Effect evaluation of allergen specific immunotherapy in patients with allergic rhinitis and asthma
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摘要: 目的:探讨变应原特异性免疫治疗(SIT)对变应性鼻炎(AR)伴变应性哮喘患者的临床疗效。方法:选择对屋尘螨过敏的AR伴变应性哮喘患者68例,随机分为SIT组和对症治疗(ST)组,每组34例。SIT组在ST治疗基础上加用3年标准化屋尘螨变应原免疫治疗;ST组仅采用对症药物治疗。观察及评价疗效指标包括:鼻炎症状评分、哮喘症状评分、用药评分、皮肤点刺试验、血清特异性IgE、外周血嗜酸细胞计数(Eos)、肺功能及出现新的致敏原的比例。结果:治疗3年后,SIT组的症状及药物评分、肺功能、Eos、皮肤点刺试验结果与对照组比较差异均有统计学意义(P<0.01)。SIT组患者治疗后slgE有所下降,与ST组比较差异无统计学意义。SIT组8.8%的患者出现新的致敏原,ST组52.9%的患者出现新的致敏原。2组在治疗过程中均未发生严重不良反应。结论:AR伴变应性哮喘患者行SIT治疗可取得良好疗效。Abstract: Objective:To evaluate the effect of allergen specific immunotherapy(SIT)in patients with allergic rhinitis and asthma.Method:A total of 68 patients with allergic rhinitis and asthma sensitized to dust mite were recruited into the study. They were randomly divided into two groups:SIT group n=34 and symptomatic therapy (ST)group:n=34. Patients in ST group received medication to treat,the symptoms, patients in SIT group received medication and 3 years of standardized allergen vaccine therapy. Evaluation index of therapy includes:rhinitis symptoms score, asthma symptoms score, drug score, skin prick test, serum specificity IgE (sIgE), peripheral eosinophil (Eos) counting,lung function. The new sensitinogen rate was also assessed.Result:Clinical symptom scores, drug scores, lung function,blood eosinophil numbers and skin test result were all improved significantly after 3-year treatment in SIT group compared to those in ST group (P<0.01). Although the level of serum slgE was decreased,there exited no statistic diferences between two groups. Only 8.8% patients have the new sensitization in SIT group,and 52.9% in ST group. There were no serious adverse reactions in treatment process.Conclusion:SIT for patients with AR and asthma can obtain excellent clinical efficacy.
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[1] BROZEK J L,BOUSQUET J,BAENA-CAGNANI C E,et al.Allergic Rhinitis and its Impact on Asthma(ARIA)guidelines:2010revision[J].J Allergy clin Immunol,2010,126:466-476.
[2] BOUSQUET J,LOCKEY R F,MALLING H J.The WHO panel members.Allergen immunotherapy:therapeutic vaccines for allergic diseases.A WHO position paper[J].J Allergy Clin Immunol,1998,102:558-562.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科分会.变应性鼻炎的诊治原则和推荐方案(2004年,兰州)[J].中华耳鼻咽喉头颈外科杂志,2005,40(3):166-167.
[4] 中华医学会呼吸病学分会哮喘组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗及教育和管理方案)[S].中华结核和呼吸杂志,2008,31(3):177-185.
[5] 乔兼善.变态反应学实验技术[J].北京:协和大学出版社,2002:107-108.
[6] 王红玉,林小平,郝创利,等.标准化屋尘螨疫苗免疫治疗对变应性支气管哮喘的疗效[J].中华结核和呼吸杂志,2006,29(10):679-679.
[7] HOGG J C,JAMES A L,PARE P D.Evidence for inflammation in asthma[J].Am Rev Respir Dis,1991,143(3 Pt 2):S39-S42.
[8] BOUSQUET J,HEJJAOUI A,CLAUZEL A M,et al.Specific immunotherapy with a standardized Dermatophagoides pteronyssinus extract.II.Prediction of efficacy of immunotherapy[J].J Allergy Clin Immunol,1998,82:971-977.
[9] ALVAREZ-CUESTA E,BOUSQUET J,CANONICA G W,et al.Standards for practical allergen-specific immunotherapy[J].Allergy,2006,61(Suppl):1-20.
[10] 王成硕,张罗,韩德民,等.标准化尘螨变应原疫苗治疗变应性鼻炎1年的疗效和安全性研究[J].中国耳鼻咽喉头颈外科,2007,14(1):3-6.
[11] JOINT TASK FORCE ON PRACTICE PARAMETERS.Allergen immunotherapy:apractice parameter.American Academy of Allergy,Asthma and Immunology.American College of Allergy,Asthma and Immunology[J].Ann Allergy Asthma Immunol,2003,90(1 Suppl 1):1-40.
[12] MAAZI H,SHIRINBAK S,WILLART M,et al.Contribution of regulatory T cells to alleviation of experimental allergic asthma after specific immunotherapy[J].Clin Exp Allergy,2012,42:1519-1528.
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