奥马珠单抗治疗儿童中重度过敏性哮喘伴过敏性合并症的疗效评价  

Efficacy of Omalizumab in the treatment of moderate-to-severe allergic asthma with allergic comorbidities in children

作　　者：丁玮 莫佳丽 张慧珊 赵萌萌 张宏菊[1] 叶乐平 Ding Wei;Mo Jiali;Zhang Huishan;Zhao Mengmeng;Zhang Hongju;Ye Leping(Department of Pediatrics,Peking University First Hospital,Beijing 100034,China;Department of Pediatrics,Children′s Medical Center Affiliated to Shanghai Jiao Tong University,Shanghai 200127,China)

机构地区：[1]北京大学第一医院儿科,北京100034 [2]上海交通大学附属儿童医学中心儿科,上海200127

出　　处：《中华实用儿科临床杂志》2022年第15期1172-1176,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81971424);北京大学第一医院科研种子基金课题(2019SF43)。

摘　　要：目的探讨奥马珠单抗治疗儿童中重度过敏性哮喘伴过敏性合并症的临床疗效。方法回顾性分析2018年7月至2022年3月北京大学第一医院儿科接受奥马珠单抗治疗并完成12个月随访的50例中重度过敏性哮喘伴过敏性合并症患儿的临床资料。比较治疗前后儿童过敏性哮喘及过敏性合并症[过敏性鼻炎(AR)、慢性自发性荨麻疹(CSU)]相关评分量表、肺功能检测指标及呼出气一氧化氮(FeNO)等的变化。采用方差分析、配对t检验、χ2检验、秩和检验进行数据间比较。结果 1.症状控制情况:与治疗前相比,奥马珠单抗治疗12个月后,≤11岁的42例患儿的儿童哮喘控制评分从(20.98±5.03)分升至(26.95±0.22)分(F=18.189,P<0.001);50例儿童哮喘控制问卷评分从(0.89±0.11)分降至(0.10±0.02)分(F=5.662,P=0.006);47例哮喘合并AR视觉模拟评分从(11.00±1.65)分降至(0.2±0.14)分(F=14.901,P<0.001);13例哮喘合并CSU控制评分从(4.82±0.88)分降至(1.87±0.61)分(F=4.329,P= 0.018)。2.生活质量改善情况:与治疗前相比,奥马珠单抗治疗12个月后,50例儿童哮喘生活质量问卷评分从(124.50±32.13)分升至(159.40±6.21)分(F=12.052,P<0.001);哮喘全球疗效评估评分从(2.23±0.70)分降至(1.07±0.26)分(F=68.865,P<0.001)。3.肺功能改善情况:与治疗前相比,奥马珠单抗治疗12个月后,1秒率<80%的患儿从13例(26%)减少至1例(2%),平均值从(91.39±12.88)%升至(96.96±8.54)%(χ2=11.960;t=2.486,均P<0.05);最大呼气峰流量占预计值百分比从(86.73±16.05)%升至(94.01±13.11)%(t=2.445,P<0.05);用力呼出50%肺活量时的瞬间流量、用力呼出75%肺活量时的瞬间流量和最大呼气中期流量中2个指标<65%的患儿从31例(62%)减少至7例(14%)(χ2=24.450,P<0.001);FeNO变化差异无统计学意义(P>0.05)。4.安全性:治疗和随访期间患儿均未发生明显不良反应。结论奥马珠单抗可显著改善过敏性哮喘伴AR和CSU患儿的临床症状、小气道功能指�Objective To investigate the clinical efficacy of Omalizumab in the treatment of moderate-to-severe allergic asthma with allergic comorbidities in children.Methods The clinical data of 50 children with moderate-to-severe allergic asthma and allergic comorbidities,who were treated with Omalizumab and completed 12-month follow-up in the Department of Pediatrics of Peking University First Hospital from July 2018 to March 2022,were retrospectively analyzed.A comparison was performed on the scale scores of childhood allergic asthma and allergic comorbidities including allergic rhinitis(AR)and chronic spontaneous urticaria(CSU),pulmonary function test indices and fractional exhaled nitric oxide(FeNO)concentration before and after treating with Omalizumab.The data were compared by ANOVA,paired t-test,chi-square test and rank sum test.Results(1)Improvement of clinical symptoms:after 12 months of Omalizumab treatment,the childhood asthma control test score of 42 children aged≤11 years increased from(20.98±5.03)points to(26.95±0.22)points(F=18.189,P<0.001).The asthma control questionnaire 7 score of 50 children decreased from(0.89±0.11)points to(0.10±0.02)points(F=5.662,P=0.006).The score of visual analogue scale of 47 children with AR decreased from(11.00±1.65)points to(0.2±0.14)points(F=14.901,P<0.001),and the urticaria control test score of 13 children with CSU decreased from(4.82±0.88)points to(1.87±0.61)points(F=4.329,P=0.018).(2)Improvement of quality of life:compared with those before treatment,the pediatric asthma quality of life questionnaire score in 50 children increased from(124.50±32.13)points to(159.40±6.21)points(F=12.052,P<0.001),and global evaluation of asthma treatment effectiveness decreased from(2.23±0.70)points to(1.07±0.26)points(F=68.865,P<0.001)after Omalizumab treatment for 12 months.(3)Improvement of pulmonary function results:after 12 months of Omalizumab treatment,the number of children with forced expiratory volume in one second/forced vital capacity<80%decreased from 13 cases(26%

关 键 词：奥马珠单抗 儿童 过敏性哮喘 过敏性合并症 疗效评价 

分 类 号：R725.6[医药卫生—儿科]