目的 观察度普利尤单抗联合左西替利嗪治疗中重度特应性皮炎的疗效。方法 选取2022年4月—2024年3月南京鼓楼医院集团宿迁医院收治的94例患者，依据治疗方法不同分为对照组（47例）和治疗组（47例）。对照组口服盐酸左西替利嗪片，5 mg/次，1次/d。在对照组基础上，治疗组皮下注射度普利尤单抗注射液，成人首剂注射负荷剂量600 mg，2周后剂量300 mg。儿童体质量60 kg及以上，首剂负荷剂量600 mg，2周后第2剂300 mg。30 kg≤体质量＜60 kg，首剂负荷剂量400 mg，2周后第2剂200 mg；15 kg≤体质量＜30 kg，给予1剂600 mg。两组治疗4周。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间、皮肤病生活质量问卷（DLQI）评分、特应性皮炎积分表（SCORAD）评分、瘙痒/睡眠和皮肤美观度评分。结果 治疗后，治疗组总有效率为95.74%，明显高于对照组的80.85%（P＜0.05）。治疗后，治疗组皮肤干燥、皮肤瘙痒、皮肤红斑和皮肤丘疹等症状缓解时间均早于对照组（P＜0.05）。治疗后，两组患者DLQI评分、SCORAD评分、瘙痒/睡眠-数字评分分级法（NRS）和皮肤美观度评分较治疗前均明显下降（P＜0.05），且治疗后，与对照组对比，治疗组患者评分降低更明显（P＜0.05）。结论 盐酸左西替利嗪与度普利尤单抗协同治疗，可改善患者特应性皮炎症状，促使炎性反应减弱，缓解患者皮损状态及生活质量。

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