凯普斯泰冷敷凝胶联合地奈德乳膏治疗儿童特应性皮炎的随机双盲对照研究

【摘要】 目的 评估凯普斯泰冷敷凝胶联合地奈德乳膏治疗儿童特应性皮炎（AD）的短期有效性和安全性。方法 采用随机、双盲、对照研究，2019年11月至2020年9月收集就诊于四川大学华西医院皮肤科的儿童AD患者60例，最终56例完成随访，试验组和对照组各28例。试验组前3 d早晚外涂地奈德乳膏，中午外涂凯普斯泰冷敷凝胶，后11 d早中晚外涂凯普斯泰冷敷凝胶，对照组前3 d早晚外涂地奈德乳膏，中午外涂安慰剂，后11 d早中晚外涂安慰剂，治疗2周。分别于治疗前、治疗（7 ± 3） d及治疗（14 ± 3） d随访，记录湿疹面积及严重程度指数（EASI评分）、瘙痒视觉模拟评分法（VAS）评分、研究者总体评分（IGA评分）、皮肤生活质量评分（DLQI评分）等临床指标及不良反应。结果 治疗1周时，试验组1例（3.57%），对照组1例（3.57%）有效；治疗2周时，试验组12例（42.86%）有效，对照组2例（7.14%）有效；经秩和检验，治疗1周和2周时两组疗效差异有统计学意义（Z = -4.318、-5.474，均P < 0.05）。治疗前，试验组和对照组EASI、VAS、IGA、DLQI评分差异均无统计学意义（P > 0.05）；经非参数Friedman检验，两组EASI评分随治疗时间的变化差异具有统计学意义（χ2 = 45.720，P < 0.05）。经两因素重复测量方差分析，治疗1周后，两组间VAS评分差异有统计学意义（F = 10.738，P = 0.002），IGA、DLQI评分差异无统计学意义（F = 0.066、0.804，P = 0.135、0.374）；治疗2周后，两组间VAS、IGA、DLQI评分差异均有统计学意义（F = 67.313、38.949、51.503，均P < 0.001）。研究期间，试验组和对照组各发生1例不良反应事件，均表现为外用药物部位刺痛感或刺激感，两组不良事件发生率差异无统计学意义（P > 0.05）。结论 短期应用凯普斯泰冷敷凝胶联合地奈德乳膏可有效治疗儿童AD，且与安慰剂比较未增加不良反应的发生。     

电针联合中药熏蒸治疗特应性皮炎血虚风燥证的临床研究

目的 评价电针联合中药熏蒸治疗特应性皮炎（AD）血虚风燥证的临床疗效。方法 选取2020年11月—2021年12月在上海市皮肤病医院就诊的60例AD血虚风燥证患者,随机分为试验组（30例）和对照组（30例）。对照组采用中药熏蒸治疗;试验组在对照组中药熏蒸的基础上加用电针治疗。2组患者均外用地松樟薄乳膏。2组疗程均为8周。观察2组治疗前后瘙痒时间占夜间睡眠的百分比（PIT）、特应性皮炎评分（SCORAD）的变化和临床疗效。结果 2组治疗后PIT、SCORAD评分均较治疗前降低（P<0.01）,且试验组治疗后PIT低于对照组（15.13±3.47比20.46±3.12,P<0.01）,SCORAD评分也低于对照组（15.79±7.63比20.57±8.80,P<0.05）。总有效率试验组高于对照组,差异有统计学意义（83.33%比60.00%,P<0.05）。结论 电针联合中药熏蒸治疗AD血虚风燥证可明显改善患者的瘙痒情况及疾病的严重程度,有较好的临床疗效。     

