司库奇尤单抗与窄谱中波紫外线治疗中重度银屑病患者对皮损面积及血清Th1/Th2细胞因子的影响  

Effect of secukinumab combined with narrow band-ultraviolet B on skin lesion area and serum Th1/Th2 cytokines in treatment of moderate-to-severe psoriasis

作　　者：杨林芳 安丽辉 王俊龙 Yang Lin-fang;An Li-hui;Wang Jun-long(Department of Dermatology,Xingtai People’s Hospital,Xingtai 054001,China)

机构地区：[1]邢台市人民医院皮肤科,邢台054001

出　　处：《中国药物应用与监测》2025年第1期70-73,共4页Chinese Journal of Drug Application and Monitoring

基　　金：河北省2024年度医学科学研究课题计划项目(20240923)。

摘　　要：目的探讨司库奇尤单抗联合窄谱中波紫外线治疗中重度银屑病患者对皮损面积及血清Th1/Th2细胞因子的影响。方法选取2021年2月至2024年2月邢台市人民医院接受治疗的中重度银屑病患者107例,按治疗方法分为对照组(53例)和研究组(54例)。对照组使用阿维A胶囊联合窄谱中波紫外线治疗,研究组给予司库奇尤单抗联合窄谱中波紫外线治疗。比较两组治疗前后银屑病皮损面积和严重程度指数(PASI)评分变化、血清Th1/Th2细胞因子水平、皮肤病生活质量评分(DLQI)及不良反应的变化。结果治疗8周后PASI评分的改善程度指标PASI 75、PASI 90、PASI 100研究组[分别为98.15%(53/54)、90.72%(49/54)、51.85%(28/54)],均高于对照组[分别为41.51%(22/53)、35.85%(19/53)、11.32%(6/53)](χ^(2)=40.933、5.094、20.269,P<0.05)。治疗后对照组与研究组血清γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)水平[分别为(64.26±11.57)pg·mL^(-1)、(52.35±9.68)pg·mL^(-1)、(3.54±0.58)pg·mL^(-1)、(1.79±0.26)pg·mL^(-1)]均低于治疗前[分别为(89.45±16.23)pg·mL^(-1)、(88.67±17.34)pg·mL^(-1)、(7.98±1.46)pg·mL^(-1)、(7.47±1.26)pg·mL^(-1)],治疗后对照组与研究组白细胞介素4(IL-4)、白细胞介素10(IL^(-1)0)水平[分别为(19.58±3.67)pg·mL^(-1)、(23.56±3.69)pg·mL^(-1)、(29.42±4.68)pg·mL^(-1)、(34.25±5.97)pg·mL^(-1)]均高于治疗前[分别为(13.23±2.52)pg·mL^(-1)、(12.67±2.13)pg·mL^(-1)、(21.56±3.78)pg·mL^(-1)、(22.61±3.35)pg·mL^(-1)],且研究组血清IFN-γ、TNF-α水平低于对照组,IL-4、IL^(-1)0高于对照组(t=5.779、20.202、5.593、4.652,P<0.05)。治疗4、8周后,对照组与研究组DLQI评分[分别为(9.29±1.36)分、(6.52±1.21)分、(5.48±0.97)分、(2.36±0.21)分]均低于治疗前DLQI评分[分别为(16.49±2.46)分、(17.31±2.07)分],且研究组低于对照组(t=11.136、23.093,P<0.05)。治疗后研究组为14.81%(8/54)低于对照组的16.98%(9/53),差异无统计学意义(χ^(2)=0.007,Objective To investigate the effect of secukinumab(SEC)combined with narrow band-ultraviolet B(NB-UVB)on skin lesion area and serum Th1/Th2 cytokines in patients with moderate-to-severe psoriasis(PsO).Methods A total of 107 patients with moderate-to-severe PsO admitted to Xingtai People’s Hospital from February 2021 to February 2024 were selected and divided into the control group(53 cases)and the study group(54 cases)according to the treatment methods.The control group was treated with acitretin capsules combined with NB-UVB and the study group with SEC in combination with NB-UVB.The psoriasis area and severity index(PASI)scores,levels of serum Th1/Th2 cytokines,dermatology life quality index(DLQI)scores before and after treatment,and adverse reactions were compared between the two groups.Results After 8 weeks of treatment,the PASI 75,PASI 90 and PASI 100,which were improvement indicators of PASI scores,in the study group were higher than those in the control group(98.15%(53/54)vs 41.51%(22/53),90.72%(49/54)vs 35.85%(19/53),51.85%(28/54)vs 11.32%(6/53))(χ^(2)=40.933,5.094,20.269,P<0.05).After treatment,a reduction in serum interferon gamma(IFN-γ)and tumor necrosis factor alpha(TNF-α)was observed in the control group((64.26±11.57)pg·mL^(-1) vs(89.45±16.23)pg·mL^(-1),(3.54±0.58)pg·mL^(-1) vs(7.98±1.46)pg·mL^(-1))and the study group((52.35±9.68)pg·mL^(-1) vs(88.67±17.34)pg·mL^(-1),(1.79±0.26)pg·mL^(-1) vs(7.47±1.26)pg·mL^(-1))as compared with those before treatment.After treatment,an increase in the levels of interleukin-4(IL-4)and interleukin-10(IL^(-1)0)was observed in the control group((19.58±3.67)pg·mL^(-1) vs(13.23±2.52)pg·mL^(-1),(29.42±4.68)pg·mL^(-1) vs(21.56±3.78)pg·mL^(-1))and the study group((23.56±3.69)pg·mL^(-1) vs(12.67±2.13)pg·mL^(-1),(34.25±5.97)pg·mL^(-1) vs(22.61±3.35)pg·mL^(-1))as compared with those before treatment.Compared to the control group,a reduction in serum IFN-γand TNF-αlevels,and an increase in IL-4 and IL^(-1)0 were detected in the study group(t

关 键 词：司库奇尤单抗 窄谱中波紫外线 中重度银屑病 皮损面积 TH1细胞因子 TH2细胞因子 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]