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重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对中重度银屑病患者血清脂肪因子水平的影响:前瞻性非随机对照试验

乔菊 李峰 何春霞 吴超 晋红中

乔菊, 李峰, 何春霞, 吴超, 晋红中. 重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对中重度银屑病患者血清脂肪因子水平的影响:前瞻性非随机对照试验[J]. 协和医学杂志, 2019, 10(3): 243-248. doi: 10.3969/j.issn.1674-9081.2019.03.010
引用本文: 乔菊, 李峰, 何春霞, 吴超, 晋红中. 重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对中重度银屑病患者血清脂肪因子水平的影响:前瞻性非随机对照试验[J]. 协和医学杂志, 2019, 10(3): 243-248. doi: 10.3969/j.issn.1674-9081.2019.03.010
Ju QIAO, Feng LI, Chun-xia HE, Chao WU, Hong-zhong JIN. Effects of the Receptor-IgG Fc Fusion Protein of Recombinant Type Ⅱ Human Tumor Necrosis Factor-α on the Levels of Serum Adipokines in Psoriatic Patients: A Prospective Non-randomized Controlled Trial[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(3): 243-248. doi: 10.3969/j.issn.1674-9081.2019.03.010
Citation: Ju QIAO, Feng LI, Chun-xia HE, Chao WU, Hong-zhong JIN. Effects of the Receptor-IgG Fc Fusion Protein of Recombinant Type Ⅱ Human Tumor Necrosis Factor-α on the Levels of Serum Adipokines in Psoriatic Patients: A Prospective Non-randomized Controlled Trial[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(3): 243-248. doi: 10.3969/j.issn.1674-9081.2019.03.010

重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对中重度银屑病患者血清脂肪因子水平的影响:前瞻性非随机对照试验

doi: 10.3969/j.issn.1674-9081.2019.03.010
基金项目: 

中国医学科学院医学与健康科技创新工程服务"一带一路"战略先导科技专项 2017-I2M-B&R-01

详细信息
    通讯作者:

    晋红中 电话:010-69151500, E-mail:jinhongzhong@263.net

  • 中图分类号: R751.05

Effects of the Receptor-IgG Fc Fusion Protein of Recombinant Type Ⅱ Human Tumor Necrosis Factor-α on the Levels of Serum Adipokines in Psoriatic Patients: A Prospective Non-randomized Controlled Trial

More Information
  • 摘要:   目的  分析注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对中重度斑块型银屑病患者血清脂联素(adiponectin, APN)、视黄醇结合蛋白4(retinol binding protein 4, RBP4)、瘦素(leptin, LEP)3种脂肪因子水平的影响。  方法  选取2016年11月至2018年5月在北京协和医院皮肤科就诊的30例中重度斑块型银屑病患者作为治疗组, 同时选取在本院健康医学部进行体检的25名健康人作为健康对照组。治疗组均给予重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白50 mg皮下注射, 每周1次, 共12次。检测健康对照组及治疗组治疗前(基线)和治疗后12周血清APN、RBP4、LEP的浓度; 分析两组之间以及治疗组治疗前后血清脂肪因子水平是否存在差异, 并采用Spearman相关分析法评估治疗组基线血清APN、RBP4、LEP表达水平与银屑病皮损面积和严重程度指数(psoriasis area and severity index, PASI)之间有无线性相关关系。  结果  治疗组基线APN水平[9.73(6.69, 12.37)比(14.25(10.53, 23.28), P<0.001]、LEP水平[0.42(0.17, 2.60)比3.90(1.38, 7.20), P=0.002]较健康对照组降低, RBP4较健康对照组升高[12.29(10.62, 21.33)比9.13(7.36, 15.78), P=0.024];治疗组治疗后APN水平[11.95(8.12, 15.26)比9.73(6.69, 12.37), P=0.027]、LEP水平[2.84(1.04, 9.34)比0.42(0.17, 2.60), P<0.001]较治疗前明显升高, 而RBP4水平较治疗前差异无统计学意义(P=0.125);基线APN、RBP4、LEP浓度均与PASI无线性相关关系。  结论  脂肪因子可能参与了银屑病的慢性炎症过程, 抗肿瘤坏死因子α治疗可能改善银屑病的炎症状态。
    利益冲突  无
  • 图  1  30例中重度银屑病患者基线期血清APN(A)、RBP4(B)、LEP(C)水平与PASI的相关性

    APN、RBP4、LEP:同表 2;PASI:银屑病皮损面积和严重程度指数

    表  1  治疗组与健康对照组一般资料比较

    组别 性别
    (男/女, n)
    年龄
    [M(Q), 岁]
    BMI
    (x±s, kg/m2)
    治疗组(n=30) 19/11 36(29, 46) 23.87±1.67
    健康对照组(n=25) 16/9 36(27, 48) 24.17±2.46
    χ2/Z/t 0.003 6.242 0.54
    P 0.959 0.793 0.592
    BMI:体质量指数
    下载: 导出CSV

    表  2  治疗前治疗组与健康对照组血清脂肪因子水平比较 [M(Q)]

    组别 APN(μg/ml) RBP4(μg/ml) LEP(ng/ml)
    治疗组(n=30) 9.73(6.69, 12.37) 12.29(10.62, 21.33) 0.42(0.17, 2.60)
    健康对照组(n=25) 14.25(10.53, 23.28) 9.13(7.36, 15.78) 3.90(1.38, 7.20)
    Z -3.753 -2.265 -3.026
    P <0.001 0.024 0.002
    APN:脂联素;RBP4:视黄醇结合蛋白4;LEP:瘦素
    下载: 导出CSV

    表  3  30例中重度银屑病患者治疗前后血清脂肪因子水平比较 [M(Q)]

    组别 APN(μg/ml) RBP4(μg/ml) LEP(ng/ml)
    治疗前 9.73(6.69, 12.37) 12.29(10.62, 21.33) 0.42(0.17, 2.60)
    治疗12周后 11.95(8.12, 15.26) 11.81(9.14, 14.88) 2.84(1.04, 9.34)
    Z -2.211 -1.532 -4.227
    P 0.027 0.125 <0.001
    APN、RBP4、LEP:同表 2
    下载: 导出CSV
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  • 收稿日期:  2019-01-23
  • 刊出日期:  2020-09-18

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