中国实用儿科杂志

中国实用儿科杂志

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尘螨特异性免疫治疗哮喘合并变应性鼻炎患儿早期疗效及影响因素研究

  

  1. 1.首都医科大学附属北京儿童医院过敏反应科，北京  100045；2.济南市儿童医院，山东  济南  250022
  • 出版日期:2016-03-06 发布日期:2016-03-09

Study on the influencing factors and the clinical efficacy of dust mite specific immunotherapy for children  with  asthma  and allergic rhinitis

  1. *Department of Allergy，Beijing Children’s Hospital，Capital Medical University，Beijing  100045，China
  • Online:2016-03-06 Published:2016-03-09

摘要：

目的    了解哮喘合并变应性鼻炎患儿经尘螨特异性免疫治疗后早期临床疗效的动态变化， 并探讨疗效影响因素。方法　收集2012年2月至11月于北京儿童医院确诊的尘螨致敏的轻中度哮喘合并变应性鼻炎患儿70例， 对其进行尘螨特异性免疫治疗联合哮喘和鼻炎的药物治疗， 并进行病例自身对照研究。结果　54例患儿完成了1年的随访， 治疗后3、 6、 9和12个月的治疗有效率分别为72.2%、 75.9%、 81.5%和87.0%； 治疗后1年SMS较基线期显著降低［（5.28±2.28） vs. （2.87±1.96），P＜0.05］，VAS较基线期显著降低［（5.59±3.35） vs. （4.04±3.68），P＜0.05］，肺功能呼气流量峰值（PEF% pred）较基线期显著升高［（95.41±15.18） vs. （99.24±16.24），P＜0.05］。结论　尘螨特异性免疫治疗联合控制药物治疗哮喘合并变应性鼻炎患儿的早期有效率随治疗时间延长而升高， 哮喘病程短、 基线期PEF%pred低、 基线期症状用药计分高的患儿特异性免疫治疗的早期临床疗效更为显著。

关键词: 儿童, 支气管哮喘, 变应性鼻炎, 特异性免疫治疗, 尘螨

Abstract:

Objective    To understand the dynamic changes of early clinical curative effect in children with asthma and allergic rhinitis who received the dust mite specific immunotherapy，and to discuss the influencing factors of the efficacy. Methods    A total of 70 cases with mild or moderate persistent asthma combined with allergic rhinitis who received the dust mite specific immunotherapy combined with drug therapy between February 2012 and November 2012 in Beijing Children’s Hospital were adopted in the case-self-control study. Results    Totally 54 cases completed treatment of 12 months. The clinical response rates to SIT （effective cases） at 3，6，9 and 12 months after SIT were 72.2%（39），75.9%（41），81.5%（44） and 87.0%（47）， respectively. After one year of treatment，the average daily SMS and VAS score were all decreased （5.28±2.28 vs. 2.87±1.96，5.59±3.35 vs. 4.04±3.68， P＜0.05）. PEF% pred was improved［（95.41±15.18） vs. （99.24±16.24），P＜0.05］. Conclusion    The effective rate of SIT increases gradually with prolonged treatment. When children with asthma and allergic rhinitis received immunotherapy combined with drug therapy，the patients with higher baseline SMS，shorter asthma history and lower PEF%pred respond more effectively to SIT.

Key words: children, bronchial asthma, allergic rhinitis, specific immunotherapy, dust mite