目的 探討甲氨蝶呤聯(lián)合度普利尤單抗治療特應性皮炎的臨床療效。方法 選取2021年3月—2022年3月福建醫(yī)科大學附屬南平第一醫(yī)院收治的76例特應性皮炎患者，隨機分為對照組和治療組，每組各38例。對照組患者皮下注射度普利尤單抗注射液，首周1次，600 mg/次，然后每2周注射300 mg；治療組在對照組基礎(chǔ)上口服甲氨蝶呤片，5 mg/次，1次/周，然后2次/周，2.5 mg/次，間隔12 h，口服甲氨蝶呤片24 h后口服葉酸10 mg。兩組持續(xù)治療16周。觀察兩組患者臨床療效，比較治療前后兩組患者嚴重程度指數(shù)（EASI）評分、研究者整體（IGA）評分、AD積分指數(shù)（SCORAD）評分和皮膚病生活質(zhì)量指數(shù)（DLQI）評分，血清白細胞介素-4（IL-4）、IL-6和γ干擾素（IFN-γ）水平，外周血嗜酸性粒細胞（EOS）和免疫球蛋白E（IgE）水平。結(jié)果 治療后，治療組總有效率明顯高于對照組（97.37% vs 81.58%，P＜0.05）。治療后，兩組EASI評分、IGA評分、SCORAD評分和DLQI評分均明顯低于治療前（P＜0.05），且治療組評分明顯低于對照組（P＜0.05）。治療后，兩組IL-4、IL-6、EOS和IgE水平明顯降低，而IFN-γ水平升高（P＜0.05），且治療組這些指標水平明顯好于對照組（P＜0.05）。結(jié)論 甲氨蝶呤聯(lián)合度普利尤單抗治療特應性皮炎可增強治療療效，減輕患者病情，改善炎癥相關(guān)因子合成，降低EOS、IgE水平，提高患者生活質(zhì)量。

Objective To investigate the efficacy of methotrexate combined with dupilumab in treatment of atopic dermatitis. Methods Patients (76 cases) with atopic dermatitis in the Nanping First Affiliated Hospital of Fujian Medical University from March 2021 to March 2022 were randomly divided into control and treatment group, and each group had 38 cases. Patients in the control group were subcutaneous injection administered with Dupilumab Injection, once for the first week, 600 mg/time, then 300 mg every two weeks. Patients in the treatment group were po administered with Methotrexate Tablets on the basis of the control group, 5 mg/time for the first week, then twice weekly, 2.5mg/time every 12 h, and they were administered with 10 mg folic acid after 24 h of Methotrexate Tablets. Patients in two groups were treated for 16 weeks. After treatment, the clinical evaluation was evaluated, and the scores of EASI, IGA, SCORAD and DLQI, the levels of IL-4, IL-6, IFN-γ, EOS and IgE in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (97.37% vs 81.58%, P < 0.05). After treatment, the scores of EASI, IGA, SCORAD and DLQI in two groups were significantly lower than those before treatment (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of IL-4, IL-6, EOS and IgE were significantly decreased, while the level of IFN- γ were significantly increased in two groups (P < 0.05), and the level of these indexes in the treatment group was significantly better than that in the control group (P < 0.05). Conclusion Methotrexate combined with dupilumab in treatment of atopic dermatitis can enhance the therapeutic effect, alleviate the condition of patients, improve the synthesis of inflammatory related factors, reduce the levels of EOS and IgE, and improve the quality of life of patients.

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