不同疗程舌下含服粉尘螨滴剂治疗螨过敏变应性鼻炎伴哮喘患儿的疗效观察  

Effects of house dust mite sublingual immunotherapy in children with allergic rhinitis and asthma

作　　者：陈实[1] 曾霞[1] 王灵[1] 陈冰[1] 陈丽丽[1] 吴少皎[1] 廖锋[1] 冯小伟[1] 

机构地区：[1]海南省人民医院儿童哮喘免疫治疗中心,海口570102

出　　处：《中华耳鼻咽喉头颈外科杂志》2015年第8期627-631,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：海南省社会发展科技专项基金（SF201413）;海南省自然科学基金（811187）

摘　　要：目的 评估不同疗程舌下含服粉尘螨滴剂特异性免疫治疗（sublingual immunotherapy,SLIT）螨过敏的变应性鼻炎（allergic rhinitis,AR）伴哮喘患儿的疗效及安全性.方法 回顾性分析100例完成了4年疗程的SLIT且随访资料完整的螨过敏AR伴哮喘患儿资料.治疗期间每3个月随访1次,分别评估患者的鼻炎症状计分（total nasal symptoms scores,TNSS）、鼻炎对症药物计分（total rhinitis medication scores,TRMS）、哮喘日间症状计分（daytime asthma symptoms scores,DASS）、哮喘夜间症状计分（nighttime asthma symptoms scores,NASS）、哮喘对症药物计分（total asthmatic medication scores,TAMS）、视觉模拟量表（visual analog scale,VAS）评分及肺功能水平的变化.以SPSS 20.0统计软件进行数据分析.结果 相比1年疗程,治疗2年后除NASS（0.00[0.00;0.00],0.00[0.00;0.00];Z=1.811;P＞0.05）差异无统计学意义外,TNSS（2.00[1.00;2.00],0.00[0.00;0.00];Z=7.021,P＜0.01）、TRMS（2.00[2.00;2.00],0.00[0.00;0.00];Z=8.855;P＜ 0.01）、VAS评分（3.00[2.00;4.00],1.00[0.00;1.00];Z =4.494,P ＜0.01）、DASS（1.00[0.00;1.00],0.00[0.00;0.00];Z=4.383,P＜0.01）、TAMS（0.00[0.00;1.00],0.00[0.00;0.00];Z=8.944;P＜0.01）均显著下降,差异有统计学意义.相比2年疗程,治疗3年后VAS评分（1.00[0.00;1.00],0.00[0.00;0.00];Z=3.645,P＜0.05）显著下降,差异有统计学意义;其他指标比较差异均无统计学意义.相比3年疗程,治疗4年后各个指标差异均无统计学意义（P值均＞0.05）.结论 相比1年疗程,螨过敏AR伴哮喘患儿进行2年以上SLIT的疗效更佳,3年疗程的VAS改善比2年疗程更显著,而3、4年疗程间的疗效比较无差异,因此粉尘螨SLIT的最佳疗程为3年.Objective To evaluate the efficacy of SLIT with Dermatophagoides farinae drops in children with allergic rhinitis and allergic asthma according to its different duration.Methods The efficacy of Dermatophagoides farinae SLIT in 100 children （aged 3-14 yr） with allergic rhinitis and allergic asthma induced by house dust mites was retrospectively analyzed.All children were treated with Dermatophagoides farinae drops for 4 years and followed-up at the interval of 3 months.Total nasal symptom scores （TNSS）,total rhinitis symptomatic medication scores （TRMS）,daytime asthma symptom scores （DASS）,nighttime asthma symptom scores （NASS）,total asthma symptomatic medication scores （TAMS）,visual analog scale scores （VAS） and lung function were assessed during follow-up visit.SPSS 20.0 software was used for data analysis.Results After 2 years＆#39; SLIT,compared with 1-year duration,besides NASS （0.00 [0.00;0.00],0.00[0.00;0.00];Z =1.811;P 〉0.05）,TNSS （2.00[1.00;2.00],0.00[0.00;0.00];Z =7.021,P〈0.01）,TRMS （2.00[2.00;2.00],0.00[0.00;0.00];Z=8.855;P〈0.01）,VAS scores （3.00[2.00;4.00],1.00[0.00;1.00];Z =4.494,P〈0.01）,DASS （1.00[0.00;1.00];0.00[0.00;0.00];Z =4.383,P 〈0.01） and TAMS （0.00[0.00;1.00],0.00[0.00;0.00];Z =8.944;P 〈 0.01） all showed significant improvement.After 3-year duration,compared with 2-year duration,VAS scores （1.00 [0.00;1.00],0.00 [0.00;0.00];Z =3.645,P 〈 0.05） in patients were significantly decreased.Other results showed no significant difference.The comparison of efficacy between 3 and 4-year duration showed no significant difference in global clinical outcomes （all P 〉 0.05）.Conclusions Patients receiving 2 year＇ SLIT achieve more clinical benefits than those who receiving 1-year duration.The higher efficacy of 3-year duration compared with 2-year duration is supported by a significant improvement in VAS.Besides,the comparison between 3 and 4-year duration shows no significant difference in global clinical outcomes.Therefore,3 yea

关 键 词：鼻炎 变应性 常年性 哮喘 舌下免疫疗法 粉尘螨 治疗结果 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R725.6[医药卫生—临床医学]