[摘要]目的：探究大疱性类天疱疮应用度普利尤单抗辅助治疗的疗效，以及对疱液中基质金属蛋白酶-2（MMP-2）、嗜酸性细胞阳离子蛋白（ECP）水平的影响。方法：选取2021年2月-2024年2月在笔者医院治疗的大疱性类天疱疮患者80例，采用随机数生成器分为两组，对照组（n=40，采用糖皮质激素+他克莫司软膏治疗），观察组（n=40，采用度普利尤单抗+糖皮质激素+他克莫司软膏治疗），比较两组治疗前后皮损情况、瘙痒程度；比较两组治疗前后MMP-2、ECP、血清BP180、BP230抗体水平，临床疗效及不良反应发生情况。结果：治疗后，与对照组相比，观察组患者的皮损情况、瘙痒症状改善更明显，MMP-2、ECP、BP180、BP230水平更低（P＜0.05）；观察组的总有效率高于对照组（P＜0.05）；两组不良反应总发生率差异无统计学意义。结论：大疱性类天疱疮应用度普利尤单抗辅助治疗，能够改善患者的皮损情况以及瘙痒症状，降低疱液中MMP-2、ECP、血清BP180、BP230抗体水平，临床疗效显著，同时安全性较高。

[关键词]大疱性类天疱疮；度普利尤单抗；基质金属蛋白酶-2；嗜酸性细胞阳离子蛋白

[中图分类号]R758.66" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0104-04

Efficacy of Dupilumab Adjuvant Therapy on Bullous Pemphigoid and Its Influence on MMP-2 and ECP Levels in Blister Fluid

CHEN Siqi， GOU Hui

（ Department of Dermatology， West China Hospital， Sichuan University， Chengdu 610041， Sichuan， China ）

Abstract： Objective" To investigate the efficacy on bullous pemphigoid treated by dupilumab adjuvant therapy and its influence on the levels of matrix metalloproteinase-2 （MMP-2） and eosinophil cationic protein （ECP） in blister fluid. Methods" Eighty patients with bullous pemphigoid who were treated in the author's hospital from February 2021 to February 2024 were selected and divided into two groups using a random number generator. The control group （n=40， treated with glucocorticoid + tacrolimus ointment）， and the observation group （n=40， treated with dupilumab + glucocorticoid + sinocorticoid）. The skin lesions and pruritus were compared between the two groups before and after treatment. The levels of MMP-2， ECP， serum BP180 and BP230 antibodies， clinical efficacy and occurrence of adverse reactions were compared between the two groups before and after treatment. Results" After treatment， compared with the control group， the skin lesions and itching symptoms in the observation group were improved more significantly， and the levels of MMP-2， ECP， BP180 and BP230 were lower （P＜0.05）. The total effective rate in the observation group was higher than that in the control group （P＜0.05）. There was no significant difference in the total incidence rate of adverse reactions between groups. Conclusion" The application of dupriuzumab in the adjuvant treatment of bullous pemphigoid can improve the skin lesions and itching symptoms of patients， and reduce the levels of MMP-2， ECP， serum BP180 and BP230 antibodies in the blister fluid， with significant clinical efficacy and safety.

Key words： bullous pemphigoid; dupilumab; matrix metalloproteinase-2; eosinophilic cationic protein

大疱性类天疱疮又称老年天疱疮，好发于老年人群[1-2]。患者皮肤会出现樱桃大至核桃大水疱，且疱壁紧张，不易破，疱液澄清或混有血液，常发生于四肢屈侧和胸腹部，伴瘙痒[3]。目前临床上治疗大疱性类天疱疮主要有口服糖皮质激素或他克莫司软膏局部治疗，难治性患者会联合免疫抑制剂[4]。但糖皮质激素长期使用会产生各种不良反应[5]。度普利尤单抗是一种由全人单克隆抗体组成的靶向生物制剂，常用于治疗成人中重度的特应性皮炎[6]。……