舌下含服免疫治疗与皮下注射免疫治疗对儿童变应性鼻炎的疗效分析  

Efficacy of sublingual immunotherapy and subcutaneous immunotherapy in children with allergic rhinitis

作　　者：段传新[1] 田滢[1] 张飞[1] 陶泽璋[2] 

机构地区：[1]湖北省妇幼保健院耳鼻咽喉科,武汉430070 [2]武汉大学人民医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第17期1354-1358,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨使用舌下含服免疫疗法(SLIT)和皮下注射免疫疗法(SCIT)治疗儿童尘螨变应性鼻炎(AR)的疗效及安全性。方法:回顾性分析186例分别接受SLIT(SLIT组104例)或SCIT(SCIT组82例)的尘螨过敏AR患儿的临床资料。观察并记录治疗后1年、2年的鼻部症状总评分、视觉模拟量表(VAS)评分、AR相关生活质量量表(RQLQ)评分、血清sIgE水平、皮肤指数(SI)、血清嗜酸粒细胞阳离子蛋白(ECP)计数、外周血嗜酸粒细胞(EOS)计数以及不良反应,对2种免疫治疗的疗效及安全性进行比较。结果:与治疗前相比,SLIT组和SCIT组患儿治疗2年后的鼻部症状评分、VAS评分、RQLQ、SI、ECP计数显著降低,差异有统计学意义(P<0.05);SLIT组和SCIT组治疗2年后患儿的血清sIgE与治疗前相比无明显下降,差异无统计学意义(P>0.05);治疗前和治疗1年、2年后,2组患儿之间的鼻部症状评分、VAS评分、RQLQ、sIgE水平、SI、ECP、EOS均差异无统计学意义(P>0.05)。SLIT组和SCIT组分别有4例和2例不良反应,均未出现严重的全身不良反应。结论:SLIT和SCIT均能显著改善尘螨过敏的AR患儿的症状,提高其生活质量,有较高的安全性,且两者之间的疗效无明显差异。接受SLIT和SCIT患儿的SI、ECP相比治疗前均显著下降,推测其可能作为潜在的疗效判定指标。Objective：To evaluate the efficacy and safety of sublingual immunotherapy（SLIT） and subcutaneous immunotherapy（SCIT） in children with pediatric allergic rhinitis. Method： This study retrospectively analyzed the efficacy and safety of SLIT and SCIT in 186 children with allergic rhinitis which induced by house dust mites. Patients were randomly divided into two groups： SLIT group consisted of 104 patients, and SCIT group consisted of 82 patients. These two groups were followed up 2 years and recorded on the following indexs including total rhinitis symptoms score（TRSS）, visual analogue scale（VAS）, the rhinoeonjunetivitis quality of life questionnaire （RQLQ）, skin index （SI）, serum specific IgE （slgE）, eosinophil cationic protein （ECP）, peripheral eosinophil （EOS） and adverse reactions. Result：After 2-year treatment, both SLIT and SCIT groups showed significant reduction ins TRSS, VAS, RQLQ,SI and ECP compared with those before treatment （P〈0.05）, while there were no significant differences in sIgE of two groups compared with those before treatment（P〉0.05）. Besides,there were no significant differences between the two groups in TRSS, VAS, RQLQ,SI, sIgE, ECP and EOS （P〉 0.05） before or after treatment. There were 3 patients in SLIT group and 2 patients in SCIT group who showed adverse reactions. For the incidence of adverse reactions,the figures were 3.85 % and 2.44 %, respectively. No severe systemic side effects were registered in these two groups. Conclusion： Both SLIT and SCIT demonstrated the improvement of symptoms and quality of life in patients with pediatric allergic rhinitis. The therapeutic efficacy is consistent with SLIT and SCIT. Both SLIT and SCIT groups indicated significantly decrease in SI and ECP, which suggest that SI and ECP may be the potential indicators in efficacy evaluation.

关 键 词：鼻炎 变应性 常年性 舌下含服免疫治疗 皮下注射免疫治疗 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]