【开放获取】凯普斯泰冷敷凝胶治疗成人轻中度特应性皮炎的随机双盲对照研究

【摘要】 目的 评价外用凯普斯泰冷敷凝胶治疗成人轻中度特应性皮炎（AD）的疗效和安全性。方法 采用随机、双盲、氢化可的松乳膏对照临床研究。2019年7月至2020年5月，于首都医科大学附属北京友谊医院收集80例成人轻中度AD患者，分为两组，每组40例。试验组外涂凯普斯泰冷敷凝胶，对照组外涂氢化可的松乳膏，每日3次，治疗4周。分别于治疗前和治疗1、2、4周随访，根据湿疹面积及严重程度指数（EASI）、视觉模拟标尺法（VAS）、研究者总体评估（IGA）评分等评价疗效，记录不良事件。主要采用重复测量的方差分析和χ2检验进行疗效和安全性比较。结果 AD患者80例，男43例、女37例，年龄（52.71 ± 16.71）岁。治疗前，两组患者性别、年龄、EASI评分、VAS评分、IGA评分差异均无统计学意义（均P > 0.05）。治疗1、2周时，试验组有效率分别为10.00%（4/40）、57.50%（23/40），对照组有效率分别为15.00%（6/40）、52.50%（21/40），两组差异均无统计学意义（均P > 0.05）。治疗4周，试验组有效率82.50%（33/40），显著高于对照组57.50%（23/40，P < 0.05）。治疗1、2、4周时，试验组VAS评分均显著低于对照组（U = 1 253.00、1 121.00、1 091.50，均P < 0.05）。两组均无药物相关不良事件发生。结论 凯普斯泰冷敷凝胶治疗成人轻中度AD安全、有效，可用于临床。     

健脾止痒颗粒治疗特应性皮炎临床观察

目的探讨中药健脾止痒颗粒治疗特应性皮炎(AD)的有效性和安全性。方法将入选AD患者随机分为治疗组(健脾止痒颗粒)32例和对照组(氯雷他定)32例,连续服药4周。采用欧洲AD评分标准(SCORAD)对AD的临床严重度进行评分,用视觉模拟尺度(VAS)评分法对瘙痒程度进行评分;同时记录SCORAD积分和VAS积分。疗程结束后,评价疗效。结果治疗组及对照组治疗4周后,SCORAD积分下降(P<0.05)、VAS积分明显下降(P<0.01)。有效率前者为84.4%,后者为43.8%。两组疗效经统计学处理,差异有显著性(χ2=12,P<0.01)。两组病例未见明显不良反应。结论健脾止痒颗粒治疗AD疗效确切,能明显降低患者SCORAD积分和VAS积分。其有效机制有待深入研究。     

盐酸非索非那定片递减疗法治疗慢性自发性荨麻疹的疗效观察

目的：探讨盐酸非索非那定片递减疗法治疗慢性自发性荨麻疹的有效性。方法在临床病史评估和自体血清皮肤试验（ASST）的基础上,将80例慢性自发性荨麻疹患者随机分配到常规剂量组和递减剂量组。常规剂量组给予口服盐酸非索非那定片120 mg/d,连续12周;递减剂量组前4周每日给予口服盐酸非索非那定片120 mg/d,第5周和第9周时尝试逐渐减量至可控制症状的最小服药量。在治疗前（基线）和治疗后第4、8、12周时评价所有患者荨麻疹疾病活动程度（UAS）、皮肤病生活质量指数（DLQI）和抗组胺药物总服用量。结果共76例患者完成12周的治疗,包括常规剂量组37例和递减剂量组39例。治疗4、8、12周后,常规剂量组（UAS 0.64±0.82、0.37±0.68、0.27±0.56;DLQI：3.62±1.82、2.81±1.65、1.37±1.14）和递减剂量组（UAS：0.61±0.87、0.48±0.72、0.28±0.61;DLQI：3.79±2.57、2.74±2.11、1.15±1.47）UAS、DLQI评分均分别显著低于各组治疗前评分（UAS：4.08±0.79、4.07±0.81;DLQI：16.19±3.79、15.92±4.2）,差异有统计学意义（均P<0.001）,但两组在治疗后同一时间UAS和DLQI评分差异均无统计学意义（P>0.05）。递减剂量组在治疗8、12周后分别有71.79%（28/39）和82.05%（32/39）患者在原有剂量基础上减少剂量仍能控制症状,且服药总量显著低于常规剂量组对应时间段的药量（均P<0.001）。结论慢性荨麻疹患者使用盐酸非索非那定治疗4~8周后,逐步减少药物剂量可取得与常规剂量类似的临床疗效。     

