| BackgroundPsoriasis is a common chronic relapsing inflammatory skin disease with typical skin lesions is scales erythema and the exact cause is not yet clear.Treatment mainly with medications, topical medications and photo therapy. oral drugs contain tretinoin, ciclosporin, methotrexate, tripterygium wilfordii and New immunosuppressant which including pimecrolimus, tacrolimus,mycophenolate mofetil, etc. tretinoin is the advent of the second revolution of skin diseases.Acitretin and vitamin A are homologous.Drugs such as tretinoin and tretinoin receptors combined in the skin to adjust the excessive proliferation and differentiation of cells and inhibit local inflammatory response.tretinoin is mainly used for dyskeratosis and hyperkeratosis of the disease.tretinoin is suitable for the psoriasis vulgaris, pityriasis pilaris, lichen planus, Eczema of eczema and verruca,etc.Acitretin is a second generation drugs of tretinoin.Studies have shown that Acitretin Capsules is the first selection medicaments on treatment of severe psoriasis vulgaris,psoriasis pustulosa,psoriasis arthropathica and erythroderma psoriaticum. Acitretin has obtained the good effect in the clinical treatment of patients with psoriasis, but it can lead to increased blood lipid in clinical application. Lipid contains some projects mainly include triglycerides(TG),cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apolipoprotein A(Apo A),apolipoprotein B(Apo B) and lipoprotein A(LPa).The rise of TC, TG, LDL- C can cause blood microcirculation and hemodynamics change.It promote the formation of atherosclerosis and subsequent cardiovascular events.Abroad study attempted to Acitretincan make the blood fat of TC, TG, LDL- C rise except HDL- C.Not influence on blood lipid in specific indicators in the domestic research for statistical analysis.ObjectiveWhich index of the blood lipid increased significantly with Acitretin Capsules in the process of treatment of psoriasis? Is it dose-dependent on elevated blood lipid?The impact of the change of blood with lipid-lowering drug taking at the same time.The influence of Acitretin elevated blood lipids.The relationship between elevated blood lipid and cardiovascular events. Carried out A statistical analysis on the blood lipids in patients with psoriasis who have taken Acitretin as treatment.Aimed to explore influence on blood lipid about Acitretin Capsules and provide better theoretical basis for clinical treatment.Material and methods1.Collected patients with psoriasis who in the hospital of zheng zhou university dermatologist from January 2012 to January 2015. 2.Homemade questionnaires for patients with psoriasis and the general data, laboratory examination and treatment of data were collected. 3.Patients are grouped according to taking Acitretin Capsules or not,Acitretin Capsules dose,taking lipid-lowering medications or not, liver and kidney function is normal or not, age,sex,smoking,drinking,Blood glucose levels,the length of the course of the disease and weight. 4.Statistics analysis: All the statistical analyses were performed by the SPSS 17.0 software and all the data are expressed with X ±S. Two sets of quantitative data was carried by t test. The comparisons between groups were carried by ANOVA.Two variables correlation measured by correlation analysis,correlation coefficient r.The inspection level is α=0.05.Results1. There are 1240 cases of patients with psoriasis in the first affiliated hospital of zhengzhou university dermatologist hospital from January 2012 to January 2015, 411 people were taken acitretin as therapeutic drugs and including 43 people were reviewed of blood lipids 2.Compared with before treatment TC,TG and LDL-C were increased after the treatment of acitretin with statistically significant(P<0.05,r>0), The rise of TG than normal ceiling and the changes of TC and LDL-C within the normal range.There were no changes in HDL-C(P>0.05). 3.Compared with the control group TC,TG and LDL-C were increased after the treatment of acitretin with statistically significant(P<0.05,r>0), The rise of TG than normal ceiling and the changes of TC and LDL-C within the normal range.There were no changes in HDL-C(P>0.05). 4. It has statistical significance that blood lipids increases with acitretin dose(P<0.05). 5.TC,LDL-C,HDL-C were decreased and TG was increased when acitretin and lipid-lowering drugs were taken at the same time. 6.TG will rise and more than normal ceiling after taking acitretin No matter which one is high among TC,TG,LDL and HDL-C. 7.The influence factors of blood lipids elevated after taking acitretin. age and kidney function have an impact on lipid existence, Gender,smoking,alcohol consumption,blood glucose course of length and weight has no influence to lipid.Conclusions1.Psoriasis patients blood lipid of TC, TG, LDL- C rise and HDL- C lower after acitretin treatment, mainly have an effect on TG.2.A dose dependent effects of blood lipid in patients of psoriasis with acitretin treatment, effect on blood lipid dose of 10 mg/d significantly less than 20 mg/d dose. 3. For acitretin treatment should be at the same time taking lipid-lowering medication for patients of psoriasis combined with hyperlipidemia. 3.A risk factor for elevated blood lipids of patients with psoriasis who taking acitretin is the elderly and the liver and kidney dysfunction. |
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