舌下特异性免疫治疗对变应性鼻炎Th2型免疫反应影响的临床观察  

The influence of sublingual immunotherapy on Th2 type immunoreaction in patients with allergic rhinitis

作　　者：孟庆翔[1] 梁勇[1] 张威[1] 谢景华[2] 苏芳[2] 杨阳[3] 

机构地区：[1]南方医科大学附属南方医院耳鼻咽喉一头颈外科,广州510515 [2]广州市第一人民医院耳鼻咽喉科 [3]广州市第一人民医院中心实验室

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第2期90-93,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:了解舌下特异性免疫治疗期间变应性鼻炎患者Th2型免疫反应的变化情况,结合临床分析,掌握舌下特异性免疫治疗对变应性鼻炎机体免疫系统产生的影响。方法:对43例行舌下特异性免疫治疗的变应性鼻炎患者进行1年的跟踪随访,收集相关的临床及实验数据,通过VAS评价临床症状的控制,鼻分泌物嗜酸细胞计数及鼻腔灌洗液IL-4、IL-13的表达评价鼻黏膜免疫情况,血清TIgE、sIgE评价全身系统免疫情况。结果:VAS在治疗1个月后开始明显下降,差异有统计学意义(t=3.343,P<0.01);至6个月VAS下降28.36%,其后下降幅度减缓,至12个月VAS下降35.62%;12个月与6个月比较,差异无统计学意义(P>0.05)。血清TIgE、sIgE在免疫治疗12个月前后差异无统计学意义(均P>0.05)。鼻腔分泌物嗜酸细胞计数的变化趋势与VAS基本同步,治疗1个月后明显下降,6个月以后降幅减缓,治疗6个月与12个月比较,差异无统计学意义(P>0.05)。治疗12个月鼻腔灌洗液IL-4、IL-13的表达也显著降低,差异有统计学意义(均P<0.01)。结论:变应性鼻炎舌下特异性免疫治疗12个月,鼻腔黏膜免疫的Th2型免疫偏倚产生部分的纠正,但是未能发现对全身系统免疫的影响。Objective：To explore the influence of suhlingual immunotherapy oi1 Th2 type immunoreaction in patients with allergic rhinitis within 12 months treatment. Method： Forty three patients with allergic rhinitis were followed-up within 12 months after receiving sublingual immunotherapy. The changes of clinic symptoms and im- munoreaction were analyzed. VAS score was applied to evaluate the efficacy of clinic treatment. TIgE and slgE in serum were tested to evaluate the systemic immunoreaction. Eosinophil counting in nasal discharge was applied to evaluate the local nasal mucosa immunoreaction. Result： VAS scores were decreased significantly one month after the starting point of treatment,companied by the decrease of EOS count in nasal discharge（P（0.05）. The chan- ges of TIgE and sIgE in serum within 12 months of sublingual immunotherapy were not significant （P〈0.05）. The levels of IL-4 and IL-13 in nasal lavage were decreased significantly after 12 months＇ treatment. Conclusion： The bias of Th2 type immunoreaction existed in nasal mucosa immune system in patients with allergic rhinitis could been rectified partially after receiving sublingual immunotherapy for 12 months, but the significant changes were not observed in systemic immune system.

关 键 词：鼻炎 变应性 免疫治疗 螨 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]