静止期寻常型银屑病患者的病程特点、生活质量和细胞因子谱

N. A. Gorlova, Y. Sherengovskaya, D. A. Ravlyuk, D. V. Prokhorov, M. B. Ispiryan
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摘要

目的研究处于静止期的寻常型银屑病患者的病程特点、生活质量和细胞因子谱。这项前瞻性横断面比较研究涉及 154 名处于静止期的寻常型银屑病患者;其中分为两组:83 名合并抑郁症的患者和 71 名无合并抑郁症的患者。采用汉密尔顿量表确定抑郁症状和严重程度。静止期寻常型银屑病合并抑郁症患者的特点是年龄较小(P=0.007),根据 PASI 指数(P<0.001)和视觉模拟量表(P=0.014)、复发频率更高(p=0.012)、根据 DLQI 问卷调查的生活质量水平更低(p<0.001),以及血清中 IL-6 和 IL-17 的数值更高(分别为 p=0.011 和 p=0.001)。汉密尔顿量表的平均总值与患者年龄呈反向相关(r=-0.61;p=0.002),与PASI指数(r=0.72;p=0.001)、视觉模拟量表(r=0.63;p<0.001)、DLQI(r=0.69;p=0.001)和IL-17(r=0.62;p=0.012)的平均总值呈正向相关。与没有抑郁症的患者相比,抑郁症患者的寻常型银屑病静止期更为严重,伴随着全身促炎性变化的增加和生活质量的显著下降。在选择寻常型银屑病的治疗策略时,必须考虑到所获得的结果,这将使治疗个性化并提高治疗效果。
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Features of the course of the disease, quality of life and cytokine profile in patients with psoriasis vulgaris in the stationary stage and comorbid depression
Aim. To study the characteristics of the course of the disease, quality of life and cytokine profile in patients with psoriasis vulgaris in the stationary stage and depression.Material and methods. A prospective, cross-sectional comparative study involved 154 patients with vulgar psoriasis in the stationary stage; Of these, two groups were formed: 83 patients with comorbid depression and 71 without comorbid depression. The Hamilton scale was used to determine depressive symptoms and severity.Result. Patients with psoriasis vulgaris in the stationary stage and depression were characterized by a younger age (p=0.007), a more severe course of the disease according to the PASI index (p<0.001), visual analogue scale (p=0.014), and a higher frequency of relapses (p=0.012) and a lower level of quality of life according to the DLQI questionnaire (p<0.001), as well as higher values of IL-6 and IL-17 in the blood serum (p=0.011; p=0.001, respectively). An inverse correlation was established between the average total value on the Hamilton scale and the age of the patients (r= –0.61; p=0.002), a direct one – with the average total values on the PASI index (r=0.72; p=0.001), visually analogue scale (r=0.63; p<0.001), DLQI (r=0.69; p=0.001) and IL-17 (r=0.62; p=0.012).Conclusion. In patients with depression, psoriasis vulgaris in the stationary stage is more severe, accompanied by an increase in systemic proinflammatory changes and a more significant decrease in quality of life than in patients without depression. The results obtained must be taken into account when choosing a therapeutic strategy for psoriasis vulgaris, which will personalize treatment and increase its effectiveness.
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