苯烯莫德对特应性皮炎患者外周血单个核细胞白细胞介素4和10、γ干扰素、T细胞转化因子β水平的影响

目的：探讨特应性皮炎（AD）患者外周血单个核细胞（PBMC）培养上清液分泌的白细胞介素4（IL?4）、γ干扰素（IFN?γ）、白细胞介素10（IL?10）和T细胞转化因子β（TGF?β）水平，及苯烯莫德对这些因子的调节作用。方法分离培养20例AD患者和20例健康对照的外周血单个核细胞，再将20例AD患者外周血单个核细胞等分为4组，分别给以磷酸缓冲盐液（PBS），400 nmol/L苯烯莫德溶液，250 nmol/L地塞米松溶液，10 nmol/L他克莫司溶液共培养后，酶联免疫吸附法检测细胞培养上清液分泌IL?4、IFN?γ、IL?10、TGF?β的水平。结果 AD组和健康对照组外周血IL?4浓度分别为（83.4±12.2）pg/ml和（44.3±5.7）pg/ml，两组比较，P＜0.05；TGF?β浓度分别为（178.9±17.40）pg/ml和（158.7±18.30）pg/ml，两组比较，P＞0.05。AD组和健康对照组外周血IFN?γ浓度分别为（12.5±2.3）pg/ml和（25.4±3.4）pg/ml，两组比较，P＜0.05；IL?10浓度分别为（144.4±4.1）pg/ml和（189.9±6.5）pg/ml，两组比较，P＜0.05。400 nmol/l苯烯莫德可降低AD患者外周血IL?4、IL?10、IFN?γ的含量，PBS对照组和苯烯莫德组IL?4浓度分别为（83.3±12.2）pg/ml和（50.2±10.1）pg/ml，两组比较，P＜0.05；IL?10的浓度分别为（144.4±4.1）pg/ml和（124.7±17.5）pg/ml，两组比较，P＞0.05；IFN?γ的浓度分别为（12.5±2.3）pg/ml和（9.56±5.1）pg/ml，两组比较，P＞0.05。苯烯莫德组与地塞米松组，他克莫司组相比，差异无统计学意义（均P＞0.05）。苯烯莫德组可升高PBS对照组AD患者外周血TGF?β含量， PBS对照组和BVM组TGF?β的浓度分别为（178.9±17.4）pg/ml和（203.6±15.3）pg/ml，两组比较， P＞0.05。苯烯莫德组与地塞米松组，他克莫司组相比，差异无统计学意义（均P＞0.05）。结论苯烯莫德可调节AD患者外周血PBMC IL?4、IFN?γ、IL?10和TGF?β的表达水平。     

患者治疗教育在不同年龄组儿童特应性皮炎治疗管理中的作用

目的评估患者治疗教育在不同年龄组儿童特应性皮炎(atopic dermatitis,AD)治疗管理中的作用。方法对53例1~11岁AD患儿进行过敏原检测和患者治疗教育,并将其分为1~4岁和5~11岁两组。3个月后进行随访,分别在初诊和随访时比较AD严重度评分(SCORAD)、患儿及其家庭生活质量评分(IDQOL/CDLQI,DFI)。结果 AD患儿s Ig E抗体阳性37例(69.81%),初诊时IDQOL评分(8.94±3.57)分,CDLQI评分(8.00±2.70)分,DFI评分分别为(8.54±4.50)分和(7.17±3.38)分。IDQOL/CDLQI评分最高的前3项是瘙痒、情绪和睡眠,低年龄组DFI评分最高的前3项是睡眠、疲劳和购物花费,高年龄组DFI评分最高的前3项是疲劳、睡眠和情绪,说明AD对两个年龄组家庭生活质量影响存在一定差异。与初诊时比较,两个年龄组AD患儿治疗教育3个月后随访时疾病严重度、患儿及其家庭生活质量均有显著改善,差异有统计学意义(P均为0.000)。结论患者教育在AD患儿长期治疗管理中发挥着重要作用,针对不同年龄患儿,可以进行差异化的患者教育。     

