屋尘螨皮下特异性免疫治疗儿童哮喘和/或变应性鼻炎致全身不良反应  

Systemic adverse reactions induced by house dust mite specific immunotherapy among children with asthma and/or allergic rhinitis

作　　者：容嘉妍[1] 黄东明[1] 王桂兰[1] 张莉[1] 王冰洁[1] 黄娟[1] 刘翔腾[1] 林嘉镖[1] 魏可英 RONG Jia-yan;HUANG Dong-ming;WANG Gui-lan;ZHANG Li;WANG Bing-jie;HUANG Juan;LIU Xiang-teng;LIN Jia-biao;WEI Ke-ying(Department of Pediatrics,Zhongshan Boai Hospital,Zhongshan city,Guandong 528400,China)

机构地区：[1]中山市博爱医院儿科,广东中山528400

出　　处：《中华临床免疫和变态反应杂志》2020年第3期233-238,共6页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的观察屋尘螨过敏的哮喘和(或)变应性鼻炎儿童进行屋尘螨变应原特异性皮下免疫治疗的全身不良反应并探讨其可能的危险因素。方法回顾性分析2010年7月至2013年6月始于中山市博爱医院儿科门诊诊断为哮喘和(或)变应性鼻炎并进行屋尘螨皮下特异性免疫治疗(为期3~5年)的患儿202例。分析每次免疫治疗后出现不良反应的相关病史资料。结果202例患儿中47例患儿出现全身不良反应。注射总次数为9285例次,共发生全身不良反应76例次(0.8%),其中速发全身不良反应93.4%(71/76例次),迟发全身不良反应6.6%(5/76例次)。76例次全身不良反应,以呼吸道症状和Ⅰ级全身不良反应为主,更易发生于免疫治疗维持阶段。不良反应在哮喘组及特异性IgE值≥50 kU/L患儿中发生率更高(P<0.01)。10岁以下儿童及7~9月份更易出现全身不良反应。结论屋尘螨过敏的哮喘和(或)变应性鼻炎儿童特异性皮下免疫治疗较少发生全身不良反应且以轻度Ⅰ级反应为主,哮喘、特异性IgE值≥50 kU/L为在免疫治疗的过程中出现不良反应的高危因素。中山地区全身不良反应主要发生在7~9月份。Objective To investigate the occurrence of systemic adverse reactions during house dust mite specific immunotherapy among children with asthma and/or allergic rhinitis and to explore the potential risk factors.Methods A retrospective study was conducted among 202 children who were diagnosed as asthma and/or allergic rhinitis and subcutaneous specific immunotherapy of house dust mite(period of 3-5 years)was administrated in outpatient department of Pediatrics,Zhongshan Boai hospital from July,2010 to June,2013.All the data of adverse reactions was collected and analyzed.Results 47 of 202 children experienced systemic adverse reactions.76(0.8%)systemic adverse reactions occurred among 9285 injections.Among them,93.4%(71/76)experienced immediate systemic adverse reactions and 6.6%(5/76)experienced delayed systemic adverse reactions.Respiratory symptoms were the main clinical manifestations of systemic adverse reactions and Grade I systemic adverse reactions were predominant,which were more likely to occur during maintenance stage of immunotherapy.The occurrence rate was significantly higher among patients whose sIgE levels were≥50 kU/L.Systemic adverse reactions were more commonly occurred in children under 10 years-old and more likely occurred since July to September in Zhongshan.Conclusions Systemic adverse reactions are rare and mainly are Grade I in predominance.Asthmatic children and specific IgE levels≥50 kU/L are the high risk factors of systemic adverse reactions during immunotherapy.Systemic adverse reactions are more likely occurred since July to September in Zhongshan.

关 键 词：屋尘螨 特异性免疫治疗 全身不良反应 

分 类 号：R72[医药卫生—儿科]