依奇珠单抗治疗中重度斑块型银屑病疗效观察  

Observation on the therapeutic effect of Ixekizumab in the treatment of moderate to severe plaque psoriasis

作　　者：林明慧 蔡长斌[1] 林苑云 张素雅[1] 陈丽香[1] LIN Minghui;CAI Changbin;LIN Yuanyun;ZHANG Suya;CHEN Lixiang(Department of Dermatology,First Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院皮肤科,福建厦门361000

出　　处：《广州医药》2024年第10期1129-1133,共5页Guangzhou Medical Journal

摘　　要：目的探讨依奇珠单抗对中重度斑块型银屑病的治疗效果。方法选取厦门大学附属第一医院2022年1月—2023年8月收治的75例中重度斑块型银屑病患者,应用抽签法进行分组,分为试验组(n=35)与对照组(n=40)。对照组采取常规外用药物治疗,试验组采取依奇珠单抗治疗。对比两组临床疗效,治疗前后外周血调节性T细胞(Treg)和辅助性T细胞17(Th17/Treg)细胞水平变化,并对所有患者进行6个月门诊复查随访,对比复发率及不良反应。结果试验组总有效率88.57%,高于对照组的67.50%(χ^(2)=4.730,P=0.028);治疗后两组患者Treg细胞升高,试验组(5.59±1.24)%高于对照组(4.12±1.13)%,对比差异有统计学意义(t=5.371,P<0.001),Th17细胞、Th17/Treg细胞降低,试验组[(1.06±0.14)%、0.19±0.05]低于对照组[(1.71±0.28)%、0.42±0.14],对比差异有统计学意义(t=12.434、9.212,P<0.001);试验组停药后6个月复发率低于对照组(5.71%vs 27.50%,χ^(2)=6.180,P=0.013);试验组不良反应发生率略高于对照组,组间对比差异无统计学意义(14.29%vs 5.00%,χ^(2)=1.900,P=0.168)。结论依奇珠单抗治疗中重度斑块型银屑病疗效显著,可调节Th17/Treg平衡,降低停药后复发率,且安全性较高。Objective To explore the therapeutic effect of Ixekizumab on moderate to severe plaque psoriasis.Methods Seventy-five patients with moderate to severe plaque psoriasis who were admitted to the First Affiliated Hospital of Xiamen University from January 2022 to August 2023 were selected and allocated by lottery into an experimental group(n=35)and a control group(n=40).The control group received routine external medication while the experimental group received Ixekizumab treatment.The clinical efficacy of two groups,changes in Th17/Treg cell values before and after treatment were compared,and a 6-month outpatient follow-up for all patients was conducted to compare recurrence rates and incidence of adverse reactions.Results The total response rate in the experimental group was 88.57%,which was higher than the 67.50%in the control group(χ^(2)=4.730,P=0.028).After treatment,the level of Treg cell in the two groups was significantly higher,and the level of Treg cell experimental in the group was higher than that in the control group[(5.59±1.24)%vs(4.12±1.13)%,t=5.371,P<0.001].After treatment,the level of Th17 and Th17/Treg cell in the two groups were lower,and the level of Th17 cell and Th17/Treg in the experimental group[(1.06±0.14)%,0.19±0.05]were significantly lower than those in the control group[(1.71±0.28)%,0.42±0.14],which was statistically significant(t=12.434、9.212,P<0.001).The relapse rate at 6 months after drug withdrawal in the experimental group was significantly lower than that in the control group(5.71%vs 27.50,χ^(2)=6.180,P=0.013).The incidence of adverse reactions in the experimental group was higher than that in the control group,but with no statistical significance(14.29%vs 5.00%,χ^(2)=1.900,P=0.168).Conclusions Ixekizumab has a significant therapeutic effect on moderate to severe plaque psoriasis.It can regulate the Th17/Treg balance and reduce the recurrence rate after discontinuation,and with high safety.

关 键 词：依奇珠单抗 斑块型银屑病 TH17/TREG 复发率 不良反应 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]