目的:比较环孢素A与甲氨蝶呤(MTX)治疗阿维A无效的泛发性脓疱型银屑病的疗效,观察长期用药的安全性.方法:将入选的泛发性脓疱型银屑病患者分为环孢素A组与MTX组,其中环孢素A组29例,MTX组32例.比较红斑和脓疱的平均消退时间、血压、血尿常规和肝肾功等生化化验指标,随访半年复发率.结果:红斑和脓疱的平均消退时间差异有显著性,环孢素A组优于MTX组;对血压影响差异有显著性,环孢素A组高于MTX组;对血尿常规和肾功能影响差异无显著性;对肝功能影响差异有显著性,MTX组明显高于环孢素A组.两组复发率无显著性.结论:在治疗阿维A无效的难治性泛发性脓疱型银屑病中,环孢素A的疗效优于MTX,安全性高于MTX.%Objective :To compare the efficacy and safety of cyclosporine A and MTX in generalized pustular psoriasis ( GPP) treatment.Methods :The GPP patients were divided into two groups respectively:the cyclosporine A group and MTX group.29 cases were included in the the cyclosporine A group, and 32 cases in the MTX group.Such indexes as average disappearance times of fever, erythema, pustules representing the efficacy of treatment , blood pressure, blood and urine routine tests and liver and kidney function tests which demonstrated the safety were compared with t-test.Recurrence rates were compared with X2-test.Results:Indexes of efficacy had significant statistical defference, cyclosporine A group was superior to MTX group.Meanwhile, test of the liver function had significant statistical defference , MTX group impaired the liver function much worse.The influence on blood pressure.had significant statistical defference, which meant cyclosporine A group was much more readily influenced by treatment.Routine analysis of blood and urine and the test of the kidney fuction had no significant statistical defferences ; the recurrence rate had no significant statistical defference, either.Conclusion In the systemic treatment of GPP, cyclosporine A showed better efficacy and safety than MTX.
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