变应性鼻炎集群免疫治疗的疗效和安全性临床分析  

Efficacy and safety of cluster immunotherapy for 154 patients with allergic rhiultis

作　　者：张罗[1,2] 王成硕[1,2] 王向东[2] 赵岩[2] 刘健慧[1] 张伟[1] 周兵[2] 韩德民[1,2] 

机构地区：[1]北京市耳鼻咽喉科研究所变应性鼻炎诊疗中心,100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科中心

出　　处：《中华耳鼻咽喉头颈外科杂志》2008年第3期187-191,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家“十一五”科技支撑计划（2007BAI18815）;北京市自然科学基金（7063074）

摘　　要：目的观察应用标准化螨变应原集群免疫治疗变应性鼻炎的疗效及安全性。方法154例螨变应原导致的中重度持续性变应性鼻炎患者，在特异性变应原免疫治疗的剂量累加阶段采用集群注射方案，6周达到维持剂量，继续治疗1年。治疗期间通过鼻部症状总评分、药物用量评分、鼻炎相关生活质量评分评价临床疗效，同时观察治疗导致的全身不良反应以评价治疗的安全性。结果所有患者在6周左右达到剂量维持阶段，缩短剂量累加阶段疗程60％以上的时间。经过1年集群免疫治疗后，鼻部症状总评分（5．43±1．31）和每日药物用量评分（0．44±0．12）均较治疗前明显减少（P值均〈0．01），总体生活质量和7个分项的生活质量明显改善（P值均〈0．01）。154例中共9例（26次）出现全身反应，全身性不良反应的发生率占注射例数的5．9％（9／154）和注射针数的0．75％（26／3464）。其中Ⅰ级反应10次，Ⅱ级反应12次，Ⅲ级反应4次，无Ⅳ级不良反应。结论对中重度持续性变应性鼻炎而言，集群免疫治疗是一种快速、有效、安全的治疗方法。Objective To evaluate the efficacy and safety of cluster immunotherapy with Dermatophagoides pteronyssinus for allergic rhinitis. Methods One huandred and fifty-four patients with allergic rhinitis to Dermatophagoides pteronyssinus were allocated to receive specific immunotherapy in a 6-week cluster schedule during the incremental-dose phase. Thereafter, these patients received maintenancedose injection at 6-week intervals untill the end of 1 year of treatment. Symptom scores and medication scores were used to evaluate the clinical efficacy and adverse reactions were recorded. A rhinoconjunctivitis quality of life questionnaire （RQLQ） was completed in the baseline and after one year treatmenL Results Cluster immunotherapy significantly reduced the symptom scores and total medication score of patients enrolled （ P 〈 0. 01 ）. The immunotherapy group also had a significant improvement in the Rhinoconjunctivitis Quality of Life Questionnaire. During the one-year of treatment, there were 26 systemic adverse reactions （0. 75% of all injection） in 9 patients （5. 9% ） and no fatal systemic reactions occurred. Conclusions The cluster immunotherapy is efficacious and safe to treat allergic rhinitis.

关 键 词：鼻炎 变应性 常年性 鼻炎 变应性 季节性 免疫疗法 抗原 尘螨属 

分 类 号：R686[医药卫生—骨科学]