中重度寻常型银屑病经司库奇尤单抗治疗后的疗效观察

Clinical Observation of Moderate to Severe Psoriasis Vulgaris Treated with Secukinumab

目的:观察中重度寻常型银屑病经司库奇尤单抗治疗后的疗效和安全性。方法:收集2018年11月-2021年7月就诊于石河子大学医学院第一附属医院皮肤科中重度寻常型银屑病患者50例,50例患者全部完成12周治疗,其中试验组25例(注射司库奇尤单抗),对照组25例(注射益赛普)。试验组给予司库奇尤单抗,300mg/次,前4周每周1次(皮下注射),随后每4周一次。对照组给予益赛普,25mg皮下注射,每周两次;分别于治疗前、4周后、12周后记录寻常型银屑病患者的皮肤病生活质量指数(DLQI)、银屑病皮损面积和严重指数(PASI),观察有无药物不良反应。结果:共经过12周的治疗,试验组和对照组患者治疗后PASI评分均下降,与治疗前比较差异具有统计学意义(P<0.01);患者治疗4周、12周后,试验组疗效均优于对照组,差异具有统计学意义(P<0.01)。试验组治疗4周后,25例达到PASI50,25例达到PASI75,19例达到PASI90;治疗12周后,25例患者均达到PASI90,3例患者达到PASI100,治疗后总有效率为100%;对照组治疗4周后,11例达PASI50,2例达PASI75,0例达PASI90;治疗12周后,7例达PASI75,0例达PASI90,0例达PASI100,总有效率为28%;试验组总有效率明显高于对照组,且两组间差异具有统计学意义(P<0.01),经过治疗患者生活质量明显改善,DLQI明显下降,且试验组生活质量改善优于对照组;所有患者治疗期间均未出现严重的不良反应。结论:司库奇尤单抗治疗中重度银屑病效果十分显著,起效迅速,不良反应较少,用药安全性较高,具有一定的临床应用价值。

Objective:To observe the curative effect and safety of moderate and severe psoriasis vulgaris treated with Secukinumab.Methods:A total of 50 patients with moderate to severe psoriasis vulgaris admitted to the Dermatology department of the First Affiliated Hospital of Shihezi University Medical College from November 2018 to July 2021 were randomly divided into two groups by parallel control,with 25 cases in the experimental group and 25 cases in the control group.The experimental group was given Secukinumab,300 mg/time,once a week for the first 4 weeks and then once every 4 weeks(subcutaneous injection).The control group was given Etanercept,25mg subcutaneously,twice a week.The psoriasis lesions area and skin quality of life index(DLQI)and severity index(PASI)of patients with psoriasis vulgaris were recorded before treatment,1 week after treatment,4 weeks after treatment and 12 weeks after treatment.The adverse drug reactions were observed.Results:After 12 weeks of treatment,PASI scores in both the experimental group and the control group decreased after treatment,with statistically significant differences(P<0.01).After treatment for 4weeks and 12 weeks,the therapeutic effct of experimental group was better than control group.The difference was statistically significant(P<0.01).In the experimental group of 25 patients with psoriasis vulgaris,after 4 weeks of treatment,25 patients reached PASI50,25 patients reached PASI 75,19 patients reached PASI90;After 12 weeks of treatment,all 25 patients achieved PASI90 and 3 patients achieved PASI100.The total effective rate after treatment was 100%.In the control group of 25 patients with psoriasis vulgaris,after 4 weeks of treatment,11 patients achieved PASI50,2 patients achieved PASI75,and 0 patients achieved PASI90.After 12 weeks of treatment,7 patients achieved PASI75,0 achieved PASI90,and 0 achieved PASI100,with a total effective rate of 28%.The total effective rate in the experimental group was significantly higher than that in the control group,and the difference between the two groups was statistically significant(P<0.01).After treatment,the quality of life the patients was significantly improved,and DLQI was significantly decreased,and the improvement of quality of life of the experimental group was better than the control group,None of thepatients had serious adverse drug reations during treatment.Conclusion:In the treatment of moderate and severe psoriasis,Secukinumab has significant effect,rapid onset,few adverse reactions,high safety,and has certain clinical application value.