目的 觀察度普利尤單抗聯(lián)合左西替利嗪治療中重度特應(yīng)性皮炎的療效。方法 選取2022年4月—2024年3月南京鼓樓醫(yī)院集團(tuán)宿遷醫(yī)院收治的94例患者，依據(jù)治療方法不同分為對照組（47例）和治療組（47例）。對照組口服鹽酸左西替利嗪片，5 mg/次，1次/d。在對照組基礎(chǔ)上，治療組皮下注射度普利尤單抗注射液，成人首劑注射負(fù)荷劑量600 mg，2周后劑量300 mg。兒童體質(zhì)量60 kg及以上，首劑負(fù)荷劑量600 mg，2周后第2劑300 mg。30 kg≤體質(zhì)量＜60 kg，首劑負(fù)荷劑量400 mg，2周后第2劑200 mg；15 kg≤體質(zhì)量＜30 kg，給予1劑600 mg。兩組治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時(shí)間、皮膚病生活質(zhì)量問卷（DLQI）評分、特應(yīng)性皮炎積分表（SCORAD）評分、瘙癢/睡眠和皮膚美觀度評分。結(jié)果 治療后，治療組總有效率為95.74%，明顯高于對照組的80.85%（P＜0.05）。治療后，治療組皮膚干燥、皮膚瘙癢、皮膚紅斑和皮膚丘疹等癥狀緩解時(shí)間均早于對照組（P＜0.05）。治療后，兩組患者DLQI評分、SCORAD評分、瘙癢/睡眠-數(shù)字評分分級法（NRS）和皮膚美觀度評分較治療前均明顯下降（P＜0.05），且治療后，與對照組對比，治療組患者評分降低更明顯（P＜0.05）。結(jié)論 鹽酸左西替利嗪與度普利尤單抗協(xié)同治療，可改善患者特應(yīng)性皮炎癥狀，促使炎性反應(yīng)減弱，緩解患者皮損狀態(tài)及生活質(zhì)量。

Objective To observe the efficacy of dupilumab combined with levocetirizine in treatment of severe atopic dermatitis. Methods Patients (94 cases) with severe atopic dermatitis in Nanjing Drum Tower Hospital Group Suqian Hospital from April 2022 to March 2024 were divided into control (47 cases) and treatment (47 cases) groups based on different treatments. Patients in the control group were po administered with Levocetirizine Hydrochloride Tablets, 5 mg/time, once daily. Patients in the treatment group were subcutaneous injection administered with Dupilumab Injection on the basis of the control group, the first loading dose for adults was 600 mg, and 300 mg 2 weeks later, the first loading dose was 600 mg for children weighing 60 kg and above, and the second dose was 300 mg 2 weeks later, the first loading dose was 400 mg for weighing 30 — 60 kg, and the second dose was 200 mg 2 weeks later, one dose of 600 mg would be given for weighing 15 — 30 kg. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, the symptom relief time, the scores of DLQI, SCORAD, pruritus/sleep and skin aesthetics in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 95.74%, which was significantly higher than that in the control group (80.85%, P < 0.05). After treatment, the relief time of symptoms such as dry skin, pruritus, erythema, and papules in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the DLQI score, SCORAD score, pruritus/sleep-NRS score and skin aesthetics score patients in two groups were significantly decreased compared with before treatment (P < 0.05), and compared with the control group, the scores decreased more significantly in the treatment group (P < 0.05). Conclusion The synergistic treatment of levocetirizine hydrochloride and Dupilumab can improve the atopic dermatitis symptoms, promote the weakening of inflammatory reactions, and relieve the patient's skin lesions and quality of life.

R986