目的 探討司庫奇尤單抗聯(lián)合卡泊三醇乳膏治療中重度銀屑病的臨床療效。方法 選取2020年9月—2021年12月在哈爾濱醫(yī)科大學(xué)附屬第四醫(yī)院松北院區(qū)治療的80例中重度銀屑病患者，隨機(jī)分對照組和治療組，每組各40例。對照組患處皮膚涂抹卡泊三醇軟膏，2次/d。在對照組的基礎(chǔ)上，治療組皮下注射司庫奇尤單抗注射液，第0、1、2、3、4周給藥，300 mg/次，而后每隔4周注射1次。兩組患者治療16周。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀改善時(shí)間，面積和嚴(yán)重程度指數(shù)（PASI）評分，T淋巴細(xì)胞免疫功能，血清白細(xì)胞介素-2（IL-2）、白細(xì)胞介素-17（IL-17）、腫瘤壞死因子-α（TNF-α）和γ干擾素（IFN-γ）水平，及不良反應(yīng)情況。結(jié)果 治療后，治療組臨床有效率（97.50%）明顯高于對照組（77.50%，P＜0.05）。治療后，治療組癥狀改善時(shí)間均明顯早于對照組（P＜0.05）。治療后，兩組PASI評分明顯下降（P＜0.05），且治療組的PASI評分明顯低于對照組（P＜0.05）。治療后，兩組免疫功能CD4^＋、CD8^＋指標(biāo)水平明顯升高（P＜0.05），且治療組的CD4^＋、CD8^＋指標(biāo)均高于對照組（P＜0.05）。治療后，兩組血清IL-2、IL-17、TNF-α、IFN-γ水平明顯降低（P＜0.05），且治療組明顯低于對照組（P＜0.05）。治療組不良反應(yīng)發(fā)生率（7.50%）明顯低于對照組（17.50%，P＜0.05）。結(jié)論 司庫奇尤單抗聯(lián)合卡泊三醇乳膏治療中重度銀屑病效果確切，能顯著減輕癥狀，對皮膚屏障功能能有效改善。

Objective To explore the clinical effect of secukinumab combined with Calcipotriol Ointment in treatment of moderate and severe psoriasis.Methods Patients (80 cases) with moderate and severe psoriasis in Songbei Hospital,the Fourth Hospital of Harbin Medical University from September 2020 to December 2021 were randomly divided into control and treatment group,and each group had 40 cases.Patients in the control group were administered with Calcipotriol Ointment to the affected skin,twice daily.Patients in the treatment group were subcutaneous injection administered with Secukinumab Injection on the basis of the control group,administration at week 0,1,2,3 and 4,300 mg/time,then injected every 4 weeks.Patients in two groups were treated for 16 weeks.After treatment,the clinical evaluation was evaluated,the improvement time of symptom,PASI score,T lymphocyte immune function,the serological levels of IL-2,IL-17,TNF-α and IFN-γ,adverse reactions in two groups before and after treatment were compared.Results After treatment,the clinical effective rate of the treatment group (97.50%) was significantly higher than that of the control group (77.50%,P<0.05).After treatment,the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P<0.05).After treatment,the PASI score in two groups were significantly decreased,and the PASI score in the treatment group was significantly lower than that of the control group (P<0.05).After treatment,the levels of immune function CD4⁺ and CD8⁺ in two groups were significantly increased,and which in the treatment group were higher than those in the control group (P<0.05).After treatment,the serum levels of IL-2,IL-17,TNF-α and IFN-γ in two group were significantly decreased (P<0.05),and which in the treatment group were significantly lower than those in the control group (P<0.05).The incidence of adverse reactions in the treatment group (7.50%) was significantly lower than that in the control group (17.50%,P<0.05).Conclusion Calcipotriol Ointment combined with Secukinumab Injection is effective in the treatment of moderate and severe psoriasis,which can significantly relieve symptoms and effectively improve skin barrier function.

R986