CAJ | 학술논문

目的：探讨银屑病患者中脂联素和瘦素水平的改变，以及甲氨蝶呤系统治疗和卡泊三醇外用治疗对脂联素和瘦素水平的影响。方法：将40例寻常型银屑病患者和40例经过年龄和性别匹配的健康志愿者（健康对照组）纳入研究。银屑病严重性评级指标采用银屑病皮损面积和严重程度指数评分。银屑病面积与严重性指数（ psoriasis area and severity index，PASI）≤10分的患者，给予卡泊三醇软膏和液态凡士林外用治疗；PASI＞10分或合并关节炎的患者，每周口服7．5 mg甲氨蝶呤治疗，并根据临床反应，4周后逐级递增至每周10 mg，8周后逐渐增加至每周15 mg。所有患者同时给予2．5 mg／d叶酸和凡士林外用治疗。对所有银屑病患者治疗前、治疗12周后及对照组人群的血浆脂联素和瘦素水平进行随访检测。结果：银屑病患者脂联素水平较对照组明显降低，瘦素水平明显高于正常对照组，差异有统计学意义（ P＜0．05）。经过12周的甲氨蝶呤和卡泊三醇软膏治疗，银屑病患者的脂联素水平较治疗前明显升高，瘦素水平较治疗前显著降低，差异有统计学意义（ P＜0．05）。结论：脂肪因子与银屑病的发病密切相关，使用甲氨蝶呤和卡泊三醇软膏治疗银屑病，可能降低代谢综合征的发生率。
목적：탐토은설병환자중지련소화수소수평적개변，이급갑안접령계통치료화잡박삼순외용치료대지련소화수소수평적영향。방법：장40례심상형은설병환자화40례경과년령화성별필배적건강지원자（건강대조조）납입연구。은설병엄중성평급지표채용은설병피손면적화엄중정도지수평분。은설병면적여엄중성지수（ psoriasis area and severity index，PASI）≤10분적환자，급여잡박삼순연고화액태범사림외용치료；PASI＞10분혹합병관절염적환자，매주구복7．5 mg갑안접령치료，병근거림상반응，4주후축급체증지매주10 mg，8주후축점증가지매주15 mg。소유환자동시급여2．5 mg／d협산화범사림외용치료。대소유은설병환자치료전、치료12주후급대조조인군적혈장지련소화수소수평진행수방검측。결과：은설병환자지련소수평교대조조명현강저，수소수평명현고우정상대조조，차이유통계학의의（ P＜0．05）。경과12주적갑안접령화잡박삼순연고치료，은설병환자적지련소수평교치료전명현승고，수소수평교치료전현저강저，차이유통계학의의（ P＜0．05）。결론：지방인자여은설병적발병밀절상관，사용갑안접령화잡박삼순연고치료은설병，가능강저대사종합정적발생솔。
OBJECTIVE:To explore the changes in levels of adiponectin and leptin in patients with psoriasis, and study the effects of methotrexate and calcipotriol for external use on adiponectin and leptin levels.METHODS: 40 patients with psoriasis vulgaris and another 40 age-and gender-matched healthy volunteers ( healthy control group) were included in the study.Psoriasis area and severity index score were applied as indexes in psoriasis severity rating.The patients with psoriasis area and severity index ( PASI ) ≤10 points were treated with calcipotriol ointment and liquid vaseline for external use, and those with PASI>10 points or with associated arthritis were administered orally with methotrexate at initial weekly dose of 7.5 mg with weekly dose increased gradually to 10 mg after 4 weeks based on clinical response and then 15 mg after 8 weeks.Moreover, all the patients were given additional concurrent folic acid (2.5 mg/d) and vaseline for external use.Plasma levels of adiponectin and leptin before treatment and after 12 weeks of treatment in all the psoriasis patients and the normal control group were detected.RESULTS: Plasma level of adiponectin was significantly reduced while plasma leptin level was significantly increased in patients with psoriasis as compared with the normal control group, and the differences between the two groups were statistically significant ( P<0.05).After 12 weeks of treatment with methotrexate and calcipotriol ointment, the level of adiponectin increased while the level of leptin decreased significantly in the patients with psoriasis, and the differences were statistically significant ( P<0.05) .CONCLUSIONS:Adipokines is closely associated with the development of psoriasis; the use of methotrexate and calcipotriol ointment in patients with psoriasis can reduce the incidence of metabolic syndrome.