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中国临床药理学与治疗学 ›› 2018, Vol. 23 ›› Issue (7): 836-840.doi: 10.12092/j.issn.1009-2501.2018.07.019

• 综述与讲座 • 上一篇    

皮肌炎治疗研究进展

卢晓红,王培光   

  1. 安徽医科大学第一附属医院皮肤性病科,合肥 230022,安徽
  • 收稿日期:2018-05-11 修回日期:2018-06-04 出版日期:2018-07-26 发布日期:2018-07-20
  • 通讯作者: 王培光,男,博士,主任医师,硕士生导师,研究方向:自身免疫性大疱病及遗传性皮肤病。 Tel:13965115871 E-mail:wpg2370@163.com
  • 作者简介:卢晓红,女,硕士研究生,研究方向:遗传性皮肤病。 Tel:17855126989 E-mail:wdm151963@163.com
  • 基金资助:

    安徽高校自然科学研究重点项目(KJ2017A201)

Progress in the treatment of dermatomyositis

LU Xiaohong,WANG Peiguang   

  1. Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
  • Received:2018-05-11 Revised:2018-06-04 Online:2018-07-26 Published:2018-07-20

摘要:

皮肌炎是一种以累及皮肤和肌肉为主的免疫性疾病。目前糖皮质激素是皮肌炎一线的治疗药物,联合使用免疫抑制剂,包括甲氨蝶呤、硫唑嘌呤、来氟米特、他克莫司及霉酚酸酯有助于提高临床疗效,降低糖皮质激素使用剂量。对于糖皮质激素和免疫抑制剂治疗无效的病情顽固者,可选择生物制剂(包括利妥昔单抗、阿巴西普、托珠单抗和英夫利昔单抗等)、静脉注射丙种球蛋白、血浆置换等疗法。一些免疫抑制剂和生物制剂治疗皮肌炎的临床疗效还有待于较大样本量的临床试验进一步验证。

关键词: 皮肌炎, 糖皮质激素, 免疫抑制剂, 生物制剂, 静脉注射免疫球蛋白, 血浆置换

Abstract:

Dermatomyositis is an autoimmune disease that mainly affects the skin and muscles. Systemic glucocorticoids is currently the first-line therapy of this disease. Combination of immunosuppressants helps to improve clinical efficacy and reduce the dosage of glucocorticoid, such as methotrexate, azathioprine, leflunomide, tacrolimus and mycophenolate mofetil. For some refractory cases without any response to the treatments of glucocorticoids and immunosuppressants, biologic agents (such as rituximab, abatacept, tocilizumab, infliximab), intravenous immunoglobulin, or plasma exchange are recommended. However, it is necessary to further demonstrate the clinical efficacy of some immunosuppressants and biologic agents on dermatomyositis in a lot of larger clinical trials.

Key words: dermatomyositis, glucocorticoids, immunosuppressive agents, intravenous immunoglobulin, plasma exchange, biological agents

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