舌下含服粉尘螨滴剂治疗学龄前与学龄期儿童过敏性哮喘伴变应性鼻炎的疗效评估  

Efficacy of sublingual immunotherapy with Dermatophagoides farinae drops in preschool and school-age children with allergic asthma and allergic rhinitis

作　　者：陈实[1] 王灵[1] 廖锋[1] 曾霞[1] 邢琼波[1] 陈冰[1] 林小珍[1] 

机构地区：[1]海南省人民医院儿童哮喘防治中心,海口570102

出　　处：《中华儿科杂志》2013年第11期831-835,共5页Chinese Journal of Pediatrics

基　　金：海南省自然科学基金（811187）;海南省卫生厅科研项目（琼卫2010-13）

摘　　要：目的 评估标准化粉尘螨滴剂舌下含服特异性免疫治疗（SLIT）学龄前与学龄期儿童过敏性哮喘伴变应性鼻炎的疗效差异.方法 对122例3～ 14岁粉尘螨过敏的哮喘伴变应性鼻炎患儿,按就诊年龄分为学龄前期组（≤6岁,59例）和学龄期组（＞6岁,63例）,采用标准化粉尘螨滴剂SLIT至少2年,并进行临床观察及随访研究.评估学龄前与学龄期组患儿免疫治疗前及治疗半年、1年和2年的哮喘日间、夜间症状、鼻部症状评分以及用药评分变化.同时收集治疗期间出现的不良反应事件.结果 SLIT半年、1年、2年后,学龄前期组患儿的哮喘日间症状评分（0.3±0.5、0.0±0.1、0.0±0.0）与学龄期组患儿（0.3±0.4、0.0±0.1、0.0 ±0.0）比较,差异无统计学意义（Z=-1.687、-0.613、0.000,P均＞0.05）；学龄前期组患儿的哮喘夜间症状评分（0.2±0.5、0.1±0.3、0.0±0.0）与学龄期组患儿（0.2±0.4、0.1 ±0.3、0.0±0.0）比较,差异无统计学意义（Z=-0.496、-0.486、0.000,P均＞0.05）；学龄前期组患儿的鼻炎症状评分（1.4±0.9、0.4±0.5、0.1±0.3）与学龄期组患儿（1.3 ±0.9、0.5±0.6、0.2±0.3）比较,差异无统计学意义（Z=-0.394、-1.166、-1.075,P均＞0.05）；学龄前期组患儿的鼻炎用药评分（1.6±0.8、0.0±0.0、0.0±0.0）与学龄期组患儿（1.7±0.7、0.0±0.0、0.0±0.0）比较,差异无统计学意义（Z=-0.655、0.000、0.000,P均＞0.05）.2年SLIT后,学龄前与学龄期组患儿大部分不再使用哮喘控制药物,差异无统计学意义（Z=0.000,P＞ 0.05）.治疗期间不良反应总发生率7％,学龄前与学龄期患儿发生率差异无统计学意义（x2 =0.000,P＞0.05）；主要表现为轻度肠胃不适和皮疹,学龄前期组患儿以腹泻居多,未发生严重不良事件.结论 学龄前与学龄期组粉尘螨过敏的哮喘伴变应性鼻炎患儿采用标准化粉尘螨滴剂进行2年SLIT均能获得显著疗效；提示对年幼儿开展S[ Abstract] Objective To evaluate the efficacy of specific sublingual immunothempy （SLIT） with Dermatophagoides farinae drops on children with allergic asthma and allergic rhinitis of the preschool and school-age groups of children and adolescents. Method This study analyzed the efficacy of SLIT in 122 children （ aged 3 - 14 yr） with house dust mites-induced allergic asthma and allergic rhinitis. According to the age,patients were defined as the preschool group （ 〈~ 6 years old,n = 59） and school-age group （ 〉 6 years old, n = 63 ）. All children were treated with Dermatophagoides farinae drops for at least 2 years. Glinical observation and foLlow-up study were conducted during the treatment. Before and after SLIT for half a year, 1 year and 2 years, asthma symptom scores （ day and night）, rhinitis symptom scores and medication scores were evaluate＆ The adverse events were assessed during the study. Result After SLIT for half a year, 1 year and 2 years,there were no significant differences between the preschool group （0. 3 ±0. 5,0. 0 ＋0. 1,0. 0 ＋0. 0） and school-age group （0 value was - 1. 687, - 0. 613,0. 000, all P 〉 3 ＋0. 4,0.0 ＋0. 1,0. 0 ＋0.0） in day scores of asthma （Z 0. 05 ）. There were no significant differences between the preschool group （0.2 ＋0. 5,0. 1 ＋0. 3,0. 0 ＋0. 0） and school-age group （0. 2 ＋0.4,0. 1 _＋0. 3,0.0 ＋_0. 0） in night scores of asthma （Z value was - 0. 496, - 0. 486,0. 000, all P 〉 0.05 ）. There was no significant differences between the preschool group （ 1.4 ＋ 0.9,0. 4 _＋ 0. 5,0. 1 ＋_ 0. 3 ） and school-age group （ 1.3 -＋ 0.9,0.5 ＋ 0. 6,0. 2 -＋ 0. 4 ） in symptom scores of allergic rhinitis （ Z value was - 0. 394, - 1. 166, - 1. 075, all P 〉 0. 05 ）. There were no significant differences between the preschool group （ 1.6 -＋ 0. 8, 0. 0 ＋ 0. 0,0. 0 -＋- 0. 0 ） and school-age group （ 1.7 _＋ 0. 7,0.0 ＋_ 0. 0, O. 0 ＋ 0. 0 ） in medication scores of allergic rhinitis （Z val

关 键 词：投药 舌下 免疫疗法 粉尘螨 哮喘 鼻炎 变应性 常年性 

分 类 号：R725.6[医药卫生—儿科]