奥马珠单抗在螨虫过敏性哮喘伴或不伴过敏性鼻炎变应原免疫治疗中对不良反应的干预效果分析  

Analysis of the intervention effect of omalizumab on adverse reactions during allergen immunotherapy for mite allergic asthma with or without allergic rhinitis

作　　者：刘俊安 李远鹏 李天林 蔡荧煌 张志荣 陈亮[3] LIU Jun-an;LI Yuan-peng;LI Tian-lin(Department of Respiratory and Critical Care Medicine,Xiamen Chang Gung Memorial Hospital Affiliated to Huaqiao University,Xiamen 361028,China)

机构地区：[1]华侨大学附属厦门长庚医院呼吸与危重症医学科,361028 [2]华侨大学附属厦门长庚医院中心实验室,361028 [3]华侨大学附属厦门长庚医院过敏中心,361028

出　　处：《中国现代药物应用》2022年第16期55-58,共4页Chinese Journal of Modern Drug Application

基　　金：奥马珠单抗在螨虫过敏伴或不伴鼻炎变应原免疫治疗中不良反应的干预分析(项目编号:3502Z20124ZD1118)。

摘　　要：目的探讨螨虫过敏性哮喘伴或不伴过敏性鼻炎变应原免疫治疗(AIT)中出现不良反应奥马珠单抗辅助AIT的临床价值。方法101例螨虫过敏性哮喘伴或不伴过敏性鼻炎患者,均进行奥马珠单抗辅助AIT治疗,比较患者治疗前后的总免疫球蛋白E(IgE)、血清特异性IgE(sIgE)阳性率、肺功能[肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、峰值呼气流速(PEF)、最大呼气中段流量(MMEF)]、呼出气一氧化氮(FeNO),观察不良反应及处理情况。结果治疗后患者的总IgE、sIgE阳性率分别为14.85%、8.91%,均低于治疗前的64.36%、50.50%,差异有统计学意义(P<0.05)。治疗后患者的VC、FVC、FEV1、PEF、MMEF分别为(3.92±0.57)L、(4.09±0.72)L、(3.49±0.71)L、(6.78±1.23)L/s、(5.29±1.10)L/s,均高于治疗前的(3.15±0.63)L、(3.26±0.64)L、(2.70±0.62)L、(5.71±1.02)L/s、(4.21±0.92)L/s,差异有统计学意义(P<0.05)。患者治疗后的FeNO为(30.44±9.26)ppb,低于治疗前的(45.23±10.11)ppb,差异有统计学意义(P<0.05)。101例患者中8例(7.82%)出现≥Ⅲ级不良反应,所有不良反应患者均接受对症治疗均有不同程度缓解。结论AIT可用于治疗螨虫过敏性哮喘伴或不伴过敏性鼻炎,治疗初期和维持期均可出现Ⅲ级不良反应,奥马珠单抗能使患者达到AIT的有效维持剂量,疗效可靠。Objective To discuss the clinical value of omalizumab on adverse reactions during allergen immunotherapy(AIT)for mite allergic asthma with or without allergic rhinitis.Methods A total of 101 patients with mite allergic asthma with or without allergic rhinitis received omalizumab adjuvant AIT therapy.The total immunoglobulin E(IgE),serum specific IgE(sIgE)positive rate,pulmonary function[vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in the 1st second(FEV1),peak expiratory flow rate(PEF),maximum mid-expiratory flow(MMEF)],fractional exhaled nitric oxide(FeNO)were compared before and after treatment.The adverse reactions and treatment were observed.Results After treatment,the positive rates of total IgE and sIgE were 14.85%and 8.91%,which were lower than 64.36%and 50.50%before treatment,and the differences were statistically significant(P<0.05).After treatment,the VC,FVC,FEV1,PEF and MMEF were(3.92±0.57)L,(4.09±0.72)L,(3.49±0.71)L,(6.78±1.23)L/s and(5.29±1.10)L/s,which were higher than(3.15±0.63)L,(3.26±0.64)L,(2.70±0.62)L,(5.71±1.02)L/s and(4.21±0.92)L/s before treatment,and the differences were statistically significant(P<0.05).The FeNO of the patients after treatment was(30.44±9.26)ppb,which was lower than(45.23±10.11)ppb before treatment,and the difference was statistically significant(P<0.05).8 out of 101 patients(7.82%)had≥gradeⅢadverse reactions,and all patients with adverse reactions received symptomatic treatment with varying degrees of remission.Conclusion AIT can be used to treat mite allergic asthma with or without allergic rhinitis,and gradeⅢadverse reactions can occur in the initial and maintenance periods of treatment.Omalizumab can enable patients to achieve an effective maintenance dose of AIT with reliable efficacy.

关 键 词：过敏性哮喘 过敏性鼻炎 变应原免疫治疗 奥马珠单抗 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R562.25[医药卫生—临床医学]