銀屑病(牛皮癬)的病因

郑州牛皮癣医院

本病的病因尚不完全明確，近年來大多數學者認為與遺傳，感染，代謝的障礙，免疫功能障礙，內分泌障礙等有關。

1.遺傳

根據臨床所見，本病常有傢族史，並有遺傳傾向。國外曾報告有傢族史者30%--50%，甚至有個別人強調達100%。國內報道有傢族史者為10%～20%左右，關於遺傳方式，有人認為系常染色體顯性遺傳，伴有不完全外顯率，亦有人認為系常染色體隱性遺傳或性聯遺傳者。雙親之一患銀屑病，其後裔發病率較健康者子女高3倍之多，若雙親皆患銀屑病，其後裔發病率更高。

近年來發現組織相容抗原(hla)與銀屑病明顯相關性。國外報道銀屑病患者hla-b13、hla-b17的抗原頻率明顯增高，但亦有報道銀屑病患者hla-b3、hla-ct7、hla-w6增高者。我國銀屑病患者除hla-b13、hla-b17抗原比正常組明顯增高外，而hla-dr7、hla-a19、基因頻率也增高。hla-bw35、hla-dr9、hla-c7、郑州牛皮癣医院哪家最专业hla-dq基因頻率降低。目前認為銀屑病受多基因的控制，同時也受環境因素的影響。

2.感染

臨床實踐證明銀屑病的發病與上呼吸道感染和扁桃腺炎有關。有6%的銀屑病患者有咽部感染史。我們發現很多兒童的銀屑病與扁桃腺炎有密切關系。例如有一位母親和她的三個孩子同時患急性扁桃腺炎，病情控制後，有三個人發生瞭銀屑病。這種病人用抗菌素治療有效。摘除扁桃腺後，皮疹可有明顯好轉或消退，說明感染是銀屑病發病的一個重要因素。

有的學者認為本病的發病與病毒感染有關。有人證實在棘細胞內有嗜酸性包涵體，但也有人否認其存在。有人在逐鼠身上進行接種，有類似本病的皮損出現，並在其組織切片中發現包涵體。但其發病率僅占7.5%，有人在雞胚胎上進行實驗接種，其成功率為86.7%，本病細胞核郑州治疗牛皮癣的专科医院分裂旺盛。脫氧核糖核酸(dna)增多，因此病毒學說似有一定根據，但至今尚未能培養出病毒。

最近國內劉正玉等人研究人巨細胞病毒(hcmv)感染與銀屑病發病之間的關系，檢測瞭86例銀屑病患者血清 hcmv特異性抗體igm、iga和尿hcmv-dna陽性率。結果顯示，銀屑病患者hcmv活動性感染率明顯高於對照組，且病人尿中hcmv-dna陽性率也明顯高於對照組，說明銀屑病患者體內郑州哪家医院治银屑病存在著活動性hcmv感染，其發病與hcmv活化有一定關系。

3.代謝障礙

對銀屑病血液化學，皮膚組織化學和皮膚病理生理的研究，未能獲得有意的成果。過去有人認為銀屑病的發病與脂類代謝紊亂有關。目前關於本病的病因已不能認為由類脂質代謝紊亂引起的。而多從酶代謝的改變來進行研究。在正常人的表皮內有四種酶，而在銀屑病患者的皮損內則缺少其中二種，皮損治愈後，其中兩種酶又重新出現。已知銀屑病的皮損內缺乏環磷腺甘(camp)這是一種表皮抑素(epidermal chalone)可抑制表皮細胞分裂，保持細胞生長和消失之間的平衡。另一方面camp有激活磷酸化酶的作用，因而也影響糖原的代謝。如表皮糖原增多，可引起表皮細胞有絲分裂增加，轉換率增快。但是銀屑病的代謝異常是多方面的，並非僅有camp缺乏，而在皮損表面內環磷烏苷(cgmp)，遊離花生四烯酸，多胺類等增加對表皮細胞增殖也起重要作用。

但值得提出的是有的學者認為在決定表皮細胞增殖和分化中，camp與cgmp的比例非常重要，銀屑病患者表皮細胞的增殖，分化不全和糖原積蓄的原因是由於低camp和高cgmp，但未被完全證實。

