【摘要】 目的:通过对阿维A治疗前后寻常性银屑病(PV)患者皮损中Th1、Th2细胞的研究,了解局部Th1、Th2、Th1/Th2平衡在PV病情发展中的变化。探讨阿维A治疗PV的作用机制。方法:采用免疫荧光双重标记法检测健康对照、阿维A治疗前后PV患者皮损中Th1(CD3~+IFN-γ~+)、Th2(CD3~+IL-4~+)细胞的数量变化。结果:①阿维A治疗前后的PV患者皮损真皮浅层T细胞分别为(24.03±8.03)个和(15.32±5.26)个、Th1细胞分别为(15.57±6.73)个和(7.66±4.28)个,数量较健康对照组增多[T细胞(5.44±0.17)、Th1细胞(3.78±0.98)个],P<0.05;Th2细胞数量在治疗前后分别为(6.29±8.39)个和(7.46±10.28)个,与健康对照组(2.44±0.77)个相比,差异无统计学意义,P>0.05;②Th1/Th2平衡在治疗前明显偏向于Th1一方,治疗前比值为6.49±8.40,治疗后为1.86±1.75,与健康对照1.58±0.25相比差异无统计学意义;③Th1/Th2平衡比例与银屑病皮损面积和严重度指数(PASI)评分呈正相关,治疗前相关系数r=0.86,治疗后相关系数r=0.69。结论:PV患者皮损处T细胞遵循Th1型免疫应答理论:Th1/Th2平衡与PASI相关;阿维A治疗PV有效,可使PASI降低;阿维A治疗PV时可能通过干预Th1/Th2平衡而起作用。更多还原

【Abstract】 Objective: To observe the effects of acitretin on Th1 and Th2 lymphocytes in the lesions of psoriatic vulgaris (PV) patients, analyze the roles of Th1,Th2 lymphocytes and the Th1/Th2 balance in the pathogensis of PV. Methods:Immunofluorescent double staining was employed to study the quantity of CD3~+IFN-γ~+Th1 cells and CD3~+IL-4~+Th2 cells in the lesions of normal controls , pre -treatment patients and post-treatment patients. Results: The quantity of T cells and Th1 cells in superficial layer of dermis of PV patient was significantly increased (P<0.05) ,but there was no difference in number of Th2 cells between the two groups (P>0.05). The shift of Th1/Th2 balance was toward Th1 cells in the lesions of pre-treatment patients, there was no difference between post-treatment patients and normal controls. There was positive correlation between the ratio of Th1/Th2 and PASI. Conclusion:Th1 cells may contribute to pathogenesis of psoriasis. The effects of acitretin may influence Th1 cell mostly in the lesions of PV.更多还原