标准化屋尘螨变应原制剂治疗儿童变应性哮喘及变应性鼻炎的耐受性及安全性  

Tolerance And Safety Of Subcutaneous Immunotherapy With Standardized House-dust mite In Asthmatic Children With Allergic Rhinitis

作　　者：朱春梅[1] 曹玲[1] 刘传合[1] 赵京[1] 马煜[1] 陈育智[1] 李志英[1] 罗雁青[1] 娄小尚[1] 

机构地区：[1]首都儿科研究所附属儿童医院哮喘中心,北京100020

出　　处：《中国医刊》2010年第4期39-42,共4页Chinese Journal of Medicine

摘　　要：目的观察标准化屋尘螨变应原制剂治疗儿童变应性哮喘及变应性鼻炎的耐受性和安全性。方法对112例临床诊断螨过敏性儿童哮喘伴或不伴变应性鼻炎患儿,应用标准化屋尘螨提取液皮下注射进行特异性免疫治疗,观察记录每次免疫注射后的不良反应发生情况,同时监测每次变应原注射前及注射后30分钟PEF变化情况。结果经过1年的治疗观察,112例患儿共注射2649次,共发生全身反应15/2649例次(0.57%),局部不良反应436/2649(16.46%)。其中速发全身反应11/2649例次(0.42%),均为Ⅰ级,包括咳嗽、胸闷、喘息发作、皮肤瘙痒、荨麻疹及头痛;迟发全身反应4/2649(0.15%),包括胸闷、喘息、荨麻疹及鼻炎;速发局部反应432/2649(16.31%),绝大多数为轻度局部反应,表现为局部皮肤潮红、肿胀(d<5cm),皮肤痒,仅有3例次局部红肿(d>5cm),未发现1例严重全身反应。注射前后30分钟的PEF平均值变化差异无统计学意义,注射27周后及1年的PEF与注射前差异有显著性。结论螨过敏性儿童哮喘及变应性鼻炎患儿对标准化屋尘螨变应原制剂特异性皮下免疫治疗的耐受性良好,治疗安全,治疗后的肺功能PEF值改善。Objective To determine the tolerance and safety of subcutaneous immunotherapy with standardized housedust mite in asthmatic children with allergic rhinitis. Methods Subcutaneous immunotherapy SIT With standardized house-dust mite extract was administrated to 112 children who were diagnosed as allergic asthma and （or） rhinitis to dust mite . The immediate and late slide-effects aider each allergen injection during immunotherapy treatment had been monitored for 1 year . Peak expiratoy flow was tested before and after 30 min of each injection for ever）, patieut. Results The total injection were 2649, 15 injections of them （0.57%） caused systemic side-effects and 436 injections （16.46%） caused local reaction. In which, 11 injections （0.41% of all injections） caused immediate mild systemic side-effects within 30 min after injection, which included cough, chest distress, wheezing, itch of skin, urticaria, and headaeh. 4 injections （0. 15% ）caused late systemic side-effects, which included chest dis- tress, wheezing, urticaria, rhinitis. 432 injections （16.31% ） were mild immediate local reactions（ 〈 5cm in diameter） and 4 injections were mild late local reactions. No any severe systemic adverse reaction was showed in the study. No significant change of PEF was observed before and after 30 min of each injection, but mean value of PEF was significant increasing during 1 year. Conclution Subcutanous SIT with standardized dust mite extract show a good tolertance in children of allergic asthma and （or） rhinitis . All local and systemic reactions are mild and respond well to treatment . After 1 year of routine treatment,mean PEF is increasing.

关 键 词：哮喘 儿童 特异性免疫治疗 尘螨 安全性 

分 类 号：R725.6[医药卫生—儿科] R765.21[医药卫生—临床医学]