窄谱中波紫外线治疗特应性皮炎疗效观察

目的：观察窄谱中波紫外线（NB—UVB）治疗特应性皮炎（AD）的疗效。方法：53例AD患者接受NB—UVB治疗仪照射治疗，每周治疗3次，连续治疗36次。采用欧洲AD评分标准（SCORAD）对AD的临床严重度进行评分，用视觉模拟尺度（VAS）评分法对瘙痒程度进行评分，同时记录SCORAD积分和VAS积分。疗程结束后评价疗效。结果：53例患者痊愈17例（32．08％），显效28例（52．83％），有效5例（9．43％），有效率为84．91％，SCORAD积分和VAS积分较治疗前明显下降（P〈0．01）。结论：NB—UVB治疗AD安全性高，近期疗效好，操作简便，患者依从性好。     

白细胞介素-32和胸腺基质淋巴细胞生成素在特应性皮炎患者外周血中的表达

目的探讨特应性皮炎(atopic dermatitis,AD)患者治疗前及治疗8周后外周血白细胞介素(IL)-32、胸腺基质淋巴细胞生成素(TSLP)的表达及意义。方法选取AD患者48例,健康对照组30例,采用酶联免疫吸附试验(ELISA)分别检测治疗前及治疗后外周血IL-32、TSLP的表达水平,分析治疗前后二者的表达意义及与AD病情严重程度(SCORAD)评分的相关性。结果 AD患者治疗前IL-32、TSLP水平较正常对照组均显著升高(P均0.01),且TSLP与SCORAD评分呈正相关(P 0.01)。AD患者应用他克莫司软膏联合复方甘草酸苷治疗后血清IL-32表达水平较治疗前明显降低(P 0.01),与正常对照组比差异无统计学意义(P 0.05);治疗后TSLP表达水平较治疗前明显降低(P 0.01),较正常对照组升高(P 0.01)。AD患者治疗前血清IL-32与TSLP水平之间有相关性,为正相关(P 0.01),治疗前SCORAD评分明显高于治疗后,差异具有统计学意义(P 0.01)。结论 IL-32、TSLP在AD患者外周血中表达升高,并与病情严重程度呈正相关。应用他克莫司和复方甘草酸苷治疗可降低IL-32和TSLP在患者血清中的表达水平。     

金银花口服液治疗幼儿特应性皮炎的临床疗效观察

目的 观察金银花口服液治疗幼儿湿热型特应性皮炎（AD）的临床疗效及对患儿血清总免疫球蛋白E(IgE)和外周血嗜酸粒细胞的影响。方法 选择沈阳市第七人民医院2020年1月—12月收治的92例AD患儿按随机分为治疗组和对照组各46例。对照组口服盐酸西替利嗪滴剂,外用院内制剂湿毒洗剂和硼酸氧化锌软膏;治疗组在对照组的基础上加服金银花口服液,均连续治疗2周。比较2组AD严重程度评分指数（SCORAD）评分、血清总IgE、外周血嗜酸粒细胞水平及临床疗效变化,并记录不良反应发生情况。结果 治疗后治疗组SCORAD评分和总IgE、嗜酸粒细胞水平均明显低于对照组（P<0.05）;治疗组有效率为71.74%高于对照组的47.83%（χ2=5.47,P=0.02）,2组不良反应比较差异无统计学意义（χ2=0.19,P=0.66）。结论 金银花口服液治疗幼儿湿热型AD疗效明显,可以有效降低血清总IgE和外周血嗜酸粒细胞水平,且安全性高。     

The effect of dermatology consultations in secondary care on treatment outcome and quality of life in new adult patients with atopic dermatitis

