奥马珠单抗治疗慢性自发性荨麻疹伴有其他过敏性疾病患者74例临床分析  

Omalizumab for the treatment of 74 patients with chronic spontaneous urticaria accompanied by other allergic diseases:a clinical analysis

作　　者：苏畅 隋秀丽[1] 刘瑞玲[1] 曹毅群[1] 姜虹[1] 严彩蓉 王惠平[2] 亓玉青[1] Su Chang;Sui Xiuli;Liu Ruiling;Cao Yiqu';Jiang Hong;Yan Cairong;Wang Huiping;Qi Yuqing(Department of Allergy,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Dermatology and Venereology,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院变态反应科,天津300052 [2]天津医科大学总医院皮肤性病科,天津300052

出　　处：《中华皮肤科杂志》2023年第6期512-517,共6页Chinese Journal of Dermatology

摘　　要：目的探讨奥马珠单抗在合并有其他过敏性疾病的慢性自发性荨麻疹患者中的治疗获益。方法回顾性收集2020年6月至2022年9月天津医科大学总医院变态反应科收治的临床诊断为慢性自发性荨麻疹、同时合并其他过敏性疾病、经奥马珠单抗治疗的患者的临床资料,分析合并过敏性疾病的种类、治疗前血清总IgE和过敏原特异性IgE水平、治疗效果及药物不良反应情况。采用配对t检验和Wilcoxon符号秩和检验评估治疗前后的差异。结果纳入74例慢性自发性荨麻疹患者,合并过敏性哮喘29例(39.2%),变应性鼻炎61例(82.4%),特应性皮炎6例(8.1%),食物过敏4例(5.4%)。治疗前44例(59.5%)出现血清总IgE或过敏原特异性IgE升高。首次奥马珠单抗治疗后,患者荨麻疹控制测试问卷评分显著提高[治疗前6.00(5.75,9.00),治疗后16.00(13.00,16.00);Z=7.39,P<0.001];治疗4次后,82.5%(33/40)患者荨麻疹症状完全控制/完全反应。奥马珠单抗治疗后,29例合并过敏性哮喘患者喘息发作次数均减少,哮喘控制测试问卷评分显著升高(治疗前18.48±3.20,首次治疗后21.07±2.88;t=8.87,P<0.001);61例合并变应性鼻炎患者,视觉模拟量表评分(治疗前5.89±1.29,首次治疗后3.28±1.46)及生活质量调查问卷评分(治疗前60.10±20.53,首次治疗后37.26±18.83)均明显减少(t=15.04、10.01,均P<0.001),变应性鼻炎症状减轻;4例合并特应性皮炎患者皮肤瘙痒减轻;2例合并食物过敏患者接触过敏食物后症状较前减轻。仅1例出现注射部位红肿、硬结伴疼痛。结论奥马珠单抗在治疗合并过敏性疾病共病的慢性自发性荨麻疹患者中,荨麻疹症状明显改善,合并的过敏性疾病也较好地控制,安全性好。奥马珠单抗治疗慢性自发性荨麻疹合并其他过敏性疾病,患者可多重获益。Objective To evaluate the clinical efficacy of omalizumab in the treatment of patients with chronic spontaneous urticaria accompanied by other allergic diseases.Methods Clinical data were retrospectively collected from 74 patients,who were clinically diagnosed with chronic spontaneous urticaria and other allergic diseases,and received subcutaneous injections of omalizumab in the Department of Allergy,Tianjin Medical University General Hospital from June 2020 to September 2022.Types of allergic diseases,serum total IgE(tlgE)and allergen-specific IgE(slgE)levels before treatment,treatment outcomes and adverse drug reactions were analyzed.Differences before and after treatment were assessed using paired t-test and Wilcoxon signed-rank sum test.Results A total of 74 patients with chronic spontaneous urticaria were involved,including 29 with complicated allergic asthma(39.2%),61 with complicated allergic rhinitis(82.4%),6 with complicated atopic dermatitis(8.1%),and 4 with food allergy(5.4%).Before treatment,elevated serum tlgE or slgE levels were observed in 44(59.5%)patients.After the first omalizumab treatment,the urticaria control test(UCT)score significantly increased compared with that before treatment(16.00[13.0.0.16.00]us.6.00[5.75,9.00],Z=7.39,P<0.001);after 4 sessions of the omalizumab treatment,82.5%(33/40)of the patients achieved complete control of urticaria symptoms or showed complete response.After omalizumab treatment,asthmatic attacks were decreased in 29 patients with allergic asthma,and asthma control test(ACT)scores significantly increased compared with those before treatment(21.07±2.88 points[after the first treatment]us.18.48±3.20 points[before treatment],t=8.87,P<0.001);among 61 patients with allergic rhinitis,global rhinitis symptom-based visual analog scale(VAS)scores(before treatment:5.89±1.29 points;after the first treatment:3.28±1.46 points)and rhinoconjunctivitis quality of life questionnaire(RQLQ)scores(before treatment:60.10±20.53 points;after the first treatment:37.26±18.83 points

关 键 词：荨麻疹 慢性自发性荨麻疹 奥马珠单抗 过敏性疾病 哮喘 鼻炎 过敏性 皮炎 特应性 食物过敏 共病现象 治疗结果 

分 类 号：R758.24[医药卫生—皮肤病学与性病学] R593.1[医药卫生—临床医学]