儿童银屑病药物治疗meta分析  

A meta-analysis of medical treatment for psoriasis in children

作　　者：陈畅 徐媛媛[1] 耿龙(指导)[1] CHEN Chang;XU Yuan-Yuan;GENG Long(The First Hospital of China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属第一医院,沈阳110000

出　　处：《中国免疫学杂志》2021年第9期1100-1106,1112,共8页Chinese Journal of Immunology

基　　金：国家自然科学基金(No.81673055)项目。

摘　　要：目的:通过meta分析,评价不同治疗方案对儿童中重度银屑病治疗的有效性和安全性。方法:在数据库中检索不同治疗方案治疗儿童银屑病的随机对照试验,纳入符合标准的数据,对其进行meta分析。结果:共有6个随机对照试验符合meta分析的标准,其中依那西普组的疗效与甲氨蝶呤组相比存在显著性差异。阿达木单抗0.8 mg/kg组的疗效优于阿达木单抗0.4 mg/kg组和甲氨蝶呤组,差异有统计学意义;应用0.4 mg/kg阿达木单抗组与应用甲氨蝶呤组的疗效差异无统计学意义。阿维A与环孢素联合用药组的疗效与环孢素治疗组相比存在显著性差异,而两组的复发率差异无统计学意义。结论:与甲氨蝶呤相比,依那西普、阿达木单抗在治疗儿童银屑病上具有一定的优势和较高的安全性。而对于常规药物治疗无效的重度银屑病,阿维A与环孢素两种药物联合应用具有较好的疗效。Objective:To evaluate the efficacy and safety of different treatment for moderate and severe psoriasis in children by meta-analysis of randomized clinical trials.Methods:A meta analysis was performed by searching the database for randomized controlled trial of children with psoriasis treated with different regimens and incorporating data that met the criteria.Results:A total of 6 randomized controlled trials meet the criteria of meta-analysis.Among them,the efficacy of etanercept group was significantly different from that of methotrexate group.The efficacy of adalimumab 0.8 mg/kg group was better than that of adalimumab 0.4 mg/kg group and methotrexate group,the difference was statistically significant.There is no statistically significant difference in the efficacy of the0.4 mg/kg adalimumab group and methotrexate group.Compared with the cyclosporine treatment group,the curative effect of the combination of Acitretin A and cyclosporine was significantly different,while the difference in the recurrence rate between the two groups was not statistically significant.Conclusion:Compared with methotrexate,etanercept and adalimumab have certain advantages and higher safety in the treatment of psoriasis in children.For severe psoriasis that was ineffective in conventional drug treatment,the combination of Acitretin A and cyclosporine has a satisfactory effect.

关 键 词：儿童银屑病 治疗 安全性 疗效 

分 类 号：R751[医药卫生—皮肤病学与性病学]