BACKGROUND: The prevalence of atopic dermatitis (AD) is increasing worldwide, and many patients present to secondary care in adult life. This is a significant contribution to the workload of all dermatology departments. There are no studies investigating the impact of a dermatology consultation within secondary care. OBJECTIVES: To examine the effect of dermatology consultations in secondary care on treatment outcome and quality of life in new adult patients with AD. METHODS: This prospective observational study recruited new adult patients with AD referred from primary care. Eczema severity was assessed using the SCORAD (Severity Scoring of AD) index and subjective good or poor clinical outcome. The Dermatology Life Quality Index (DLQI) was used to quantify the impact of AD on adult patients. Patients were assessed at initial consultation (T1), 6 weeks (T2) and 3 months (T3). Statistical analysis was performed using independent t-tests, repeated-measures analysis of variance, correlation coefficients and Bonferroni post hoc comparisons. RESULTS: Sixty-three patients were recruited (37 women, 26 men) with a mean age of 34 years. Mean SCORAD at T1 was 48.2 and the majority (51%) had severe eczema (objective SCORAD>40). Mean SCORAD reduced by 52% from T1 to T2 (P<0.001) but there was no significant change in SCORAD from T2 to T3. A subjective good clinical outcome was validated by a decrease in SCORAD of >20 (P<0.001). Patients in the good clinical outcome group were significantly older than those in the poor clinical outcome group (38 vs. 27 years, P<0.05). The mean age at presentation of women was significantly younger than men (29 vs. 43 years, P<0.01). Women's mean SCORAD improved over all three visits, while men's mean SCORAD improved from T1 to T2 but worsened from T2 to T3 (P<0.001). The mean DLQI reduced over all three visits, from 9.5 at T1 to 8.8 at T2 and 7.0 at T3, and was significantly correlated with SCORAD at T1 and T2 (P<0.01). Patients accurately self-scored their eczema on a body map as shown by a significant correlation between these scores and SCORAD at T1 and T2 (P<0.001). CONCLUSIONS: We have shown that within the first 3 months of referral to secondary care, new adult patients with AD have the greatest improvement in AD, measured by SCORAD, after their initial appointment. Quality of life, as measured by DLQI, continued to improve over all three visits.     

Impact of disease severity on work productivity and activity impairment in Japanese patients with atopic dermatitis

Atopic dermatitis (AD) is a common inflammatory skin disease that is characterized by chronic and persisting pruritic and eczematous lesions. There has been no study of work productivity and activity in AD patients in relation to disease severity. The purpose of this study was to examine the impact of disease severity on work productivity and activity impairment (WPAI) in adult AD patients using the Japanese version of the questionnaire. Data were collected from 112 AD patients who visited the Jikei University Hospital. Outcomes as measured by the questionnaire included employment status, total work productivity impairment (TWPI) and total activity impairment (TAI). We investigated the correlation between TWPI or TAI scores and severity scoring of AD (SCORAD) for disease severity and dermatology life quality index (DLQI) for quality of life impairment. Both TWPI and TAI scores were significantly correlated with the SCORAD and DLQI scores (P < 0.001), indicating disease severity is significantly associated with WPAI in Japanese adult AD patients. Further studies are necessary to evaluate the effects of treatments on WPAI for severe AD patients.     

An assessment of anxiety and dermatology life quality in patients with atopic dermatitis

Anxiety is a prevalent psychological factor associated with atopic dermatitis (AD). AD patients generally suffer from a high anxiety level, and psychological treatment documents a positive effect on the anxiety level, as well as the course and management of the disease. The Dermatology Life Quality Index (DLQI) has been suggested as a relevant clinical measure in AD. This study investigated the relationship between the severity of AD, dermatological life quality and anxiety. Thirty-two adults suffering from AD were examined using the Severity Scoring of AD Index (SCORAD), the DLQI and the Spielberger State-Trait Anxiety Index (STAI). Twenty-two healthy controls were examined using the DLQI and STAI. Results showed that the AD group had higher anxiety and lower dermatological life quality than the control group. In the AD group a significant positive correlation was found between SCORAD and DLQI and between DLQI and STAI. However, no correlation was found between SCORAD and STAI. The results suggest that: (i) both severity of eczema and anxiety are important for dermatological life quality; (ii) psychological inferences should not be made from the severity of eczema, but from the psychological measures, and vice versa; and (iii) both dermatological and psychological assessment is important in AD.     

