular endothelial growth factor（VEGF） and basic fibroblast growth factor（bFGF）. Methods：A total of 80 patients with moderate and severe psoriasis vulgaris, who were treated in Suizhou Central Hospital of Hubei Province from June 2014 to June 2016, were selected and were randomly divided into experimental group（n=40） and control group（n=40）. Thalidomide was given to the experimental group orally; methotrexate was given to the control group orally, the two groups were treated for 10 weeks. The effects of treatment were evaluated by psoriasis area and severity index score（PASI score）. The levels of serum TNF-α,VEGF and bFGF were determined by enzyme linked immunosorbent assay（ELISA）, and the safety evaluation were carried out. Results：The effective rate（72.50%） of the experimental group was higher than that（47.50%） of the control group, and the incidence of adverse reactions（5.00%） in the experimental group was lower than that（20.00%） in the control group, the difference was statistically significant（P〈0.05）. The levels of serum TNF-α, VEGF and bFGF in the two groups after treatment were significantly lower than those before treatment, and the levels of serum TNF-α, VEGF and bFGF in the experimental group were lower than those in the control group, and the differences were statistically significant（all P〈0.05）. Conclusion： Thalidomide has good efficacy and lower incidence of adverse reactions in the treatment of psoriasis. Its mechanism of action may be related to its inhibition of the expression of TNF-α, VEGF and bFGF in the serum of patients with psoriasis.

关 键 词：银屑病 沙利度胺 肿瘤坏死因子-Α 血管内皮生长因子 碱性成纤维细胞生长因子 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]