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目的探讨代谢综合征(MS)是否影响寻常性银屑病的疗效及其机制。方法 72例银屑病患者均接受窄谱中波紫外线(NB-UVB)照射,同时外用卡泊三醇软膏及卤米松软膏治疗,共12周,其中伴MS组34例。采用银屑病皮损面积及严重度指数(PASI)评分判断疗效,酶联免疫吸咐试验(ELISA)检测治疗前后患者血清白细胞介素(IL)-17水平的变化。结果经过12周治疗,伴MS组有效率为53%,不伴MS组有效率为82%;不伴有MS的银屑病患者血清IL-17水平与治疗前相比明显下降,差异具有统计学意义(P<0.05);伴有MS的银屑病患者血清中IL-17无明显变化(P>0.05)。结论伴有MS的寻常性银屑病患者接受治疗的疗效比不伴有MS的银屑病患者差,其机制可能是代谢综合征通过持久维持系统性炎症从而影响临床疗效。
Objective To investigate whether the metabolic syndrome (MS) affects the efficacy and mechanism of psoriasis vulgaris. Methods Seventy-two patients with psoriasis were treated with narrow-band ultraviolet B (NB-UVB) irradiation and external use of calcipotriol ointment and halometasone ointment for 12 weeks, including 34 with MS. The effect of psoriasis lesions area and severity index (PASI) score was evaluated. The level of serum interleukin (IL) -17 in patients before and after treatment was detected by enzyme linked immunosorbent assay (ELISA). Results After 12 weeks treatment, the effective rate was 53% in MS group and 82% in non-MS group. The level of serum IL-17 in patients with psoriasis without MS was significantly lower than that before treatment, and the difference was statistically significant (P <0.05). There was no significant change in serum IL-17 in patients with MS accompanied with psoriasis (P> 0.05). Conclusions Patients with psoriasis vulgaris who have MS are less likely to receive treatment than those without psoriasis. This may be due to the metabolic syndrome that affects the clinical outcome by sustaining systemic inflammation.