古塞奇尤单抗治疗重度斑块状银屑病临床价值研究  

Value of guselkumab in the treatment of severe plaque psoriasis

作　　者：张伟娜 唐丹荔 牛妍艳 ZHANG Weina;TANG Danli;NIU Yanyan(Department of Dermatology,Jiangsu Province(Suqian)Hospital,Suqian 223800,China)

机构地区：[1]江苏省人民医院宿迁医院皮肤科,江苏宿迁223800

出　　处：《陕西医学杂志》2025年第2期239-243,共5页Shaanxi Medical Journal

基　　金：江苏省卫生健康委员会医学科学研究计划项目(2023SF-1062)。

摘　　要：目的:探讨古塞奇尤单抗治疗重度斑块状银屑病的临床价值。方法:选取重度斑块状银屑病患者124例,并随机分为对照组(62例)和观察组(62例)。对照组给予英夫利西单抗治疗。观察组给予古塞奇尤单抗治疗。比较两组患者临床疗效,治疗前后血液流变学指标、血清辅助性T细胞17(Th17)细胞因子水平及皮肤屏障功能,治疗不同时间点患者生活质量。记录治疗期间不良反应发生情况。结果:对照组总有效率72.58%低于观察组90.32%(P<0.05)。治疗后,两组全血黏度低切及高切、血浆黏度、血清白细胞介素(IL)-17、IL-22、IL-23水平、pH值、经表皮水分丢失量低于治疗前,且观察组低于对照组;皮脂含量、角质层含水量高于治疗前,且观察组高于对照组(均P<0.05)。治疗第4、12周及治疗结束时,观察组皮肤病生活质量指数(DLQI)评分低于对照组(均P<0.05)。对照组不良反应发生率为29.03%,较观察组12.90%升高(P<0.05)。结论:古塞奇尤单抗治疗重度斑块状银屑病疗效较好,能够调控Th17细胞活化,改善患者生活质量,恢复皮肤屏障功能,且安全性较好。Objective:To explore the clinical value of guselkumab in the treatment of severe plaque psoriasis.Methods:A total of 124 patients with severe plaque psoriasis were selected and randomly divided into a control group(62 cases)and an observation group(62 cases).The control group was treated with infliximab,while the observation group was treated with guselkumab.The clinical efficacy,hematological rheology indicators,serum Th17 cytokine levels,and skin barrier function before and after treatment were compared between the two groups.The quality of life of patients at different time points during treatment was also compared between the two groups.Adverse reactions occurring during the treatment period were recorded.Results:The total effective rate in the control group was 72.58%,lower than the 90.32%in the observation group(P<0.05).Post-treatment,both groups exhibited reduced whole blood viscosity,plasma viscosity,and serum levels of IL-17,IL-22,IL-23,pH value,and transepidermal water loss compared to pre-treatment levels,with the observation group showing greater reductions(all P<0.05).Similarly,sebum content and stratum corneum hydration increased post-treatment in both groups,but were more pronounced in the observation group(all P<0.05).The DLQI scores were lower in the observation group at weeks 4 and 12,as well as at the end of treatment(all P<0.05).The incidence of adverse reactions in the control group was 29.03%,higher than the 12.90%in the observation group(P<0.05).Conclusion:Guselkumab is effective in treating severe plaque psoriasis,can regulate the activation of Th17 cells,improve patients’quality of life,restore skin barrier function,and has good safety.

关 键 词：重度斑块状银屑病 古塞奇尤单抗 辅助性T细胞17 皮肤屏障功能 生活质量 安全性 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]