舌下特异性免疫治疗对不同年龄变应性鼻炎患儿的疗效分析  

Therapeutic effect of sublingual specific immunotherapy on children with allergic rhinitis in different ages

作　　者：张薇 唐力行[1] 王蓬鵬 杨小健[1] 段清川 韩阳[1] 肖潇[1] 葛文彤[1] ZHANG Wei;TANG Li-xing;WANG Peng-peng;YANG Xiao-jian;DUAN Qing-chuan;HAN Yang;XIAO Xiao;GE Wen-tong(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院耳鼻咽喉头颈外科

出　　处：《中国耳鼻咽喉颅底外科杂志》2019年第6期595-599,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：北京市医院管理局儿科学科协同发展中心儿科专项重点项目子课题(XTZD201801);北京市科委培育项目(Z161100000116050)

摘　　要：目的评估不同年龄组变应性鼻炎(allergic rhinitis,AR)患儿在经舌下特异性免疫治疗(sublinguul immunotherapy,SLIT)后的起效时间及客观指标变化。方法对282例接受2年舌下特异性免疫治疗的AR患儿的病例资料进行分析。所有患儿均为中重度粉尘螨AR患者,且均接受标准化舌下含服粉尘螨滴剂治疗,并辅以对症药物治疗。其中2~5岁年龄组83例,6~9岁年龄组102例、10~13岁年龄组97例。统计3组患儿在治疗前与治疗3、6、12、24个月时的鼻部症状总评分(total nasal symptom score,TNSS)、药物总评分(total medication score,TMS)、视觉模拟量表标尺(visual analogue scale,VAS)评分和嗜酸性粒细胞(eosinophil,EOS)水平。结果①全体患儿在接受SLIT治疗3个月后TNSS、TMS和VAS都显著降低,与治疗前比较差异具有统计学意义(P均<0.05);而治疗6个月与治疗3个月比较,VAS差异无统计学意义(Z=2.70,P均>0.05);②经各不同年龄组间比较,2~5岁组与10~13岁组在治疗3个月时,TNSS、VAS均具有统计学意义(Z=3.09、3.99,P<0.05);③接受SLIT半年后的EOS较基线明显下降(Z=-4.544,P<0.05)。结论舌下粉尘螨滴剂治疗3个月后,不同年龄组患儿均观察到疗效,高龄儿童组起效更快;加强对3~12个月龄患儿宣传教育和管理有利于提升和巩固疗效;EOS水平的变化与免疫治疗相关。Objective To evaluate the onset time of sublingual immunotherapy(SLIT)and the objective index changes in children with allergic rhinitis(AR)in different age groups.Methods Case data of 282 children with AR who underwent 2-year SLIT with Dermatophagoides fannae drops were analyzed.All children with moderate to severe house dust mites-induced AR were divided into three groups according to the age(aged 2~5 years,n=83;aged 6~9 years,n=102;aged 10~13 years,n=97)and treated by SLIT with Dermatophagoides fannae drops and symptomatic drugs.Their total nasal symptom score(TNSS),total medication score(TMS),visual analogue scale(VAS)score,and eosinophil(EOS)level at baseline,3 months,6 months,12 months,and 24 months of treatment were recorded.Results①Compared with the baseline,the TNSS,TMS and VAS got reduced in all 3 groups at 3 months of SLIT,and the differences were statistically significant(all P<0.05),but the differences between VAS at 3 and 6 months of SLIT were statistically insignificant(P>0.05).②The differences of TNSS and VAS at 3 months of SLIT between the 2~5 year old group and the 10~13 year old group were statistically significant(both P<0.05).③Compared with the baseline,the EOS decreased significantly after treatment for half a year of SLIT(all P<0.05).Conclusions The onset of action of SLIT with Dermatophagoides fannae drops can be observed at 3 months of treatment in children of all age groups,and that in the older group is more rapid than the younger group.In order to promote and consolidate the curative effect,it is necessary to strengthen the education and management during the 3 rd to 12 th month of treatment.The change of EOS has a certain correlation with immunotherapy.

关 键 词：变应性鼻炎 常年性 粉尘螨 舌下免疫治疗 治疗效果 儿童 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]