他克莫司软膏外涂联合度普利尤单抗治疗特应性皮炎的临床效果  

Clinical effect of external application of tacrolimus ointment combined with dupilumab on atopic dermatitis

作　　者：冯华 陈自学 唐娟 FENG Hua;CHEN Zi-xue;TANG Juan(Department of Dermatology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan,CHINA)

机构地区：[1]郑州大学附属郑州中心医院皮肤科,河南郑州450007

出　　处：《海南医学》2024年第11期1617-1622,共6页Hainan Medical Journal

基　　金：河南省郑州市科技攻关发展项目(编号:141PPTGG310)。

摘　　要：目的探究他克莫司软膏外涂联合度普利尤单抗治疗特应性皮炎(AD)患者的临床效果。方法选取2021年1月至2023年1月于郑州大学附属郑州中心医院接受治疗的98例AD患者作为研究对象,按随机数表法以1:1比例分为对照组和研究组,每组49例。对照组患者采用他克莫司软膏治疗,研究组患者在对照组治疗的基础上予以度普利尤单抗皮下注射治疗,疗程16周。比较两组患者治疗期间不同时间段的美观评分,以及治疗前、治疗16周后的特应性皮炎积分指数(SCORAD)评分、血液指标[免疫球蛋白E(lgE)、嗜酸性粒细胞(EOS)百分率、EOS绝对值]水平;比较两组患者治疗期间的用药不良反应发生情况;随访3个月,比较两组患者的复发情况。结果治疗4周、8周、16周后,研究组患者的美观评分分别为(1.15±0.43)分、(0.68±0.26)分、(0.21±0.09)分,明显低于对照组的(1.42±0.52)分、(1.01±0.34)分、(0.45±0.16)分,差异均有统计学意义(P<0.05);治疗16周后,两组患者的SCORAD评分(皮损严重程度、皮肤病变范围、瘙痒和睡眠、总体评分)、lgE、EOS百分比及EOS绝对值均低于治疗前,且研究组患者的上述各项指标明显低于对照组,差异有统计学意义(P<0.05);用药期间,研究组患者的用药不良反应总发生率为10.20%,略高于对照组的6.12%,但差异无统计学意义(P>0.05);随访3个月后,研究组患者的复发率为6.12%,明显低于对照组的20.41%,差异有统计学意义(P<0.05)。结论他克莫司软膏联合度普利尤单抗治疗AD患者可显著提高美肤效果,降低lgE及EOS水平,安全性高,有较好的应用价值。Objective To explore the clinical effect of external application of tacrolimus ointment combined with dupilumab in the treatment of patients with atopic dermatitis(AD).Methods Ninety-eight AD patients who received treatment at Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to January 2023 were selected as the study subjects.They were randomly divided into a control group and a study group in a 1:1 ratio using a random number table method,with 49 patients in each group.Patients in the control group were treated with tacrolimus ointment,while those in the study group were given subcutaneous injection of dupilumab on the basis of the treatment in the control group,for 16 weeks.The aesthetic score at different time points during treatment,scoring atopic dermatitis index(SCORAD)scores,and levels of blood indicators[immunoglobulin E(lgE),percentage of eosinophils(EOS),absolute value of EOS]before treatment and after 16 weeks of treatment,occurrence of adverse reactions during treatment and recurrence after 3 months of follow-up were compared between the two groups.Results After 4 weeks,8 weeks,and 16 weeks of treatment,the aesthetic scores were(1.15±0.43)points,(0.68±0.26)points,and(0.21±0.09)points in the study group,significantly lower than(1.42±0.52)points,(1.01±0.34)points,and(0.45±0.16)points in the control group(P<0.05).After 16 weeks of treatment,the SCORAD scores(severity of skin lesions,extent of skin lesions,itching and sleep,overall score),lgE,percentage of EOS,and absolute value of EOS in the two groups were significantly lower than those before treatment,and the above indicators in the study group were significantly lower than those in the control group,with statistically significant differences(P<0.05).During medication,the total incidence rate of adverse reactions in the study group was 10.20%,which was slightly higher than 6.12% in the control group(P>0.05).After 3 months of follow-up,the recurrence rate was 6.12% in study group,significantly lower than 20.41% in t

关 键 词：特应性皮炎 他克莫司 度普利尤单抗 美肤效果 

分 类 号：R751.05[医药卫生—皮肤病学与性病学]