奥马珠单抗治疗儿童过敏性哮喘的临床疗效观察  

Clinical effect observation of omalizumab in the treatment of allergic asthma in children

作　　者：皇惠杰 向莉[1] 侯晓玲[1] 魏勉 Huua Huijie;Xiang Li;Hou Xiaoling;WeiMian(Department of Allergy,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院过敏反应科、儿科重大疾病研究教育部重点实验室,100045

出　　处：《北京医学》2023年第1期47-51,共5页Beijing Medical Journal

基　　金：国家呼吸系统疾病临床医学研究中心“呼吸专项”(HXZX-20210203、HXZX-20210204、HXZX-202107)。

摘　　要：目的探讨奥马珠单抗治疗儿童过敏性哮喘的临床疗效。方法选取2021年8月至2022年3月首都医科大学附属北京儿童医院过敏反应科确诊为过敏性哮喘并应用奥马珠单抗治疗的患儿。根据治疗有效性全球评估(global evaluation of treatment effectiveness,GETE)分析患儿治疗16周时的临床疗效,并观察治疗4周和16周时儿童哮喘控制测试(childhood asthma control test/asthma control test,c-ACT/ACT)得分,哮喘和鼻炎视觉模拟评分(visual analogue scale,VAS),哮喘生活质量调查问卷(mini Asthma Quality of Life Questionnaire,mini-AQLQ)得分,每日激素剂量,血清总IgE、肺功能和呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)情况。结果共纳入35例患儿,其中77.1%的患儿在治疗16周时对奥马珠单抗有“极好”或“好”的应答。与治疗前相比,治疗4周和16周时患儿的c-ACT/ACT得分均升高[25.0(20.3,26.8)分,24.5(21.5,27.0)分比23.0(18.0,23.0)分;23.5(21.3,24.8)分,24.5(24.0,25.0)分比22.0(18.0,24.8)分],哮喘VAS[1.0(0.0,2.8)分,1.0(0.0,1.0)分比2.3(0.6,6.3)分]和鼻炎VAS[1.0(0.0,4.8)分,1.4(0.1,3.0)分比4.7(2.1,5.9)分]均下降,哮喘mini-AQLQ评分均升高[98.5(93.0,103.0)分,103.0(98.5,103.8)分比91.0(83.3,96.5)分],差异均有统计学意义(P<0.05)。与治疗前相比,治疗16周时患儿的每日激素剂量下降[100.0(71.0,150.0)μg比160.0(125.0,200.0)μg]、血清总IgE明显升高[1593.0(1131.0,2367.0)kU/L比684.0(331.0,1489.0)kU/L],差异均有统计学意义(P=0.000)。与治疗前相比,治疗16周时患儿肺功能指标无明显改善,差异均无统计学意义(P>0.05),但FeNO显著降低,差异有统计学意义(P<0.05)。结论在过敏性哮喘儿童中应用奥马珠单抗,可以减少患儿临床症状和糖皮质激素的剂量,改善患儿生活质量。Objective To explore the clinical efficacy of omalizumab in the treatment of allergic asthma in children.Methods The children diagnosed as allergic asthma in the Department of Allergy,Beijing Children’s Hospital,Capital Medical University from August 2021 to March 2022 were selected and treated with omalizumab.According to the global evaluation of treatment effectiveness(GETE),the clinical efficacy of children after 16 weeks of treatment was analyzed,childhood asthma control test/asthma control test(c-ACT/ACT)score,visual analogue scale(VAS)of asthma and rhinitis,mini Asthma Quality of Life Questionnaire(mini-AQLQ)score,daily corticosteroid dosage,total serum IgE,pulmonary function and fractional exhaled nitric oxide(FeNO)were observed at 4 and 16 weeks of treatment.Results A total of35 children were included,of which 77.1%had excellent or good response to omalizumab after 16 weeks of treatment.Compared with pre-treatment,the c-ACT/ACT of children at 4 and 16 weeks after the treatment increased[25.0(20.3,26.8)score,24.5(21.5,27.0)score vs.23.0(18.0,23.0)score;23.5(21.3,24.8)score,24.5(24.0,25.0)score vs.22.0(18.0,24.8)score],the VAS of asthma and rhinitis decreased[1.0(0.0,2.8)score,1.0(0.0,1.0)score vs.2.3(0.6,6.3)score,and1.0(0.0,4.8)score,1.4(0.1,3.0)score vs.4.7(2.1,5.9)score],the score of asthma mini-AQLQ were increased[98.5(93.0,103.0)score,103.0(98.5,103.8)score vs.91.0(83.3,96.5)score],the differences were statistically significant(all P<0.05).Compared with pre-treatment,the daily corticosteroid dosage of children at 16 weeks of treatment decreased[100.0(71.0,150.0)μg vs.160(125.0,200.0)μg]and total serum IgE level was significantly increased[1593.0(1131.0,2367.0)kU/L vs.684.0(331.0,1489.0)k U/L],and the differences were statistically significantall(all P=0.000).Compared with pre-treatment,there were no significant improvements in pulmonary function indexes of children at 16 weeks of treatment(all P>0.05),but the FeNO decreased significantly(P<0.05).Conclusions The application of omalizumab in childre

关 键 词：过敏性哮喘 奥马珠单抗 哮喘控制测试 儿童 

分 类 号：R725.6[医药卫生—儿科]