变应原皮下特异性免疫治疗依从率及影响因素的系统评价与Meta分析  

Compliance rate of subcutaneous allergen specific immunotherapy and its influencing factors: a systemic review and Meta analysis

作　　者：王玲[1] 高亚东[1,3] 王永博 董翔 WANG Ling;GAO Yadong;WANG Yongbo;DONG Xiang(Department of Allergy,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Center for Evidence-based and Translational Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Allergy,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]武汉大学中南医院过敏反应科,武汉430071 [2]武汉大学中南医院循证与转化医学中心,武汉430071 [3]浙江大学医学院附属第一医院变态反应科,杭州310003

出　　处：《中华临床免疫和变态反应杂志》2024年第2期148-156,共9页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的良好的患者依从率是保证变应原特异性免疫治疗的关键,本研究系统评价变应原皮下特异性免疫治疗(皮下脱敏治疗)患者的依从率及影响因素。方法检索PubMed、Cochrane library、Web of Science、CINAHL,中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据知识服务平台和维普(VIP)数据库,检索时限为建库至2023年8月。采用澳大利亚JBI循证卫生保健中心研究真实性评价标准进行文献评价。采用Revman5.3版软件对皮下脱敏治疗依从率进行Meta分析,对影响依从率的因素采用描述性分析。结果共纳入符合条件的文献28篇,结果显示皮下特异性免疫治疗依从率在23.00%~91.46%之间,合并依从率为67.00%(95%CI:57.00%~77.00%);影响依从率的主要因素包括药物不良反应(1.40%~29.00%)、治疗效果未达预期(2.60%~44.00%)、症状改善(4.00%~60.60%)、经济原因(1.00%~47.90%)等;儿童患者的依从率明显高于成人(OR=0.53,95%CI:0.47~0.61,P<0.000)。结论皮下脱敏治疗的总体依从率偏低,且影响依从率的因素较多,采取个性化措施增加患者依从率是提高皮下脱敏治疗的关键。Objective High compliance is the key point for achievement of allergen specific immunotherapy.The aim of this study is to investigate the compliance rate and its influencing factors of subcutaneous allergen specific immunotherapy.Method PubMed,Cochrane library,Web of science,Cumulative Index to Nursing and Allied Health Literature(CINAHL),China Biology Medicine disc(CBMdisc),China National Knowledge Infrastructure(CNKI),Wanfang and Database of Chinese sci-tech periodicals(VIP)were searched,literatures with subject heading including“subcutaneous immunotherapy”,“allergen immunotherapy”,“compliance rate”and“influencing factors”were included from inception to August 2023.Quality of literatures was evaluated by using Joanna Briggs Institute’s critical appraisal tools.Meta-analysis was performed by using RevMan 5.3 software.Influencing factors was described by using descriptive analysis.Results A total of 28 literatures were ultimately included for analysis.The range of compliance rate of subcutaneous immunotherapy varied from 23.00%to 91.46%,while the combined compliance rate was 67.00%(95%CI:57.00%,77.00%).The major influencing factors of compliance included adverse reactions(1.40%-29.00%),ineffectiveness(2.60%-44.00%),discontinuation after appearance of improvement(4.00%-60.60%)and economic burden(1.00%-47.90%).The compliance rate of children was higher than that of adult in real-life study(OR=0.53,95%CI:0.47,0.61,P<0.000).Conclusion The overall compliance rate of subcutaneous immunotherapy was relatively low and influenced by many factors.The key point for improving therapeutic effects of subcutaneous allergen immunotherapy is to improve compliance by taking on targeted measures.

关 键 词：变应原免疫治疗 皮下注射 依从率 影响因素 系统评价 

分 类 号：R593.1[医药卫生—内科学] G353.1[医药卫生—临床医学]