Dermatology life quality index scores in children with vitiligo: comparison with atopic dermatitis and healthy control subjects

Vitiligo and atopic dermatitis (AD) are two major cutaneous diseases that affect quality of life (QoL) by causing functional and psychosocial disorders. Our objective was to calculate Children’s Dermatology Life Quality Index (CDLQI) scores in children with vitiligo and to compare these values with those in AD patients and healthy control subjects. The CDLQI was completed for 50 vitiligo and 50 AD patients presenting at the dermatology polyclinic, as well as for 50 age‐ and sex‐matched healthy controls. All subgroups in the vitiligo patient group had significantly higher total CDLQI scores than healthy controls. Vitiligo patients were found to have increased scores on all parameters, except itch, clothes/shoes, and sleep, compared with the AD patient group. Scores on itch and sleep were significantly higher in the AD group than in the vitiligo patients. Quality of life in children with vitiligo is substantially lower than in children with AD. This decline in QoL is critical in the psychosocial development of the former group.     

湿包裹治疗儿童重度特应性皮炎的疗效观察

目的观察湿包裹(WWT)治疗儿童重度特应性皮炎(AD)的疗效和安全性。方法2018年9月-2019年9月在南京儿童医院皮肤科门诊诊断为重度AD的患儿(符合Williams诊断标准,SCORAD>50分)40例,随机分为WWT组(n=20)和传统治疗组(n=20)。WWT组采用0.1%糠酸莫米松乳膏联合2%莫匹罗星软膏行WWT,传统治疗组采用同样药物直接外用治疗,均连续治疗5 d。评估两组治疗前后患儿AD积分指数评分(SCORAD)及瘙痒程度直观模拟尺评分(VAS)的改善情况。结果WWT组治疗前SCOARD评分和VAS评分分别为(62.53±7.33)分和(6.55±1.15)分,治疗后分别为(20.71±3.40)分和(0.35±0.49)分,较前显著下降(P<0.01)。WWT组SCORAD评分下降分值为(41.83±6.61)分,显著高于传统治疗组(28.52±6.67)分(P<0.01);WWT组VAS评分下降分值为(6.20±1.28)分,与传统治疗组(5.50±1.28)分差异无统计学意义(P>0.05)。WWT组5例患儿主诉治疗过程中出现潮湿不适。结论WWT治疗儿童重度AD起效快,不良反应少,疗效优于传统外用药物。     

度普利尤单抗治疗123例特应性皮炎的疗效及安全性分析

【摘要】 目的 探讨度普利尤单抗治疗特应性皮炎（AD）的临床疗效及安全性。方法 通过双向性研究分析2020年7月至2022年3月于中南大学湘雅二医院皮肤科接受度普利尤单抗治疗的123例AD患者的临床资料,评估度普利尤单抗的疗效及安全性。主要指标为治疗前、治疗4、8、12、16周的患者湿疹面积和严重程度指数（EASI）、瘙痒峰值数字评定量表（NRS）、以患者为导向的湿疹测量评分（POEM）和皮肤病生活质量指数（DLQI）评分,同时记录不良反应及不良事件。治疗前后各评分的比较采用配对样本t检验或重复测量资料的方差分析;不同类型皮损及不同IgE水平患者疗效比较采用Mann-Whitney U检验;采用基于稳健标准误的多元回归模型分析疗效的影响因素。结果 123例AD患者中,107例纳入疗效分析,85例（79.44%）完成了至少4周治疗,其中6例（7.06%）达EASI75,23例（27.06%）达EASI50,EASI、NRS、POEM、DLQI评分（10.41 ± 6.72、4.12 ± 1.74、8.60 ± 4.29、7.81 ± 4.38）均显著低于治疗前（18.08 ± 10.69、7.21 ± 2.01、16.88 ± 5.74、12.95 ± 5.95）,均P < 0.001。共47例（43.93%）完成了至少16周治疗,28例成人患者中23例（82.14%）、19例青少年及儿童中17例（89.47%）达EASI75及以上;治疗4、8、12、16周EASI、NRS、POEM、DLQI评分与治疗前相比差异均有统计学意义（均P < 0.001）,且第4、8、12、16周各评分均显著低于前一相邻时间点（均P < 0.05）。治疗4周时,伴结节性痒疹的AD患者EASI评分改善率显著低于不伴者（U = 151.00,P = 0.006）,而伴与不伴干皮症的AD患者间EASI评分改善率差异无统计学意义（P > 0.05）;治疗16周时,不同类型皮损患者间EASI评分改善率差异无统计学意义（均P > 0.05）。基于稳健标准误的多元回归分析显示,第16周时EASI改善程度与皮疹类型无关（β = 3.20,P = 0.075）,和年龄（β = -0.22,P = 0.030）、成年与否（β = 9.54,P = 0.049）、直系亲属家族史（β = 7.46,P = 0.017）具有相关性;NRS评分改善程度与皮疹类型（β = 0.55,P = 0.032）、年龄（β = -0.04,P = 0.033）、体重（β = -0.05,P = 0.020）、成年与否（β = 2.06,P = 0.003）、是否合并使用抗组胺药物（β = -1.91,P = 0.001） 具有相关性。不良反应：123例患者中,6例（4.88%）发生结膜炎,2例（1.63%）出现面部红斑。不良事件：1例右前额出现白癜风样改变,3例分别因过敏性紫癜、双上肢周围神经远端轴索损害、癫痫停药,与度普利尤单抗的相关性不确定。结论 度普利尤单抗治疗AD疗效显著,总体安全性好,可作为传统治疗欠满意患者的治疗新选择。     

