[1]顾洋,王召阳,向欣,等.甲氨蝶呤治疗儿童重度斑块型银屑病的疗效及对炎症因子的影响[J].中国皮肤性病学杂志,2019,(08):890-894.[doi:10.13735/j.cjdv.1001-7089.201807128]
　GU Yang,WANG Zhaoyang,XIANG Xin,et al.Methotrexate in the Treatment of Pediatric Severe Plaque Psoriasis and its Effect on Serum Levels of Inflammatory Cytokines in Patients[J].The Chinese Journal of Dermatovenereology,2019,(08):890-894.[doi:10.13735/j.cjdv.1001-7089.201807128]
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甲氨蝶呤治疗儿童重度斑块型银屑病的疗效及对炎症因子的影响
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《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2019年08期
页码:
890-894
栏目:
论著
出版日期:
2019-07-15

文章信息/Info

Title:
Methotrexate in the Treatment of Pediatric Severe Plaque Psoriasis and its Effect on Serum Levels of Inflammatory Cytokines in Patients
文章编号:
1001-7089(2019)08-0890-05
作者:
顾洋; 王召阳; 向欣; 徐子刚
首都医科大学附属北京儿童医院,北京 100045
Author(s):
GU Yang; WANG Zhaoyang; XIANG Xin; XU Zigang
(Department of Dermatology and Venereology,Beijing Children's Hospital,Beijing 100045,China)
关键词:
甲氨蝶呤;  儿童重度斑块型银屑病;  IL-17A;  IL-23;  TNF-α
Keywords:
Methotrexate;  Pediatric severe plaque psoriasis;  IL-17A;  IL-23;  TNF-α
分类号:
R 758.63
DOI:
10.13735/j.cjdv.1001-7089.201807128
文献标志码:
A
摘要:
目的 探讨甲氨蝶呤(MTX)治疗儿童重度斑块型银屑病的疗效及对血清中炎症因子IL-17A、IL-23、TNF-α的影响。 方法 18例儿童重度斑块型银屑病患者口服MTX每周0.1～0.3 mg/kg,治疗4～24周,以银屑病受累面积和严重程度(PASI)评分和儿童皮肤病生活质量指数(CDLQI)评分评价疗效; 采用液相悬浮芯片法测定基线和治疗24周后患者血清中IL-17A、IL-23和TNF-α的水平。 结果 18例儿童重度斑块型银屑病患者治疗4、8、12、24周后PASI评分较治疗前显著下降(P均<0.05); 治疗4、8、12、24周后达到PASI75的患者比例分别为11.76%、40.00%、76.92%、100%。治疗12、24周后CDLQI的中位值较治疗前显著下降。9例患者治疗24周后血清中IL-17A、IL-23和TNF-α的水平较治疗前降低(P均<0.05)。不良反应有恶心、食欲减退、谷丙转氨酶及谷草转氨酶轻度升高。 结论 在医师严密的监测下,小剂量的MTX治疗儿童重度斑块型银屑病疗效良好,安全性较高,患者满意度高。随着疗效的提高,患者血清中炎症因子的水平逐渐降低。
Abstract:
Objective The study aims to evaluate the effectiveness of methotrexate(MTX)in the treatment of severe plaque psoriasis in children and to measure the serum levels of IL-17A,IL-23 and TNF-α in patients.Methods Eighteen pediatric severe plaque psoriasis patients were enrolled in this study.A single dose of 0.1～0.3 mg/kg MTX was prescribed once weekly for 4～24 weeks.The efficacy of MTX was evaluated by the psoriasis area-and-severity index(PASI)and children's dermatology life quality index(CDLQI).The baseline and the serum levels of IL-17A,IL-23,TNF-α after 24 weeks of MTX therapy were detected by liquid phase suspension chip.Results PASI score in MTX-treated patients significantly decreased at 4,8,12,24 weeks compared to baseline values(P<0.05).PASI75 at week 4,8,12,24,was achieved in 11.76%,40.00%,76.92%,100% patients,respectively.Median CDLQI decreased significantly at 12 and 24 weeks.After 24 weeks of MTX treatment,the serum concentrations of IL-17A,IL-23,TNF-α were lower than at baseline(P<0.05).The adverse events included nausea,loss of appetite,mildly elevated alanine aminotransferase and aspartate transaminase.Conclusion A low dose of MTX is effective and safe for severe pediatric plaque psoriasis under expert supervision.The reduction in serum concentrations of IL-17A,IL-23,TNF-α after MTX treatment indicates MTX therapeutic efficacy.

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备注/Memo

备注/Memo:
[基金项目] 北京市科委“首都临床特色应用研究”专项课题(Z161100000516070); 北京市自然科学基金资助项目(7174300); 北京市医院管理局临床医学发展专项(ZYLX 201601); 北京市医院管理局儿科学科协同发展中心专项经费资助(XTZD20180502)
[作者单位] 首都医科大学附属北京儿童医院,北京 100045
[通讯作者] 徐子刚,E-mail:xuzigang@bch.com.cn
[Corresponding author] XU Zigang,E-mail:xuzigang@bch.com.cn
更新日期/Last Update: 2019-07-15