生物制剂在罕见、难治性皮肤病中的应用：疗效与挑战的系统综述与 Meta 分析

开琴 王(自贡市第一人民医院皮肤科，中国;)
慧 姜(滨州医学院烟台附属医院皮肤科，中国;)
文双 李(安宁市中医医院皮肤科，中国;)
永书 桂(文山壮族苗族自治州皮肤病防治所，中国;)

摘要

目的：系统评价生物制剂对比安慰剂治疗中重度化脓性汗腺炎（HS）的短期疗效与安全性。方法：计算机检索PubMed、Embase、Cochrane Library和Web of Science数据库，搜集建库至2025年9月30日的相关随机对照试验（RCT）。由四名研究者独立筛选文献、提取资料并评价偏倚风险后，采用RevMan Web软件进行Meta分析。结果：共纳入9项RCT，合计1974例患者。Meta分析结果显示，与对照组相比，生物制剂能显著提高患者的临床应答率（合并风险比 [RR] = 1.82， 95% CI: [1.47, 2.25]， P = 0.003）。总效应的95%预测区间为 [0.93, 2.18]，提示未来研究结果仍存在一定不确定性。研究间存在中度异质性（I² = 47%）。定性综合提示临床应用面临疗效衰减、感染风险、经济负担及缺乏预测性生物标志物等挑战。结论：生物制剂能显著提高中重度HS患者的短期临床应答率，但疗效存在异质性，临床应用需综合权衡获益、风险及成本。

关键词

化脓性汗腺炎；生物制剂；Meta分析；随机对照试验；疗效

参考

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DOI: http://dx.doi.org/10.12345/yzlcyxzz.v9i1.35843