目的 探讨司库奇尤单抗联合卡泊三醇乳膏治疗中重度银屑病的临床疗效。方法 选取2020年9月—2021年12月在哈尔滨医科大学附属第四医院松北院区治疗的80例中重度银屑病患者，随机分对照组和治疗组，每组各40例。对照组患处皮肤涂抹卡泊三醇软膏，2次/d。在对照组的基础上，治疗组皮下注射司库奇尤单抗注射液，第0、1、2、3、4周给药，300 mg/次，而后每隔4周注射1次。两组患者治疗16周。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，面积和严重程度指数（PASI）评分，T淋巴细胞免疫功能，血清白细胞介素-2（IL-2）、白细胞介素-17（IL-17）、肿瘤坏死因子-α（TNF-α）和γ干扰素（IFN-γ）水平，及不良反应情况。结果 治疗后，治疗组临床有效率（97.50%）明显高于对照组（77.50%，P＜0.05）。治疗后，治疗组症状改善时间均明显早于对照组（P＜0.05）。治疗后，两组PASI评分明显下降（P＜0.05），且治疗组的PASI评分明显低于对照组（P＜0.05）。治疗后，两组免疫功能CD4^＋、CD8^＋指标水平明显升高（P＜0.05），且治疗组的CD4^＋、CD8^＋指标均高于对照组（P＜0.05）。治疗后，两组血清IL-2、IL-17、TNF-α、IFN-γ水平明显降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗组不良反应发生率（7.50%）明显低于对照组（17.50%，P＜0.05）。结论 司库奇尤单抗联合卡泊三醇乳膏治疗中重度银屑病效果确切，能显著减轻症状，对皮肤屏障功能能有效改善。

Objective To explore the clinical effect of secukinumab combined with Calcipotriol Ointment in treatment of moderate and severe psoriasis.Methods Patients (80 cases) with moderate and severe psoriasis in Songbei Hospital,the Fourth Hospital of Harbin Medical University from September 2020 to December 2021 were randomly divided into control and treatment group,and each group had 40 cases.Patients in the control group were administered with Calcipotriol Ointment to the affected skin,twice daily.Patients in the treatment group were subcutaneous injection administered with Secukinumab Injection on the basis of the control group,administration at week 0,1,2,3 and 4,300 mg/time,then injected every 4 weeks.Patients in two groups were treated for 16 weeks.After treatment,the clinical evaluation was evaluated,the improvement time of symptom,PASI score,T lymphocyte immune function,the serological levels of IL-2,IL-17,TNF-α and IFN-γ,adverse reactions in two groups before and after treatment were compared.Results After treatment,the clinical effective rate of the treatment group (97.50%) was significantly higher than that of the control group (77.50%,P<0.05).After treatment,the improvement time of symptom in the treatment group was significantly earlier than that in the control group (P<0.05).After treatment,the PASI score in two groups were significantly decreased,and the PASI score in the treatment group was significantly lower than that of the control group (P<0.05).After treatment,the levels of immune function CD4⁺ and CD8⁺ in two groups were significantly increased,and which in the treatment group were higher than those in the control group (P<0.05).After treatment,the serum levels of IL-2,IL-17,TNF-α and IFN-γ in two group were significantly decreased (P<0.05),and which in the treatment group were significantly lower than those in the control group (P<0.05).The incidence of adverse reactions in the treatment group (7.50%) was significantly lower than that in the control group (17.50%,P<0.05).Conclusion Calcipotriol Ointment combined with Secukinumab Injection is effective in the treatment of moderate and severe psoriasis,which can significantly relieve symptoms and effectively improve skin barrier function.

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