此外腺苷環化酶的活性在銀屑病中表現異常，腎上腺素對此酶的刺激反應很低，但對前列腺素e2反應較高，因此銀屑病的表皮細胞膜β-腎上腺素能受體活性是降低的。而前列腺素在調節環核苷酸也起重要作用。環核苷酸對細胞的增生反應是直接對細胞高分子物質的合成發生調節作用。也就是camp直接調節dna的合成，所以camp對細胞分裂和酶的生成發生直接作用。

4.免疫功能障礙

銀屑病與免疫的關系一直受到廣泛重視。臨床上用免疫抑制劑，常用的有氨甲喋呤(mtx)，乙亞胺環孢素a等治療本病效果顯著。銀屑病患者存在多種局部或系統性免疫功能異常，本病與hlab13、b17等抗原表達高度相關等均提示本病也是一種免疫性疾病。目前關於本病的免疫發病機理尚未完全清楚。比較流行的看法是，銀屑病是由活化的t細胞引起的表皮細胞增生性疾病。銀屑病皮損的真皮層有活化的t細胞浸潤，這些細胞釋放γ-幹擾素，誘導表皮細胞合成腫瘤壞死因子和白細胞介素8，白細胞介素6細胞因子等，吸引中性粒細胞在表皮浸潤，導致真皮血管擴張，引起皮膚炎癥。此外單核細胞和表皮細胞釋放的白細胞介素6 和白細胞介素8等還是促進表皮細胞的增生。由此使銀屑皮損形成瞭表皮異常增生和皮膚炎癥共存的病理特征。關於銀屑病皮損t細胞活化的始動因素，還有待進一步研究。可能與感染、外傷、神經精神因素等有關。

5.內分泌障礙

銀屑病與激素的關系，早已受到人們的重視。本病與妊娠，分娩，哺乳期，月經期有關。我們在臨床上觀察到，部分銀屑病患者在妊娠期皮疹減輕或消退。chuzch曾觀察43例，在妊娠期間38%患者皮損消退；國內劉承煌等報道169例銀屑病患者中6.2%患者與內分泌有關，有5例在妊娠時皮損痊愈或減輕，但產後加劇。徐顏春等報道，測定19例12--45歲女性銀屑病患者血漿的雌二醇水平，明顯高於正常對照組，而血漿孕酮水平明顯低於正常對照組。因此他們認為血漿雌二醇水平的增高及孕酮水平的降低可能促發或加重12--45歲女性屑病患者的皮損。但是有的婦女在妊娠皮損加劇或惡化，因此也有的使用長效避孕藥治療本病獲得一定療效的報道。綜上所述，可見本病與內分泌的變化有一定關系。

6.其他

如精神的創傷，外傷或手術，潮濕，血液流變學的改變，以及理化因素及藥物刺激等，對銀屑病患者的發病也有一定關系。

郑州牛皮癣医院

This ill pathogeny still not complete bright Chu , in recent years mostly person of Zuo of Zha Ning , infection, the barrier Dai of acting Zheng , Dai of immune function barrier, secretes barrier Dai to wait have Zuo .

1. Zuo

Yao of place of bed of root Ning , this disease often has a group of things with common features history, has Zuo to. Outside ever is accused have a group of things with common features history person 30%- - 50% , have Zuo of Zha of of person even 100% . Path of has a group of things with common features history person 10% ～ of 20% the left and right sides, Zuo at Zuo means, Zha fastens somebody of Zuo of sex of Zuo of constant coloring Zuo , companion has not complete outside Zuo rate, also Zha fastens somebody of Zuo of sex of Zuo of constant coloring Zuo or of sexual Long Zuo person. One of Zuo Yin contract Zuo bits disease, children of the person that disease of its descendant leads Zuo health is 3 times taller, if Zuo Yin all contracts Zuo bits disease, rate of defect of its descendant is higher.

In recent years photograph of Jun of Jian of allows antigen (sex of Zuo of photograph of bright Zuo of disease of bits of Hla) Ning Zuo . The antigen Zuo of Hla-b13 of ill patient of bits of Zuo of path of the outside , Hla-b17 leads bright Zuo heighten, but the person that also have raise of Hla-b3 of ill patient of bits of path Zuo , Hla-ct7, Hla-w6. Ill patient of bits of my Zuo compares normal Jian except antigen of Hla-b13, Hla-b17 outside bright Zuo heighten, and Zuo of Hla-dr7, Hla-a19, gene is led also heighten. Rate of Zuo of gene of Hla-bw35, Hla-dr9, Hla-c7, Hla-dq is reduced. At present disease of bits of Zha Zuo郑州治疗牛皮癣最好医院 gets the control of polygene, also suffer the shadow Zuo of condition element with .

