CAJ | 학술논문

目的：分析云南地区慢性光化性皮炎（ chronic actinic dermatitis CAD）患者最小红斑量和光斑贴试验的情况，探讨IL-6、TNF-α与CAD发病的相关性。方法采用SUV 1000型日光模拟器对21例CAD患者和40例正常对照者进行最小红斑量的测定。采用SS-03AB型紫外线光疗仪和标准光斑贴试验试剂盒对21例CAD患者和21例正常对照者进行光斑贴试验（光源：UVA 5J／cm2）。采用酶联免疫吸附法检测CAD患者、正常对照者血清中IL-6、 TNF-α的含量。结果① CAD患者的UVA-MED、UVB-MED较正常人对照组明显降低（P＜0.05）。且CAD患者的MED值与皮肤类型无关（P＞0.05），正常对照组的MED值与皮肤类型、性别均无关（ P＞0.05）；②CAD患者、正常人中光斑贴试验阳性率分别为57.1％，47.6％。 CAD患者最常见的光变应原依次为芳香混合物、D-松萝酸、木材合成物；正常人最常见的光变应原依次为芳香混合物、D-松萝酸、秘鲁香脂；③ IL-6在CAD患者组的含量低于正常人对照组（ P＜0.05）。 TNF-α在两组中的差异无统计学意义（ P＞0.05）。结论最小红斑量的测定提示CAD的发病与UVA、UVB的照射有关，其中UVA更为敏感；CAD患者及正常人对照组都对多种（光）接触性变应原呈阳性反应；CAD的发病可能和IL-6的降低有一定的关系。
목적：분석운남지구만성광화성피염（ chronic actinic dermatitis CAD）환자최소홍반량화광반첩시험적정황，탐토IL-6、TNF-α여CAD발병적상관성。방법채용SUV 1000형일광모의기대21례CAD환자화40례정상대조자진행최소홍반량적측정。채용SS-03AB형자외선광료의화표준광반첩시험시제합대21례CAD환자화21례정상대조자진행광반첩시험（광원：UVA 5J／cm2）。채용매련면역흡부법검측CAD환자、정상대조자혈청중IL-6、 TNF-α적함량。결과① CAD환자적UVA-MED、UVB-MED교정상인대조조명현강저（P＜0.05）。차CAD환자적MED치여피부류형무관（P＞0.05），정상대조조적MED치여피부류형、성별균무관（ P＞0.05）；②CAD환자、정상인중광반첩시험양성솔분별위57.1％，47.6％。 CAD환자최상견적광변응원의차위방향혼합물、D-송라산、목재합성물；정상인최상견적광변응원의차위방향혼합물、D-송라산、비로향지；③ IL-6재CAD환자조적함량저우정상인대조조（ P＜0.05）。 TNF-α재량조중적차이무통계학의의（ P＞0.05）。결론최소홍반량적측정제시CAD적발병여UVA、UVB적조사유관，기중UVA경위민감；CAD환자급정상인대조조도대다충（광）접촉성변응원정양성반응；CAD적발병가능화IL-6적강저유일정적관계。
Objective To analyze the role of the minimal erythema dose and photopatch test in the pathogene-sis of chronic actinic dermatitis ( CAD) and to investigate the expression of IL-6 and TNF-αin the patient with CAD.Methods The minimal erythema dose ( MED) of 21 patients with CAD and 40 normal controls were measured by SUV 1000 type ultraviolet simulator.Photopatch test was performed on 21 patients with CAD and 21 normal con-trols by standard photopatch test kit, then they were irradiated by SS-03AB type ultraviolet phototherapy instrument. The ultraviolet A ( 5J/cm2 ) was used as the source of irradiation.The serum levels of IL-6 and TNF-αof patients with CAD and normal controls were tested by ELISA.Results The UVA-MED and UVB-MED of patients with CAD were significantly less than that of normal controls ( P<0.05) .The MED of patients with CAD between men and women were not significant differences, also in normal control ( P>0.05) .The photopatch test results have shown that the positive rates were 57.1%and 47.6%in the patients with CAD and the normal controls respectively.The most common photo allergens of patients with CAD were fragrance mixture, D-usnic acid and wood composites.The fra-grance mixture, D-usnic acid and balsam of Peru were the most common photo-allergens in the normal controls, The serum level of IL-6 in CAD group was significantly decreased than that of the control group( P<0.05) .The level of <br> TNF-αwere no significant differences between the patient and normal controls ( P>0.05) .Conclusion The ultravio-let A and ultraviolet B radiation may play an important role in the pathogenesis of CAD, which is more sensitive to UVA.The photopatch test results have shown that positive reactions for a variety of allergens in CAD patients and healthy controls.The lower level of IL-6 may play a role in the pathogenesis of CAD.