英夫利西单抗治疗寻常性银屑病的疗效及对血脂代谢的影响

Therapeutic effect of infliximab on psoriasis vulgaris and its effect on blood lipid metabolism

目的回顾性分析英夫利西单抗治疗寻常性银屑病的疗效及对血脂代谢的影响。方法纳入2015年1月至2020年12月在上海市皮肤病医院住院期间采用英夫利西单抗治疗的寻常型银屑病患者,比较治疗前后血脂代谢水平[包括甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、载脂蛋白A1和载脂蛋白B]及银屑病皮损面积和严重程度指数(PASI)评分。结果英夫利西单抗治疗寻常型银屑病疗效显著,平均PASI评分治疗前为15.30[12.00,19.65],在治疗后12、24及52周分别为1.20[0.20,3.65]、1.20[0.60,3.40]和2.40[1.70,8.15]分,差异均有统计学意义(P<0.05)。TG、载脂蛋白A1在治疗后12、24及52周较治疗前升高,差异有统计学意义(P<0.05)。HDL-C水平治疗后12周相比于基线短暂升高,继续治疗逐渐恢复至基线水平。而TG、LDL-C及载脂蛋白B治疗前后并未发现明显改变。结论英夫利西单抗治疗寻常型银屑病疗效优越,上调银屑病患者的HDL-C和载脂蛋白A1水平,对银屑病炎症有保护作用;同时也可一定程度上调TG水平,对银屑病患者的血脂代谢有明确的影响。

Objective To observe and analyze the efficacy of infliximab in the treatment of psoriasis vulgaris and its effect on blood lipid metabolism retrospectively.Methods Patients with psoriasis vulgaris treated with infliximab in Shanghai Skin Disease Hospital from January 2015 to December 2020 were included.The levels of blood lipid metabolism,including triglyceride(TG),cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),apolipoprotein A1 and apolipoprotein B,and psoriatic lesion area and severity index(PASI)score were compared before and after treatment.Results Infliximab was effective in the treatment of psoriasis vulgaris.The average PASI score was 15.30[12.00,19.65]before treatment,at 12,24 and 52 weeks after treatment,the scores were 1.20[0.20,3.65],1.20[0.60,3.40]and 2.40[1.70,8.15],respectively(P<0.05).TG and apolipoprotein A1 at 12,24 and 52 weeks after treatment were significantly higher than those before treatment(P<0.05).HDL-C level was briefly increased 12 weeks after treatment compared with the baseline,and gradually returned to baseline after continued treatment.There were no significant changes in TG,LDL-C and apolipoprotein B before and after treatment.Conclusion Infliximab is effective in the treatment of psoriasis vulgaris,it can up regulate the levels of HDL-C and apolipoprotein A1 in patients with psoriasis vulgaris and protect the inflammation of psoriasis.At the same time,it can also increase the level of triglyceride to a certain extent,which has a clear impact on the blood lipid metabolism of patients with psoriasis vulgaris.