阿维A联合甲氨蝶呤治疗脓疱性及红皮病性银屑病的回顾分析
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摘要
目的:探讨阿维A联合甲氨蝶呤治疗泛发性脓疱性银屑病(GPP)及红皮病性银屑病(EP)的临床疗效以及安全性。方法:对115例GPP及EP患者进行回顾性分析,按不同治疗方法将其分为3组:阿维A组31例、甲氨蝶呤组33例以及阿维A联合甲氨碟呤组(联合治疗组)51例。观察3组治疗后有效率及不良反应发生率,比较3组疗效及安全性。结果:对于GPP,联合治疗组有效率明显高于甲氨蝶呤组(P<0.05);对于EP,联合治疗组有效率明显高于阿维A组和甲氨蝶呤组(P<0.05)。3组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿维A联合甲氨蝶呤治疗GPP和EP,可提高病情严重者的疗效,可作为单一疗法无效时的选择。
Objective:To assess the clinical efficacy and the safety of oral acitretin combined with methotrexate for generalized pustular psoriasis(GPP) and erythroderma psoriaticum(EP). Methods:One hundred fifteen cases of GPP and EP were retrospectively analyzed. According to the treatments, they were divided into three groups, i.e., acitretin group(n=31),methotrexate group(n=33) and acitretin combined with methotrexate group(n=51). Effective rates and the adverse reactions were determined.Results:For GPP, effective rate in combination group was significantly higher than that in methotrexate group(P<0.05). For EP,effective rate in combination group was significantly higher than that in both acitretin and methotrexate groups(P<0.05). There were no significant differences in incidence of adverse events among three groups(P>0.05). Conclusions:Acitretin combined with methotrexate can improve the efficacy for severe GPP and EP, and can be used as an alternative when single therapy is ineffective.
Objective:To assess the clinical efficacy and the safety of oral acitretin combined with methotrexate for generalized pustular psoriasis(GPP) and erythroderma psoriaticum(EP). Methods:One hundred fifteen cases of GPP and EP were retrospectively analyzed. According to the treatments, they were divided into three groups, i.e., acitretin group(n=31),methotrexate group(n=33) and acitretin combined with methotrexate group(n=51). Effective rates and the adverse reactions were determined.Results:For GPP, effective rate in combination group was significantly higher than that in methotrexate group(P<0.05). For EP,effective rate in combination group was significantly higher than that in both acitretin and methotrexate groups(P<0.05). There were no significant differences in incidence of adverse events among three groups(P>0.05). Conclusions:Acitretin combined with methotrexate can improve the efficacy for severe GPP and EP, and can be used as an alternative when single therapy is ineffective.
引文
[1]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:1015.
[2]Umezawa Y,Ozawa A,Kawasima T,et al.Therapeutic guidelines for the treatment of generalized pustular psoriasis(GPP)based on a proposed classification of disease severity[J].Arch Dermatol Res,2003,295(Suppl 1):43-54.
[3]杨雪源,陈志强.阿维A治疗严重类型银屑病临床疗效观察[J].临床皮肤科杂志,2013,32(10):610-611.
[4]龙亭.甲氨蝶呤治疗银屑病临床观察[J].中国实用医药,2014,9(4):161-162.
[5]Kuenzli S,Saumt JH.Retinoids for the treatment of psoriasis:outlook for the future[J].Curr Opin Investig Drugs,2001,2(5):625-630.
[6]Elango T,Dayalan H,Gnanaraj P,et al.Impact of methotrexate on oxidative stress and apoptosis markers in psoriatic patients[J].Clin Exp Med,2014,14(4):431-437.
[7]中华医学会皮肤性病学分会.阿维A治疗银屑病专家共识(2017版)[J].中华皮肤科杂志,2017,50(6):397-399.
[8]Lowella G,Stepheni K,Barbaraa G,et al.Fitzpatrck’s Dermatology in General Medicine[M].Eighth edition.New York:The McGraw-Hill Companies,2012:2740.
[9]Vanderveen E,Ellis C.Methotrexate and etretinate in the treatment of psoriasis[J].Arch Dermatol,1984,120(12):1555-1556.
[10]Rosenbaum MM,Roenigk HH.Treatment of generalized pustular psoriasis with etretinate(Ro 10-9359)and methotrexate[J].J Am Acad Dermatol,1984,10(2 Pt 2):357-361.
[11]卢庆芳,孙本海,李怀章,等.小剂量阿维A与MTX联合治疗重症寻常型银屑病随机对照研究[J].中国麻风皮肤病杂志,2006,22(5):372-374.
[12]武潇琪,李亚萍.泛发性脓疱型银屑病82例临床分析[J].中南大学学报(医学版),2017,42(2):173-178.
[2]Umezawa Y,Ozawa A,Kawasima T,et al.Therapeutic guidelines for the treatment of generalized pustular psoriasis(GPP)based on a proposed classification of disease severity[J].Arch Dermatol Res,2003,295(Suppl 1):43-54.
[3]杨雪源,陈志强.阿维A治疗严重类型银屑病临床疗效观察[J].临床皮肤科杂志,2013,32(10):610-611.
[4]龙亭.甲氨蝶呤治疗银屑病临床观察[J].中国实用医药,2014,9(4):161-162.
[5]Kuenzli S,Saumt JH.Retinoids for the treatment of psoriasis:outlook for the future[J].Curr Opin Investig Drugs,2001,2(5):625-630.
[6]Elango T,Dayalan H,Gnanaraj P,et al.Impact of methotrexate on oxidative stress and apoptosis markers in psoriatic patients[J].Clin Exp Med,2014,14(4):431-437.
[7]中华医学会皮肤性病学分会.阿维A治疗银屑病专家共识(2017版)[J].中华皮肤科杂志,2017,50(6):397-399.
[8]Lowella G,Stepheni K,Barbaraa G,et al.Fitzpatrck’s Dermatology in General Medicine[M].Eighth edition.New York:The McGraw-Hill Companies,2012:2740.
[9]Vanderveen E,Ellis C.Methotrexate and etretinate in the treatment of psoriasis[J].Arch Dermatol,1984,120(12):1555-1556.
[10]Rosenbaum MM,Roenigk HH.Treatment of generalized pustular psoriasis with etretinate(Ro 10-9359)and methotrexate[J].J Am Acad Dermatol,1984,10(2 Pt 2):357-361.
[11]卢庆芳,孙本海,李怀章,等.小剂量阿维A与MTX联合治疗重症寻常型银屑病随机对照研究[J].中国麻风皮肤病杂志,2006,22(5):372-374.
[12]武潇琪,李亚萍.泛发性脓疱型银屑病82例临床分析[J].中南大学学报(医学版),2017,42(2):173-178.