摘要
目的:观察口服环孢素联合外用卡泊三醇倍他米松治疗掌跖脓疱病(PPP)的临床疗效,并通过检测患者环孢素血药浓度,探讨其起始给药剂量、血药浓度等对PPP临床疗效的影响。方法:32例PPP患者予口服环孢素联合外用卡泊三醇倍他米松治疗,于治疗前、治疗后1周及治疗后1个月对患者进行疗效判定,并于治疗后1周及治疗后1个月检测患者外周血环孢素谷浓度。结果:治疗后1周有效率达46.88%,治疗后1个月有效率达81.25%。治疗后1周及1个月后的掌跖脓疱病型银屑病面积和严重程度指数(PPPASI)总积分、脓疱积分、红斑积分及鳞屑积分与治疗前相比均下降,差异具有统计学意义(P<0.05);治疗后1周及1个月后的脓疱积分下降指数高于红斑、鳞屑积分,差异具有统计学意义(P<0.05)。治疗后1周PPPASI积分下降指数与治疗后1个月PPPASI积分下降指数呈正相关(r=0.761,P<0.05)。环孢素起始给药剂量与治疗后1周及1个月PPPASI积分下降指数呈正相关(r1=0.40、r2=0.46,P<0.05),与治疗后1周血药浓度呈正相关(r=0.399,P<0.05)。起始给药剂量高[2.5~4 mg/(kg·d)]的患者治疗后1周PPPASI积分下降指数高于起始给药剂量低[1.5~2.5 mg/(kg·d)]的患者,差异有统计学意义(P<0.05)。环孢素治疗后1个月血药浓度与治疗后1个月PPPASI积分下降指数呈正相关(r=0.37,P<0.05)。结论:口服环孢素联合外用卡泊三醇倍他米松治疗PPP近期疗效理想,起效快,尤其对脓疱的缓解效果好,环孢素起始剂量可给予2.5~4 mg/(kg·d)为宜。
Objective: To evaluate the clinical efficacy of cyclosporine A for palmoplantar pustulosis, examine the concentration of cyclosporine A, and investigate the effects of initial dose and concentration of cyclosporine A on the clinical efficacy of palmoplantar pustulosis. Methods: A total of 32 patients with palmoplantar pustulosis were treated with cyclosporine A combined with captopril betamethasone cream. The modified PASI score(PPPASI score) was assessed before treatment and at 1 week and 1 month after treatment. The minimum cyclosporine A concentration was detected at 1 week and 1 month after treatment. Results: The effective rate reached 46.88% at one week after treatment, and 81.25% at one month after treatment. The PPPASI score, pustule score,erythema score,% and scale score at 1 week and 1 month after treatment decreased compared with those before treatment, and the difference was statistically significant(P<0.05). At two time points, the pustule score decline index was higher than the erythema and scale score, and the difference was statistically significant(P<0.05). The decrease in PPPASI score at 1 week after treatment was positively correlated with the decrease in PPPASI score at 1 month after treatment(r=0.761,P<0.05). The initial dose of cyclosporine A was positively correlated with the decrease in PPPASI scores at 1 week and 1 month after treatment(r1=0.40、r2=0.46,P<0.05),and was positively correlated with the blood concentration at 1 week after treatment(r =0.399,P <0.05). In patients with high initial dose [2.5~4 mg/(kg·d)] at 1 week after treatment, PPPASI score decline was larger than that in the patients with low initial dose [1.5~2.5 mg/(kg·d)], and the difference was statistically significant(P<0.05). The blood concentration of cyclosporine A at 1 month after treatment was positively correlated with the decrease in PPPASI score at one month after treatment(r=0.37,P<0.05).Conclusions: Oral cyclosporine A combined with captopril betamethasone cream has ideal quick-onset curative effect on pa
作者
宋翠豪
张钧芬
马亮
杨京润
郑艺
王睿
丁香玉
李承新
SONG Cui-hao;ZHANG Jun-fen;MA Liang;YANG Jing-run;ZHENG yi;WANG Rui;DING Xiang-yu;LI Cheng-xin(Department of Dermatology,Chinese PLA General Hospital,Beijing 100853,China)
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2021年第7期401-405,共5页
Journal of Clinical Dermatology
基金
国家自然科学基金(81972936)
首都特色基金项目(Z181100001718038)
解放军总医院科技创新苗圃基金项目(18KMM10)资助项目。
关键词
掌跖脓疱病
环孢素
血药浓度
palmoplantar pustulosis
cyclosporine A
blood drug concentration
