变应性鼻炎患者皮下免疫治疗和舌下免疫治疗的临床依从性对比及分析  

Comparative analysis of clinical compliance with subcutaneous immunotherapy and sublingual immunotherapy in patients with allergic rhinitis

作　　者：张燕影[1] 刘业海[1] 马燕[1] 邱建新[1] Zhang Yanying;Liu Yehai;Ma Yan;Qiu Jianxin(Department of Otorhinolaryngology Head and Neck Surgery,the First Afiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉头颈外科,合肥230000

出　　处：《国际耳鼻咽喉头颈外科杂志》2022年第4期187-191,共5页International Journal of Otolaryngology-Head and Neck Surgery

基　　金：2020年安徽省卫生健康软科学研究重点项目(2020WR02014);2021年高等学校省级质量工程项目(2021jyxm0726)。

摘　　要：目的探讨变应性鼻炎(allergic rhinitis,AR)患者的皮下免疫治疗(subcutaneous immunotherapy,SCIT)和舌下免疫治疗(sublingual immunotherapy,SLIT)的临床依从性,并提出有效的改善方法。方法对安徽医科大学第一附属医院耳鼻咽喉头颈外科从2018年6月至2019年6月开始治疗截止到2021年6月统计时间为止,登记在案愿意接受特异性免疫治疗(allergen specific immunotherapy,ASIT)患者的依从性进行回顾性研究。坚持ASIT时间达到或超过2年视为依从性好,未满2年者视为依从性差。结果共收集ASIT患者424例,成功随访311例,SLIT依从性为40.22%,SCIT依从性为70%,两者依从性比较差异有统计学意义χ^(2)=12.541,P<0.05)。坚持2年以上治疗者,年龄5~14岁者67例,年龄≥14岁者70例,不同年龄的依从性比较差异有统计学意义(χ^(2)=14.949,P<0.05)。SCIT与SLIT依从性差的原因比较差异无统计学意义(χ^(2)=2.81,P>0.05),坚持不到1年放弃的主要原因是患者自觉效果不明显,1~2年放弃的主要原因是患者自觉症状缓解或控制,两者比较差异有统计学意义(χ^(2)=59.519,P<0.05)。结论AR患者的SCIT依从性高于SLIT,影响依从性的主要因素是患者自觉治疗效果不明显。与患者充分沟通交流,了解患者的想法,制定个性化治疗方案是提高依从性的关键。Objective To investigate the clinical compliance of subcutaneous immunotherapy(SCIT)and sublingual immunotherapy(SLIT)in patients with allergic rhinitis and propose how to improve patients'compliance.Methods A retrospective study was conducted on compliance of patients who were registered to our hospital in allergen specific immunotherapy(ASIT)from June 2018 to June 2019 until the statistical time of June 2021.Patients with full ASIT time or more than 2 years were grouped as good compliance,and patients with less than 2 years follow-up weregrouped as poor compliance.Results A total of 424 registered patients received ASIT,311 patients were successfully followed up.SLIT adherence was 40.22% and SCIT adherence was 70%(χ^(2)=12541,P<0.05).Among those treated for more than 2 years,a total of 67 patients were aged between 5 and 14 years and a total of 70 cases aged over 14 years,compliance comparison varies by age(χ^(2)=14949,P<0.05).Frequency of poor compliance between SCIT and SLIT showed no difference(P>0.05).The main reason that followed up less than 1 year was that patients consider it ineffectiveand that followed up less than 2 years was that patients think it is effective.However,reasons between less than 1 year and less than 2 years are differences(χ^(2)=59.519,P<0.05).Conclusions The compliance of SCIT in AR patients is higher than the SLIT,and the main factor affecting the compliance is that the patient's conscious effect is not obvious.Maintaining doctor-patient contact,fully communicating with patients,understanding patients'ideas,and developing personalized treatment plans are the keys to improving compliance.

关 键 词：耳鼻咽喉头颈外科 舌下免疫治疗 安徽医科大学 特异性免疫治疗 皮下免疫治疗 治疗者 ALLERGIC 变应性鼻炎 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]