影响常年性变应性鼻炎免疫治疗效果的相关因素探讨  

Perennial allergic rhinitis: stepwise regression analysis on the correlation with the efficacy of allergen-specific immunotherapy

作　　者：王全桂[1] 刘志贤[1] 张志超[1] 刘世援[1] 

机构地区：[1]北京大学第一医院耳鼻咽喉头颈外科,北京100034

出　　处：《临床耳鼻咽喉科杂志》2006年第11期481-483,共3页Journal of Clinical Otorhinolaryngology

摘　　要：目的:探讨影响常年性变应性鼻炎免疫治疗效果的相关因素。方法:根据患者病史所提供的线索,结合皮肤试验或激发试验,选择敏感变应原浸液,按递增剂量对164例常年性变应性鼻炎患者常规进行皮下免疫治疗,每周2次,起始浓度依据皮试反应或终点滴定试验来决定,直至102时改用维持量注射,每次0.5ml,注射间隔时间逐渐延长,至每月1次。根据患者治疗前后的症状和体征得分情况,分为显效、有效和无效。选择性别、年龄、病程、病情、伴哮喘或有哮喘史、个人和(或)家族过敏史、免疫治疗时间、皮试反应、伴随眼耳口腔瘙痒或流泪、鼻分泌物中嗜酸粒细胞等10个影响变应性鼻炎免疫治疗效果的可能因素进行多元逐步回归分析,筛查影响免疫治疗效果的因素。结果:总有效率为68.7%,其中显效率为14.4%,有效率为54.3%。影响免疫治疗效果的主要因素是免疫治疗时间,即时间越长,效果越好(P<0.01);伴哮喘或有哮喘史和年龄因素也可能影响免疫治疗效果(P值分别为0.081和0.063),即伴哮喘或有哮喘史的患者和年龄大的患者效果较差。其他因素与免疫治疗效果无关。结论:常年性变应性鼻炎免疫治疗是有效的;免疫治疗时间越长,效果越好。Objective：To investigate the correlation factors of the immunotherapeutic efficiency of perennial allergic rhinitis （PAR）. Method：One hundred and sixty-four patients with PAR were treated with specific immunotherapy （IT） in our department between 1990 and 2000. Specific allergens were selected through the history and skin test or nasal provocation test. The patients were given subcutaneous injections with allergen extract which was produced by Xiehe Hospital. The individual initiative dose was determined by the skin test reaction or the end point concentration. The doses were gradually increased until the maintenance dose （10^2 w/v, 0.5 ml once time）, then the interval between injections was gradually increased up to one month. The clinical effectiveness evaluation based on the symptoms and signs before and after IT was judged as marked, moderated and poor response. The possible factors which affected the efficacy of IT were selected. These factors included sex, age, illness duration, disease condition, asthma, duration of IT, reaction condition of the skin test, accompanying itch of eye, ear and oral cavity, eosinophilia in nasal smears and family history of atopy. The correlation factors with efficacy were sifted with multifactorial stepwise regression analysis. Result： The marked, moderated and poor response were 14.4%, 54.3% and 31.3% respectively. The efficacy of IT correlated well with the duration of IT（ P 〈0.01）, but not with sex, illness duration, disease condition, reaction condition of the skin test, accompanying itch of eye, ear and oral cavity, eosinophilia in nasal smears and family history of atopy. Asthma and age maybe influenced the effect of IT（ P =0. 081, P = 0. 063）. Conclusion： This study demonstrates that the immunotherapy is effective in the treatment of perennial allergic rhinitis. The duration is the factor significantly influences the efficacy of IT. The efficacy of long-IT was superior to that of the short-IT.

关 键 词：鼻炎 变应性 常年性 免疫治疗 疗效 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]