奥马珠单抗在儿童变应性哮喘并特应性皮炎中的应用  

Application of Omalizumab for allergic asthma combined with atopic dermatitis in children

作　　者：文惯宇 邓欢 刘峰[1] 严敏 陈鸣霞 赵德育[1] Wen Guanyu;Deng Huan;Liu Feng;Yan Min;Chen Mingxia;Zhao Deyu(Department of Respiratory,Children′s Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院呼吸科,210008

出　　处：《中华实用儿科临床杂志》2021年第12期957-960,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨奥马珠单抗在变应性哮喘(AS)并特应性皮炎(AD)患儿中的应用。方法回顾性分析2018年11月至2020年8月于南京医科大学附属儿童医院呼吸科诊断中重度AS并AD 5例患儿临床资料,治疗均遵循AS规范化治疗联合奥马珠单抗,观察奥马珠单抗治疗AD的疗效和不良反应。选择特应性皮炎严重程度指数(SCORAD)、湿疹面积及严重度指数(EASI)、儿童皮肤病生活质量的指数(CDLQI)和峰值瘙痒数字评价量表(NRS)评价AD患儿的皮损严重程度、面积、瘙痒及其对生活质量的影响。结果5例患儿在治疗4个月后,SCORAD、EASI、CDLQI和NRS评分(60.80±10.79比40.30±15.62;13.93±6.81比6.18±2.70;18.80±6.26比13.20±4.82;8.60±0.89比6.00±1.87)均明显下降,差异均有统计学意义(t=7.833、4.106、5.199、5.099,均P<0.05)。2例患儿在奥马珠单抗治疗后联合变应原特异性免疫治疗,免疫治疗过程顺利,未见不良反应。5例患儿共接受奥马珠单抗皮下注射104次,均未见不良反应。结论在中重度AS并AD患儿治疗中,奥马珠单抗可明显减轻其皮损严重程度、减少皮炎面积,显著改善其生活质量。奥马珠单抗在特异性免疫治疗前使用,可提高机体对变应原的免疫耐受性和安全性。奥马珠单抗长期皮下注射,安全性好,不良反应轻。奥马珠单抗有望成为治疗儿童AD的新型靶向药物,且可作为变应原特异性免疫治疗的辅助药物。Objective To investigate the treatment of Omalizumab for allergic asthma(AS)combined with atopic dermatitis(AD)in children.Methods Five children who were diagnosed with moderate-to-severe AS combined with AD were admitted in the Department of Respiratory,Children′s Hospital of Nanjing Medical University from November 2018 to August 2020.All children were treated with standardized treatment of AS and Omalizumab.The efficacy and adverse reactions of Omalizumab treated for AD were observed.The scoring atopic dermatitis index(SCORAD),eczema area and severity index(EASI),the children′s dermatology life quality index(CDLQI)and numerical rating scale(NRS)were selected,the scales were used to evaluate the severity,area,itching and quality of life of AD children.Results The AD-related evaluation indexes were remarkably decreased through the treatment of Omalizumab for 4 months,including SCORAD,EASI,CDLQI,and NRS(60.80±10.79 vs.40.30±15.62;13.93±6.81 vs.6.18±2.70;18.80±6.26 vs.13.20±4.82;8.60±0.89 vs.6.00±1.87),the differences were statistically significant(t=7.833,4.106,5.199,5.099,all P<0.05).Two children administered the combination of Omalizumab and allergen specific immunotherapy,and no adverse reactions were observed in the process of immunotherapy.Totally,104 hypodermic injections were accepted in all children,without adverse reactions being observed.Conclusions This study suggested that the Omalizumab treatment can significantly reduce the severity and area of AD,and improve the quality of life for children with moderate-to-severe AS combined with AD.The application of Omalizumab before the allergen specific immunotherapy can improve the immunotolerance and security.There were mild adverse reactions in the treatment with the long-term hypodermic injection of Omalizumab that has higher security.Being taken together,Omalizumab is a potential novel target drug for the treatment of AD in children,and perhaps it is an adjuvant administration for allergen specific immunotherapy.

关 键 词：变应性哮喘 特应性皮炎 奥马珠单抗 疗效 不良反应 

分 类 号：R758.2[医药卫生—皮肤病学与性病学] R725.6[医药卫生—临床医学]