奥马珠单抗在过敏性哮喘中对哮喘和致敏的作用  

Effects of Omalizumab on Asthma and Sensitization in Allergic Asthma

作　　者：毛雅 丁美[1] 梁慧玲 董翔 刘光辉 MAO Ya;DING Mei;LIANG Huiling;DONG Xiang;LIU Guanghui(Department of Allergy,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院过敏反应科,武汉430071

出　　处：《医药导报》2021年第12期1684-1690,共7页Herald of Medicine

基　　金：中央高校基本科研业务费专项资金资助项目(2042020kf0158)。

摘　　要：目的分析奥马珠单抗在治疗过敏性哮喘中对哮喘和致敏状态的作用。方法对2018年5月—2020年8月在武汉大学中南医院过敏反应科就诊的21例接受奥马珠单抗治疗的过敏性哮喘患者进行了回顾性分析。收集和分析开始治疗时、治疗4个月后和治疗12个月后的临床资料,包括哮喘控制测试(ACT)评分、呼出气一氧化氮(FeNO)、第一秒用力呼气容积(FEV 1)、用力肺活量(FVC)、一秒率(FEV 1/FVC)、皮肤点刺试验(SPT)。ΔSPT与ΔFeNO、ΔFEV 1/FVC等进行pearson相关性分析。结果治疗4个月后,ACT评分由(17.43±2.71)分升至(22.43±1.80)分(P<0.0001),FeNO由(46.95±44.40)×10^(-9)降至(26.26±28.24)×10^(-9)(P<0.01),FEV 1由(2.37±1.11)L升至(2.76±0.95)L(P<0.01),FVC由(3.30±1.50)L升至(3.62±1.35)L(P<0.01),FEV 1/FVC由(72.37±13.23)%升至(81.02±10.17)%(P<0.05)。粉尘螨SPT由(8.50±5.21)mm减小至(4.50±2.94)mm(P<0.01),屋尘螨SPT由(10.33±4.94)mm减小至(4.42±2.87)mm(P<0.0001)。屋尘螨ΔSPT与ΔFeNO呈显著正相关(r=0.66,P=0.027),与FEV 1/FVC增加值呈正相关趋势(r=0.56,P=0.073)。结论奥马珠单抗可有效改善过敏性哮喘患者的临床症状、气道嗜酸粒细胞炎症、肺功能及致敏状态。致敏状态的改善和气道嗜酸性粒细胞炎症及肺通气功能的改善具有一致性,即SPT与FeNO、FEV 1/FVC一样,有着评估哮喘病情控制情况的作用。Objective To analyze effects of omalizumab on asthma and sensitization in the treatment of allergic asthma.Methods This study retrospectively collected the clinical data of 21 patients with allergic asthma who received omalizumab in the Department of Allergy,Zhongnan Hospital of Wuhan University from May 2018 to August 2020.Their clinical data,including asthma control test(ACT)score,exhaled nitric oxide(FeNO),forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC,and Skin Prick Test(SPT),were collected and analyzed at the beginning of treatment,4 months after treatment,and 12 months after treatment.Pearson correlation analysis was conducted betweenΔSPT andΔFeNO,ΔFEV1/FVC,etc.Results After 4 months of treatment,the patient's ACT score increased from(17.43±2.71)to(22.43±1.80)(P<0.0001),and FeNO decreased from(46.95±44.40)×10^(-9)to(26.26±28.24)×10^(-9)(P<0.01).FEV1 increased from(2.37±1.11)L to(2.76±0.95)L(P<0.01),and FVC increased from(3.30±1.50)L to(3.62±1.35)L(P<0.01),with the FEV1/FVC increased from(72.37±13.23)%to(81.02±10.17)%(P<0.05).The SPT of Dermatophagoides farina(Df)decreased from(8.50±5.21)mm to(4.50±2.94)mm(P<0.01),and the SPT of Dermatophagoides pteronyssinus(Dp)decreased from(10.33±4.94)mm to(4.42±2.87)mm(P<0.0001).TheΔSPT of Dp was positively correlated withΔFeNO(r=0.66,P=0.027),and the increased FEV1/FVC was positively correlated with the decreased SPT of Dp(r=0.56,P=0.073).Conclusion Omalizumab can effectively improve the clinical symptoms,airway eosinophilic inflammation,lung function,and sensitization in patients with allergic asthma.Moreover,the improvement of sensitization status was correlated with the improvement of airway eosinophil inflammation and lung ventilation function.Meanwhile,SPT,like FeNO and FEV1/FVC,plays an important role in assessing the condition control of asthma.

关 键 词：奥马珠单抗 过敏性哮喘 致敏状态 皮肤点刺试验 

分 类 号：R974.3[医药卫生—药品]