度普利尤单抗治疗合并多种2型炎症疾病的疗效分析  

Efficacy of duplizumab in the treatment of multiple type 2 inflammatory diseases

作　　者：谢佳星[1,2] 林慧敏 张筱娴 张清玲[1] Xie Jiaxing;Lin Huimin;Zhang Xiaoxian;Zhang Qingling(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou Institute of Respiratory Health,National Clinical Research Center for Respiratory Disease,State Key Laboratory of Respiratory Disease,Guangzhou 510120,China;Department of Respiratory and Critical Care Medicine,Yangjiang People′s Hospital,the Affiliated Hospital of Guangdong Medical University,Yangjiang 529500,China)

机构地区：[1]广州医科大学附属第一医院呼吸与危重症医学科,广州呼吸健康研究院,国家呼吸系统疾病临床医学研究中心,呼吸疾病国家重点实验室,广州510120 [2]广东医科大学附属阳江医院(阳江市人民医院)呼吸与危重症医学科,阳江529500

出　　处：《中国医师杂志》2022年第3期350-354,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(82070026)。

摘　　要：目的分析合并多种2型炎症疾病患者加用IL-4Rα单克隆抗体(度普利尤单抗)的治疗效果。方法纳入自2020年8月开始加用度普利尤单抗治疗的6例合并多种2型炎症疾病患者,回顾性分析度普利尤单抗治疗前后的气道炎症指标、肺功能、鼻窦CT及哮喘控制问卷-5(ACQ-5)、鼻腔鼻窦结局测试-22(SNOT-22)、宾夕法尼亚大学嗅觉识别测试(UPSIT)及瘙痒数值峰值评分量表(NRS)等评分变化,所有患者度普利尤单抗治疗时间均>5个月。结果6例患者中4例同时患有重症哮喘与慢性鼻窦炎,2例患者同时患有重症哮喘、慢性鼻窦炎与特应性皮炎,6例患者治疗后肺功能均有改善,诱导痰嗜酸粒细胞、呼出气一氧化氮及总IgE水平下降(均P<0.05),鼻窦CT改善,ACQ-5、SNOT-22、UPSIT等评分均明显改善(均P<0.05),但治疗过程中3例患者出现外周血嗜酸性粒细胞增高。结论度普利尤单抗对合并多种2型炎症疾病均有疗效,无明显不良反应,治疗期间外周嗜酸性粒细胞可能增加。Objective To analyze the therapeutic effect of adding interleukin(IL)-4Ra monoclonal antibody(duplizumab)to patients with multiple types of inflammatory diseases.Methods Six patients with multiple types of inflammatory diseases who started to use duplizumab from August 2020 were enrolled.The changes of airway inflammation,lung function,sinuses computed tomography(CT),Asthma Control Questionnaire-5(ACQ-5),Si no-Nasal Outcome Test-22(SNOT-22),Pennsylvania Smell Identification Test(UPSIT)and Numerical Rating Scale(NRS)score before and after duplizumab treatment were retrospectively analyzed.All patients were treated with doprilumab for more than 5 months.Results 4 of the 6 patients had both severe asthma and chronic sinusitis,and 2 patients had both severe asthma,chronic sinusitis and atopic dermatitis.After treatment,the pulmonary function of 6 patients was improved,the levels of sputum eosinophils,exhaled nitric oxide and total IgE were decreased(all P<0.05),and the scores of paranasal sinus CT,ACQ-5,SNOT-22 and UPSIT were significantly improved(all P<0.05).However,3 patients had increased peripheral blood eosinophils during the treatment.Conclusions Duplizumab is effective for a variety of type 2 inflammatory diseases without obvious adverse reactions,and the peripheral eosinophils may increase during the treatment.

关 键 词：哮喘 皮炎 特应性 鼻窦炎 2型炎症 度普利尤单抗 

分 类 号：R979.5[医药卫生—药品]