摘要
目的:探讨依奇珠单抗联合甲氨蝶呤治疗中重度难治性斑块型银屑病的临床应用、安全性、不良反应情况及对睡眠质量的影响。方法:选取2019年4月至2023年1月福清市医院皮肤科,和厦门长庚医院皮肤科收治的中重度难治性斑块型银屑病患者60例作为研究对象,随机分为对照组和观察组,每组30例。对照组采用甲氨蝶呤,每周服药1次,顿服,疗程12周;观察组在对照组基础上,采用依奇珠单抗治疗,皮下注射300 mg,1次/周,连续5次,之后每个月1次,疗程12周。通过银屑病变面积和严重程度指数(PASI)、体表受累面积(BSA)和瘙痒数字评定量表(PNRS)评估患者银屑病严重程度和疗效;采用皮肤病生命质量指标(DLQI)和汉密尔顿抑郁量表(HAMD)评估中重度难治性银屑病对患者生活的影响;采用匹兹堡睡眠质量指数(PSQI)评估患者的睡眠质量。结果:观察组未见脱落,对照组脱落3例,均因久未见明显疗效,1例放弃治疗,2例患者情绪焦虑,改用生物制剂治疗,均按脱落处理。治疗后,观察组PASI 50、PASI 75、PASI 90均明显高于对照组(P<0.001);治疗后,患者PASI、BSA、DLQI、HAMD评分均得到明显改善;依奇珠单抗安全性较高,不良反应率较低;治疗后,患者的PSQI评分明显得到改善,且观察组患者的睡眠质量改善程度高于对照组(P<0.001)。结论:依奇珠单抗在治疗中重度难治性斑块型银屑病的疗效较为明确,可有效改善患者银屑病皮损面积,抑制皮肤瘙痒,提高其生命质量,缓解抑郁情绪,提高睡眠质量,安全性较好,不良反应率较低,可为临床治疗中重度难治性斑块型银屑病提供参考依据。
Objective:To explore the clinical application,safety,sleep quality,and adverse reactions of the combination of Ignituzumab and Methotrexate in the treatment of moderate to severe refractory plaque psoriasis.Methods:Sixty patients with moderate to severe refractory plaque psoriasis who visited the dermatology department of Fuqing Hospital and Xiamen Changgeng Hospital from April 2019 to January 2023 were selected as the study subjects.The control group received methotrexate once a week,taken orally for 12 weeks;on the basis of the control group,the observation group received treatment with IXE monoclonal antibody,subcutaneous injection of 300 mg,treatment for 1 week/time,continuous 5 times,and then once a month for a course of 12 weeks.Assess the severity and efficacy of psoriasis in patients using the Psoriasis Area Severity Index(PASI),Body Surface Area(BSA),and Pruritus numerical rating scale(PNRS);the Dermatology Life Quality Index(DLQI),Hamilton Depression Scale(HAMD)are used to evaluate the impact of moderate to severe refractory psoriasis on daily life,and the Pittsburgh Sleep Quality Index(PSQI)are used to assesses patients′sleep quality.Results:There was no dropout in the observation group,while there were 3 dropouts in the control group.Due to the lack of significant therapeutic effect for a long time,1 patient gave up treatment,and 2 patients were emotionally anxious and switched to biological therapy,all treated as dropouts.The PASI 50,PASI 75,and PASI 90 of the observation group were significantly higher than those of the control group after treatment(P<0.001);after treatment,the patient′s PASI,BSA,DLQI,and HAMD scores all showed significant improvement;IXE has high safety and low incidence of adverse reactions,after treatment,the PSQI score of patients was significantly improved,and the sleep quality of patients in the observation group was higher than that in the control group(P<0.001).Conclusion:IXE has a clear therapeutic effect in the treatment of moderate to severe refractory plaque psoriasis.It can effectively improve the skin lesion area of patients with psoriasis,inhibit skin itching,improve their quality of life,alleviate depressive emotions,improve patients′sleep quality,have good safety,and a low incidence of adverse reactions.It can provide a reference basis for clinical treatment of moderate to severe refractory plaque psoriasis.
作者
陈玉
吴菁
霍玉萍
李雪丽
CHEN Yu;WU Jing;HUO Yuping;LI Xueli(Dermatology Department of Fuqing Hospital,Fujian Province,Fuzhou 350300,China;Dermatology Department of Xiamen Changgeng Hospital,Xiamen 361000,China;Department of Dermatology,Mindong Hospital,Ningde City,Fujian Province,Ningde 352000,China)
出处
《世界睡眠医学杂志》
2024年第6期1189-1193,共5页
World Journal of Sleep Medicine
基金
福建省自然基金项目(2023J011911)。
