JAK抑制剂在慢性手部湿疹治疗中的应用及其复发的影响因素分析OA

Objective To evaluate the clinical efficacy of Janus kinase(JAK)inhibitors in treating chronic hand eczema(CHE)and to identify factors influencing disease recurrence.Methods A total of 156 patients with CHE admitted to the hospital from October 2021 to October 2024 were randomly assigned to a control group and a study group,each comprising 78 patients.The control group underwent conventional treatment,whereas the study group received a combination of conventional treatment and JAK inhibitor therapy.The treatment duration was 4 weeks,with weekly follow-ups.The clinical efficacy was compared between the two groups,including the Jena Hand Eczema Score(JHS)and Itching Visual Analog Scale(VAS)score before and after treatment.After completing the treatment,a 6-month follow-up was conducted to compare the recurrence rates and analyze the factors influencing recurrence.Results The study group exhibited a higher total effective rate of 92.31%compared to the control group's 80.77%(P＜0.05).Following 4 weeks of treatment,both groups demonstrated a significant reduction in JHS and VAS scores,with the study group achieving lower scores than the control group(P＜0.05).After 6 months of follow-up,with 2 patients lost to follow-up in each group,a total of 131 patients were included in the analysis,comprising 57 patients with recurrence(recurrence group)and 74 without recurrence(non-recurrence group).Univariate analysis revealed that the recurrence group had a higher prevalence of allergic history,family history of eczema,alcohol consumption,use of JAK inhibitors in combination with conventional therapy,and contact with hand irritants.They also had higher baseline JHS and VAS scores and a lower frequency of moisturizer use compared to the non-recurrence group(P＜0.05).Multivariate analysis further indicated that allergic history,treatment modality,exposure to hand irritants,baseline JHS score,and VAS score were independent factors influencing recurrence within 6 months post-CHE treatment(P＜0.05).The treatment modality acted as a protective factor(OR=0.321),while the remaining factors were identified as risk factors(OR＞1).Conclusion JAK inhibitors demonstrate significant therapeutic efficacy in managing chronic hand eczema,effectively alleviating symptoms and reducing itching intensity.Allergic history,treatment approach,exposure to hand irritants,baseline JHS score,and baseline VAS score are identified as independent factors influencing the recurrence of chronic hand eczema within 6 months after treatment.The treatment approach serves as a protective factor,whereas the other factors are considered risk factors.