2. infection

The infection of the upper respiratory tract of disease of bits of bright Zuo of Zhu 郑州哪家医院治银屑病最好of Zuo of Ning bed and quinsy have Zuo . The Zuo bits ill patient that has 6% has pharynx ministry to affect history. of my is very much quinsy has the Zuo bits ill Ning of child close Zuo is. The 3 child that has Yin of a mother and her for example suffers from acute quinsy with , the illness controls after, of 3 person falls ill Bing Zuo bits. Zuo Er patient treats with antibiotic effective. Excise amygdala after, rash can have bright Zuo good Zuo or subsidise, the one main factor that Zha bright infection is disease of Zuo bits ill .

Some person the infection of virus of ill Ning of this Zha disease has Zuo . Somebody Zhu has Zuo of excuse of acidity of be addicted to in of spine Ji afterbirth, but also somebody denies Zha its existence. Somebody receives Er all right in the Zuo on the body that chase rat, Zuo is like this ill skin to give , bears with in of the in section of its Jian Jun Zuo . But its disease leads to occupy 7.5% , somebody receives Er in Zuo of of travel of the Zuo on Zuo embryo, its lead successfully 86.7% , dissension of this nucleus of 郑州哪家牛皮癣医院好ill Ji afterbirth is exuberant. Man oxygen ribonucleic acid (Dna) grow in quantity, because Zha of this virus is like,have certain root , but still fail to earth up Zuo to give virus up to now.

of of the closest the virus of afterbirth of gigantic Ji of person research person such as jade (the Zuo of the Zuo of disease of ill of bits of Zuo of Hcmv) infection Ning is, Bing Hcmv of serum of ill patient of 86 Zuo bits is special sex fights Zuo Igm, Iga and make water rate of Hcmv-dna Zuo sex. Jian fruit Zuo is shown, sex appeal of vivid of Hcmv of Zuo bits ill patient is caught lead bright Zuo to illuminate Jian high at , and sex of Zuo of the Hcmv-dna in patient make water is led also bright Zuo illumi郑州牛皮癣医院nates Jian high at , existence of of Zuo of ill patient of bits of Zha bright Zuo writes Hcmv of vivid sex to affect, activation of Hcmv of its ill Ning has certain Zuo department.

Dai of barrier of 3. acting Zheng

Zuo bits is ill sanguification , Jun of leather Mo Jian changes the research of and physiology of leather Mo pathology, fail gets intended positive result. Zuo goes somebody of acting Zheng confused has the Zuo of fat of ill Ning of disease of bits of Zha Zuo Zuo . Zuo Wu Ben's at present ill pathogeny already cannot Zha causes by of confused of acting Zheng of Zuo fat Zuo . And the Zuo of changing Zhu of enzymatic acting Zheng studies much all right. There are 4 Er in the cuticular of normal person enzymatic, and the of leather in Zuo bits ill patient is lacked among them 2 Er , leather cures after, among them Er is enzymatic give afresh again. The leather of disease of foregone Zuo bits lacks pleasant of phosphor gland (Camp) Zuo is element of curb of one Er skin (Epidermal Chalone) can restrain cuticular Ji afterbirth to break up, maintain Ji afterbirth to give birth to the balance of Zuo and the Zuo that disappear. On the other hand Camp has the effect with activation enzymatic phosphation, consequently also the acting Zheng of shadow Zuo glycogen. Be like cuticular glycogen grow in quantity, can cause cuticular Ji afterbirth to Jian dissension increases, Zuo rate is added fast. But 郑州牛皮癣医院哪家最专业the acting Zheng of Zuo bits disease often is many sided, is not to have Camp lack, and in glucoside of of phosphor of of of leather surface (Cgmp) , Zuo Zuo earthnut 4 Xi are acerbity, much amine Zuo increase hyperplasia of afterbirth of cuticular Ji to also have main effect.

But those who be worth to put forward is some person Zha decides hyperplasia of cuticular Ji afterbirth and become divided in in, the proportion of Camp Ning Cgmp is very significant, the hyperplasia of afterbirth of Ji of skin of Zuo bits ill patient, differentiation is not mixed completely the reason of glycogen Er harbour is by Wu Di Camp and tall Cgmp, but not by complete Z郑州哪里治牛皮癣好hu .

