白细胞介素17A拮抗剂治疗中重度难治性斑块型银屑病及对睡眠质量的影响

Clinical Application of Interleukin-17A Antagonist in the Treatment of Moderate to Severe Refractory Plaque Psoriasis and Its Impact on Sleep Quality

目的:观察白细胞介素17A(IL-17A)拮抗剂治疗中重度难治性斑块型银屑病的临床应用、安全性评估及对患者睡眠质量影响情况。方法:选取2019年7月至2023年4月福清市医院皮肤科、宁德市闽东医院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40例作为研究对象,使用IL-17A拮抗剂皮下注射治疗,疗程16周。采用银屑病面积和严重度指数(PASI)和体表受累面积(BSA)评分银屑病患者病情的严重程度,皮肤病生命质量指数(DLQI)评分、焦虑自评量表(SAS)评分和匹兹堡睡眠质量指数(PSQI)评分评估患者的生命质量、焦虑程度和睡眠质量。结果:1)IL-17A拮抗剂在治疗16周后,PASI、BSA、DLQI、SAS评分显著降低(P<0.001)。2)观察组治疗后患者睡眠质量明显提高,PSQI总分<5分,高睡眠质量患者占62.5%。PASI和PSQI总分进行相关性系数r=0.714,呈正相关。结论:IL-17拮抗剂在治疗中重度斑块型难治性银屑病疗效可观,基本能够改善患者的临床症状,消退银屑病皮损,降低炎症反应,提高患者生命质量和睡眠质量,缓解患者焦虑情绪,且具有较高的安全性和较低的不良反应。

Objective:To observe the clinical application,safety evaluation,and impact on sleep quality of patients with moderate to severe refractory plaque psoriasis treated with IL-17A antagonists.Methods:Forty patients with moderate to severe refractory plaque psoriasis admitted to the Dermatology Department of Fuqing Hospital and the Dermatology Department of Ningde Mindong Hospital and Xiamen Chang Gung Hospital from July 2019 to April 2023 were selected as the study subjects and treated with subcutaneous injection of IL-17A antagonist for 16 weeks.The severity of psoriasis patients was evaluated using PASI and BSA scores,while DLQI,SAS,and PSQI scores were used to assess their quality of life,anxiety level,and sleep quality.Results:After 16 weeks of treatment with IL-17A antagonists,the PASI,BSA,DLQI,and SAS scores significantly decreased(P<0.001) After treatment,the sleep quality of patients in the observation group significantly improved,with a total PSQI score of less than 5,and 62.5% of patients had high sleep quality.The correlation coefficient between PASI and PSQI total score is r=0.714,showing a positive correlation.Conclusion:Interleukin-17A antagonists have significant therapeutic effects in the treatment of moderate to severe plaque type refractory psoriasis.They can basically improve the clinical symptoms of patients,eliminate psoriasis skin lesions,reduce inflammatory reactions,improve the quality of life and sleep of patients,alleviate anxiety,and have high safety and low adverse reactions.