环孢素A与甲氨蝶呤治疗难治性泛发性脓疱型银屑病疗效比较

目的探讨环孢素A与甲氨蝶呤(MTX)治疗难治性泛发性脓疱型银屑病(GPP)的临床疗效。方法将48例难治性GPP随机分为A组和B组各24例。A组采用环孢素A治疗,B组采用MTX治疗。比较2组的临床疗效、症状和体征消失时间、复发率及不良反应。结果 A组总有效率和复发率分别为87.5%、8.3%,B组为79.2%、12.5%,2组比较差异均无统计学意义(P>0.05)。A组体温恢复正常时间及红斑、脓疱消退时间短于B组;血压升高发生率高于B组,肝功能、血常规异常发生率低于B组,差异均有统计学意义(P<0.05和P<0.01)。但2组肾功能、尿常规异常发生率比较差异无统计学意义(P>0.05)。结论环孢素A与MTX治疗难治性GPP均能取得较好的临床疗效,且环孢素A具有起效更快、对肝功能影响较小等优点。

Efficacy comparison between CysA and MTX in treatment of refractory generalized pustular psoriasis

Objective To discuss the clinical efficacy of CysA and MTX in treatment of refractory generalized pustular psoriasis.Methods 48 cases with refractory generalized pustular psoriasis were randomly divided into A group and B group,each of 24 cases.A group was treated with CysA,and B group was with MTX.The clinical efficacy,the average times for symptoms and signs to disappear,relapse rate and untoward reaction was compared between 2 groups.Results The total effective rate and recurrence rate of A group were 87.5%,8.3%,which of B group were 79.2%,12.5%,there were no significant difference between 2 groups（P〉0.05）.The recovery time of temperature and the recession time of erythema and pustule of A group were shorter than that of B group;hypertension cases of A group were more than B group;and abnormal routine blood cases and dysfunction of liver of A group were less than that of B group,the differences were statistically significant（P0.05）.Conclusion CysA and MTX in treatment of refractory generalized pustular psoriasis show good clinical efficacy.And CysA takes effects faster,with little effect on liver and renal function.