儿童特应性皮炎严重程度与血清25-羟维生素D和总IgE水平的相关性

目的：明确儿童特应性皮炎患者特应性皮炎严重程度与血清25-羟维生素D和IgE水平的相关性。方法：参考SCORAD评分法评估60例特应性皮炎患者疾病严重程度，并检测特应性皮炎患者及55例对照组血清25-羟基维生素D3水平以及特应性皮炎患者总IgE水平。结果：特应性皮炎组患者血清25-羟维生素D水平(16.13±6.68)ng/mL低于对照组(19.81±8.24)ng/mL，差异有统计学意义（P<0.05）。根据SCORAD评分，特应性皮炎患者中33例为轻度、20例为中度，7例为重度。轻度组血清25-羟基维生素D3水平为(18.69±7.01)ng/mL，高于中度(12.81±4.35)ng/mL，差异有统计学意义（P<0.05）。血清25-羟维生素D与SCORAD评分之间有显著负相关（P<0.05）。IgE水平与SCORAD评分之间无相关性（P>0.05）。结论：AD患者血清25-羟基维生素D与AD严重程度呈负相关。     

Salivary chromogranin A levels correlate with disease severity but do not reflect anxiety or personality of adult patients with atopic dermatitis

Stress‐induced scratching is an issue in patients with adult atopic dermatitis (AD). Although itching and stress are believed to be intimately related, no objective index is available; therefore, most evaluations are subjective. Using saliva, which is easily collected, we investigated the degree to which AD severity and patient stress levels are reflected in stress proteins in the saliva. Here, we evaluated the severity (Scoring Atopic Dermatitis [SCORAD] score), stress (State–Trait Anxiety Index [STAI] score), personality (Tokyo University Egogram [TEG] II score) and quality of life (Dermatology Life Quality Index [DLQI] score) of 51 patients with AD who were examined in the Department of Dermatology of Shimane University between April and December 2015. We collected saliva and measured salivary chromogranin A (CgA), amylase and cortisol. The amount of salivary CgA per protein in patients with AD was correlated with their SCORAD score (r = 0.458, P < 0.001). There was no correlation between cortisol or amylase levels and SCORAD score. SCORAD score was correlated with DLQI (r = 0.390, P = 0.006). CgA per protein was correlated with DLQI (r = 0.393, P = 0.004). There was no correlation between scores for the anxiety component of the STAI, TEG II or DLQI. Our results suggested that patients with more severe AD may have high stress levels. The personalities of these patients with AD tended to involve elevated anxiety levels.