单一屋尘螨与双螨变应原免疫治疗的安全性分析  

Safety analysis of systemic reactions in immunotherapy of single house dust mite and double mite allergen

作　　者：蒲西 周薇 曾越 刘书楠 傅远瑜 曾小丽 李双 田静 周维康 曾丹 PU Xi;ZHOU Wei;ZENG Yue;LIU Shunan;FU Yuanyu;ZENG Xiaoli;LI Shuang;TIAN Jing;ZHOU Weikang;ZENG Dan(Department of Dermatology,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China;Department of Allergy,Chongqing General Hospital,Chongqing 400010,China)

机构地区：[1]西南医科大学附属医院皮肤科,四川泸州646000 [2]重庆市人民医院过敏反应科,400010

出　　处：《重庆医学》2022年第3期432-437,共6页Chongqing medicine

基　　金：重庆市卫生健康委重点课题(2015XMSB00025);重庆市渝中区科委集成示范与成果转化项目(20150404)。

摘　　要：目的探讨使用单一屋尘螨与双螨变应原特异性免疫治疗(AIT)的安全性及可能的全身不良反应危险因素。方法观察记录使用单一屋尘螨变应原注射液和双螨变应原注射液的尘螨过敏患者在AIT期间不良反应发生的情况,分析对比两种变应原注射液的安全性。结果64例单一屋尘螨AIT患者共接受2726次注射,有26例患者共发生96次全身不良反应,Ⅰ级反应占79.17%;儿童(OR=3.927,P=0.011)更易发生全身不良反应,其临床表现主要为咳嗽、咳痰、胸闷和鼻部症状。50例双螨脱敏治疗患者共接受1534次注射,有8例患者共发生过13次全身不良反应,Ⅲ级反应占46.15%。发生过局部不良反应(OR=4.200,P<0.001)的患者更易发生全身不良反应。两种皮下脱敏方式全身不良反应80%以上都为即时反应,在5-7月、10-11月为全身不良反应的高发期。结论单一屋尘螨注射液AIT全身不良反应发生率较双螨变应原注射液高,但双螨AIT患者更易发生严重过敏反应。Objective To investigate the safety and possible risk factors of systemic reaction in Allergen specific immunotherapy(AIT)with single house dust mite allergen and double mite allergen.Methods The adverse reactions of house dust mite allergic patients using single house dust mite allergen injection and double mite allergen injection during AIT were observed and recorded.The safety of the two allergen injections was analyzed and compared.Results A total of 2726 injections were given to 64 patients with single house dust mite allergen during AIT,and 96 systemic reactions occurred in 26 patients,accounting for 79.17%with grade I reactions.Children were more prone to systemic reactions(OR=3.927,P=0.011),whose clinical manifestations mainly included cough and sputum,chest tightness and nasal symptoms.A total of 1534 injections were given to 50 patients with double mite allergen,8 patients had 13 systemic reactions,accounting for 46.15%with gradeⅢreactions.Patients who have had local reactions were more likely to have systemic reactions(OR=4.200,P<0.001).More than 80%of the systemic reactions of the two subcutaneous desensitization methods were immediate reactions,and the high incidence period of systemic reactions was from May to July and from October to November.Conclusion The incidence of systemic adverse reactions treated with single house dust mite injection was higher than that with double mite allergen injection during AIT,but patients with dual dust mite injection AIT were more prone to severe allergic reactions.

关 键 词：变应原特异性免疫治疗 尘螨 变应原疫苗 安全性 不良反应 

分 类 号：R392.8[医药卫生—免疫学]