葎草花粉变应原免疫治疗疗效和安全性评估  

Efficacy and Safety of Specific Immunotherapy with Humulus Pollen Extract

作　　者：关凯[1] 魏庆宇[1,2] 尹佳[1] 

机构地区：[1]中国医学科学院 北京协和医学院 北京协和医院变态反应科,北京100730 [2]沈阳202医院变态反应科,沈阳110003

出　　处：《中华临床免疫和变态反应杂志》2012年第4期279-284,共6页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的回顾性评价单一葎草花粉变应原制剂治疗葎草花粉过敏性鼻炎伴发或不伴发过敏性哮喘的疗效和安全性。方法回顾近13年接受单一葎草花粉变应原免疫治疗(SIT)的葎草花粉过敏性鼻炎患者,比较SIT治疗前后过敏性鼻炎临床症状的严重程度,症状持续时间,治疗药物,总体自评和不良反应;对伴发过敏性哮喘患者比较SIT治疗前后发病季节哮喘控制测试(ACT)评分,治疗药物和总体自评。结果 40例葎草花粉过敏性鼻炎患者中7例(17.5%)伴发过敏性哮喘。过敏性哮喘患者的哮喘症状晚于鼻炎症状4(3,6)年出现,7例过敏性鼻炎伴过敏性哮喘患者中5例(71.4%)在鼻炎发病5年内发展伴发过敏性哮喘。SIT治疗前后,过敏性鼻炎症状总评分[10(9,11)vs.5(4,6)]、症状年累计时间[8(8,12)周vs.4(4,7)周]、药物积分[385(320,465)vs.125(69,200)]差异均有统计学意义(均P<0.001),85%总体自评为病情改善。2例患者发生全身不良反应,其中Ⅱ类和Ⅲ类各1例次。伴发过敏性哮喘的7例患者经SIT治疗,6例发病季节ACT评分由未控制改善为完全或良好控制,治疗前后哮喘药物积分[240(110,250)vs.25(0,70)]差异有统计学意义(P<0.05),所有患者总体自评均为明显改善。结论使用葎草花粉变应原单一制剂可有效、安全地治疗葎草花粉过敏性鼻炎伴发或不伴发过敏性哮喘。Objective To evaluate the efficacy and safety of allergen specific immunotherapy （SIT） for Humulus pollen-allergic rhinitis （AR） with/without asthma by using Humulus pollen extract. Methods AR patient who was prescribes SIT only by Humulus pollen extracts during the past 13 years were reviewed in this study. Symptom score, duration of symptom in pollen season, medication score and self-assessment of AR were compared for pre- and after SIT. Adverse reactions were also recorded. Asthma control test （ACT）, asthma medication score and self-assessment were also assessed among the patients with asthma. Results There were 40 AR patients who were only allergic to Humulus pollen, while 17.5% （7/40） were also attacked by asthma. The onset of asthma was 4 （3, 6） years later than AR. 71.4% （5/7） AR cases developed asthma within 5 years. Symptom score of AR 10 （9, 11） vs. 5 （4, 6） , P 〈0. 001; duration of symptom in pollen season of AR 8 （8, 12） vs. 4 （4, 7） weeks, P 〈0. 001 ; and medication score of AR 385 （320, 465） vs. 125 （69, 200） , P 〈 0. 001 was statistic significantly improved for pre- and after SIT; Self-assessment was improved among 85% patients. Systemic reactions were recoded among 5% （2/40） patients, which belong to type II （1/2） and type III （1/2） respectively. 86% （6/7） uncontrolled asthma patients improved to well controlled after SIT; medication score of asthma 240 （110, 250） vs. 25 （0, 70） was statistic significantly improved significantly, P 〈 0. 05; Patients＇ self-assessment about asthma was also improved. Conclusion SIT with Humulus pollen extract is an effective and safety treatment for Humulus pollen -AR patients with/without asthma.

关 键 词：葎草 免疫治疗 疗效 安全性 

分 类 号：R593[医药卫生—内科学]