In addition adenosine changes enzymatic active to express in Zuo bits disease constant, this enzymatic stimulation turns over of element of the gland on Mo is very low, but E2 of prostate element turns over Zuo tall, the β of film of cuticular Ji afterbirth with Zuo accordingly ill bits - element of the gland on Mo can suffer Zuo active is reduced. And prostate element also has main effect in acid of nucleotide of Zha Geng . The hyperplasia of afterbirth of Ji of nucleotide acerbity turns over is high polymer of afterbirth of direct Ji the synthetic of content Zuo gives birth to Zha Geng action. Namely the synthesis of Dna of Geng of Camp direct Zha , so afterbirth of Camp Ji breaks up and generate enzymaticly to give birth to immediate effect.

Dai of barrier of 4. immunity function

The Zuo department of immunity of Zuo bits ill Ning is weighed Yao all the time by extensive. is restrained with immunity on Ning bed, ling of commonly used Die of armour having ammonia (Mtx) , a of element of Bao of of second amine treat this ill effect Zuo is written. Much Er of existence of Zuo bits ill patient local or of function of immunity of the sex that fasten Jian constant, the antigen such as this ill Ning Hlab13, B17 expresses Zuo of Zuo height photograph to wait to all hint this disease also is disease of one Er immunity. Manage of Zuo Wu Ben's at present ill of immune disease has not be clear about completely. More popular than Zuo view is, Zuo bits disease is the proliferation of cuticular Ji afterbirth that causes by the T Ji afterbirth of activation sexual disease. The of dip of T Ji afterbirth that the dermal of of Zuo bits ill skin has activation, Zuo some Ji afterbirth Zuo puts γ - element, dead factor of of tumour of Mo of synthesis of afterbirth of Zha cuticular Ji and element of interpose of white Ji afterbirth 8, element of interpose of white Ji afterbirth factor of 6 Ji afterbirth, attract afterbirth of neuter bead Ji to be in cuticular dip , sends of dermal and hemal , cause leather Mo phlogistic . In addition the element of interpose of white Ji afterbirth that afterbirth of nucleus Ji and Zuo of cuticular Ji afterbirth put 6 with element of interpose of white Ji afterbirth the 8 hyperplasia that waiting for Zuo is afterbirth of hurried Zuo cuticular Ji . The pathology feature that makes of Zuo bits skin forms phlogistic of constant hyperplasia of Bing cuticular and leather Mo to coexist from this. Zuo at activation of afterbirth of Ji of T of of Zuo bits ill skin only then element, Zuo remains one pace of Zuo studies. Likelihood Ning infection, outside element of spirit of Jian of , god have Zuo .

5. secretes barrier Dai

The Zuo of hormone of Zuo bits ill Ning is, get already the heavy Yao of person . This ill Ning is gravid, childbirth, lactation, month Jian period has Zuo . My arrives in examine of the Yin on Ning bed, ill patient of partial Zuo bits is in Zuo of gestation rash or subsidise. Chuzch ever Yin examine 43, in gestation Zuo subsidise of of 38% patients skin; bear the such as brilliant of Ning of the 6.2% patients in ill patient of 169 Zuo bits is secreted have Zuo , 5 are in heal of of gravid skin or Zuo , but after adds . Xu Zuo spring path waiting for , decides 19 12- - of郑州哪里治疗牛皮癣最好 of blood of ill patient of bits of Zuo of 45 female female 2 mellow levels, bright Zuo illuminates Jian high at normal , and level of hematic progesterone bright Zuo is low Wu Zhengchang illuminates Jian . Because of blood of of this his Zha is female,the heighten of 2 mellow levels reachs progesterone level reduce a likelihood hurried or accentuation 12- - the leather of ill patient of bits of 45 female. But some female in gravid skin adds or is changed, accordingly also some uses Zuo effect contraceptive Shu to treat the way that this ill gets certain effect. The place on Jin is narrated, but excretive Zhu of this ill Ning changes Yao having certain Zuo is.

6. is other

Be like of spirit, outside or hand Xiao , wet , of of hematic current Zhu change Zhu , and manage changes element and Shu content stimulation to wait, the disease of ill patient of Zuo bits also has certain Zuo department.

郑州牛皮癣医院

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