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一项针对特应性皮炎患者在接受外用他克莫司治疗的前 4 年中出现的湿疹和呼吸道症状进行的 10 年开放性随访研究。

A 10-year open follow-up of eczema and respiratory symptoms in patients with atopic dermatitis treated with topical tacrolimus for the first 4 years.

机构信息

Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

J Dermatolog Treat. 2010 May;21(3):167-70. doi: 10.3109/09546630903493329.

Abstract

OBJECTIVES

To examine the 10-year outcome of affected body surface area (BSA), respiratory symptoms, and serum IgE in adult AD patients 6 years after a 4-year intervention with topical tacrolimus.

METHODS

Patients who 10 years ago participated in a 4-year, open tacrolimus study (n = 65) were contacted for assessment of affected BSA, bronchial hyper-reactivity (BHR), respiratory symptoms, skin prick tests and serum IgE.

RESULTS

Altogether, 50 (77%) patients attended the follow-up visit. The median affected BSA decreased from 19% to 1.6% during the 10-year follow-up (p < 0.0001). Patients with active asthma and rhinitis symptoms at baseline reported a significant decrease at the follow-up (p = 0.02 andp = 0.01). In patients with BHR at baseline, the provocative dose of inhaled histamine producing a 15% decrease in FEV(1) increased. Responders (>or= 60% improvement of affected BSA) to tacrolimus treatment at the 1-year visit had a significantly smaller affected BSA at the 4- and 10-year visits than non-responders (< 60% improvement). Responders also showed a significant decrease in serum IgE at the follow-up visit compared to baseline (p = 0.002).

CONCLUSIONS

The long-term, effective treatment of patients with AD may have a beneficial effect on affected BSA, respiratory symptoms, and serum IgE.

摘要

目的

研究经外用他克莫司治疗 4 年后,6 年后对成人 AD 患者的受累体表面积(BSA)、呼吸道症状和血清 IgE 的 10 年结果。

方法

10 年前参加过为期 4 年的开放性他克莫司研究的患者(n=65)接受了受累 BSA、支气管高反应性(BHR)、呼吸道症状、皮肤点刺试验和血清 IgE 的评估。

结果

共有 50 名(77%)患者参加了随访。在 10 年的随访中,受累 BSA 中位数从 19%下降至 1.6%(p<0.0001)。基线时有哮喘和鼻炎症状的患者在随访时报告症状显著改善(p=0.02 和 p=0.01)。在基线时存在 BHR 的患者,吸入组胺导致 FEV1 下降 15%的激发剂量增加。在 1 年访视时对他克莫司治疗有反应(受累 BSA 改善≥60%)的患者在 4 年和 10 年访视时的受累 BSA 明显较小,而非反应者(受累 BSA 改善<60%)的患者则较小。与基线相比,反应者在随访时的血清 IgE 也显著下降(p=0.002)。

结论

对 AD 患者进行长期有效的治疗可能对受累 BSA、呼吸道症状和血清 IgE 产生有益的影响。

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