窄谱中波紫外线对银屑病患者微循环的影响

目的通过观察治疗前后银屑病患者血管内皮细胞的损伤情况和血管生成活性的改变来探讨窄谱中波紫外线对患者微循环的影响，以及各指标变化对病程发展的影响。方法检测51例银屑病患者的血管内皮损伤的标志物-血管性血友病因子（vWF）、可溶性血栓调节蛋白（STM）及血管增生活性的标志物——血管内皮生长因子（VEGF）和碱性成纤维细胞生长因子（bFGF）的血浆水平和50例健康体检者的各项指标，同时对窄谱中波紫外线治疗前后寻常型银屑病患者各项指标进行检测，并结合PASl分值进行分析。结果银屑病进行期（VEGF329．5土129．1、bFGF15．1±5．0、sTM61．5土3．5、vWF169．2±47．3）和静止期患者（258．4±105．2、11．7±3．8、46．2±2．9、124．6±39．9）水平均高于对照纽（216．5±55．3、7．3±4．5、27．1±1．5、102．0±28．3），差异有统计学意义（P〈0．01），进行期银屑病患者各项指标水平高于静止期患者，差异有统计学意义（P〈0．01）。银屑病患者治疗后的（VEGF218．4±105．2、bFGF7．5士4．5、sTM37．6±5．6、vWF116．0土21．3）低于治疗前（329．5±129．1、12．12±5．0、85．5±5．5、169．2±17．3），差异均有统计学意义（P〈0．01）。治疗后银屑病患者PASl分值有显著降低（P〈0．01），PASI分值与vWF、VEGF有显著相关性（P〈0．01），与bFGF、3TM无显著性相关（P〉0．05）。结论银屑病患者存在显著的内皮细胞损伤，这种损伤导致血管生成活性的增加。而经窄谱中波紫外线治疗后患者上述指标则趋近正常，其变化趋势与病程发展明显相关。

INFLUENCE OF NARROW-BAND ULTRA VIOLET B LIGHT ON MICROCIRCULATION IN PATIENTS WITH PSO-RIASIS

Objective To study endothelial cell damage and change of angiogenie activity in patients with psoriasis, and to investigate the influence of narrow - band ultra violet B light （NBUVB） on microcirculation and relationship among different parameters and the process of the pathology. Methods The patients were treated with NB- UVB and markers of endothelial cell damage and angiogenic activity were assayed in patients with psoriasis. Results Compared with the control （VEGF 216.5 ± 55.3, bFGF 7.3 ±4. 5, sTM 27. 1 ± 1.5, vWF 102.0 ± 28.3）, levels of the VEGF, bFGF, sTM, vWF were increased significantly in patients group（P〈0.01）. Compared the patients in activated stage group （VEGF 329.5 ± 129.1, bFGF 15.1 ± 5.0, sTM 61.5 ± 3.5, vWF 169.2 ± 47.3）with whom in stable stage group（258.4 ±105.2,11.7± 3.8,46. 2 ± 2.9,124.6 ±39.9）, the levels were increased significantly （P〈0.01）. Compared the parameters of patients in pretherapy group（329.5 ± 129.1, 12.12 ± 5.0, 85.5 ± 5.5, 169.2 ± 17.3） with those in post - treatment group（VEGF 218. 4 ± 105.2, hFGF 7. 5 ± 4.5, sTM 37.6 ± 5.6, vWF 116.0 ± 21.3）, the level of the VEGF, hFGF, ＇sTM, and vWF were decreased significantly（P〈0.01）. The serum levels of both vWF and VEGF were significandy correlated to PASI value in patients pretreated with NB- UVB, there was no significant relationship among PASI and the others parameters（P〉0.05）. Conclusion There was damage of endothelial cell in patients with psoriasis and it decreased the angiogenic activity after the treatment of NB- UVB, which is closed to the normal level, and the abnormal of microcirculation is closely related to the development of psoriasis.