标准化免疫治疗对哮喘儿童屋尘螨特异性IgG_4和肺功能的影响  

Influence of specific immunotherapy on Dermatophagoides pteronyssinus-specific IgG_4 and pulmonary function in children suffering from allergic asthma

作　　者：韩洁[1] 黄英[1] 王模奎[2] 

机构地区：[1]重庆医科大学附属儿童医院呼吸中心,重庆400014 [2]宜宾市第一人民医院新生儿科,四川宜宾644000

出　　处：《第三军医大学学报》2011年第6期618-620,共3页Journal of Third Military Medical University

基　　金："十一五"国家科技支撑计划基金(2007BAI24B05);重庆市自然科学基金(CSTC2007BB5320)~~

摘　　要：目的探讨标准化屋尘螨变应原制剂免疫治疗儿童哮喘,对其肺功能、气道反应性及血清屋尘螨特异性IgG4、血清屋尘螨特异性IgE的影响。方法选择31例轻-中度屋尘螨过敏性哮喘儿童,给予标准化屋尘螨变应原制剂治疗,疗程25周,检测治疗前后肺功能指标FEV1和PEF占预计值的百分比,PC20、血清屋尘螨特异性IgG4和屋尘螨特异性IgE水平。结果标准化特异性免疫治疗前后哮喘患儿肺功能FEV1和PEF占预计值的百分比分别为:治疗前(97.87±23.44)%、(99.95±29.52)%,治疗后(114.81±17.65)%、(116.51±19.52)%;治疗前后PC20值分别为(1.49±2.75)、(7.31±7.02)mg/ml;血清屋尘螨特异性IgG4水平治疗前为271.4 AU/ml(436.6 AU/ml)、治疗后为2 450.5 AU/ml(2 771.95 AU/ml);血清屋尘螨特异性IgE水平治疗前为87.14 AU/ml(70.26 AU/ml)、治疗后为100.00 AU/ml(59.25 AU/ml)。除了特异性IgE在治疗前后无显著变化(P>0.05)外,其余各项指标在治疗后均有显著上升(P<0.01)。结论特异性免疫治疗对变应性哮喘患儿的肺功能有明显的改善,血清屋尘螨特异性IgG4的升高在哮喘的免疫治疗中发挥了重要的保护作用。Objective To explore the influence of specific Dermatophagoides pteronyssinus allergen preparation on pulmonary function,airway responsiveness,serum Dermatophagoides pteronyssinus-specific IgG4 and serum Dermatophagoides pteronyssinus-specific IgE of children suffering from allergic asthma.Methods Thirty-one children with mild-to-moderate dermatophagoides pteronyssinus allergic asthma were treated with specific immunotherapy using Dermatophagoides pteronyssinus allergen preparation for 25 weeks.The pulmonary function indexes,including percentages of FEV1 and PEF to their forecast values and PC20,as well as serum Dermatophagoides pteronyssinus-specific IgG4 level and serum Dermatophagoides pteronyssinus-specific IgE level were determined before and after the specific immunotherapy.Results After the specific immunotherapy,the percentages of FEV1 and PEF compared with their forecast values increased from（97.87±23.44）% and（99.95±29.52）% to（114.81±17.65）% and（116.51±19.52）%,respectively（P0.01）.PC20 increased from 1.49±2.75 mg/ml to 7.31±7.02 mg/ml（P0.01）.Serum Dermatophagoides pteronyssinus-specific IgG4 level and serum Dermatophagoides pteronyssinus-specific IgE level changed from 271.4 AU/ml（436.6 AU/ml） and 87.14 AU/ml（70.26 AU/ml） to 2 450.5 AU/ml（2 771.95 AU/ml） and 100.00 AU/ml（59.25 AU/ml）,respectively,indicating insignificant difference of specific IgE level（P0.05） but significant increase of specific IgG4 level（P0.01）.Conclusion Specific immunotherapy can significantly improve the pulmonary function of children suffering from allergic asthma.The increase of serum Dermatophagoides pteronyssinus-specific IgG4 plays an important role in immunotherapy of asthma.

关 键 词：变应性哮喘 标准化特异性免疫治疗 肺功能 屋尘螨特异性IgG4 

分 类 号：R725.622.5[医药卫生—儿科] R457.2[医药卫生—临床医学]