屋尘螨皮下特异性免疫治疗支气管哮喘和(或)变应性鼻炎患儿全身不良反应的危险因素  

Risk Factors for Systemic Reactions in Children with Bronchial Asthma and(or)Atopic Rhinitis Treated with Subcutaneous Immunotherapy for House Dust Mite

作　　者：张立 魏金凤 吴素玲 Zhang Li;Wei Jinfeng;Wu Suling(Hangzhou Children’s Hospital,Hangzhou 310014,China)

机构地区：[1]杭州市儿童医院,杭州310014

出　　处：《儿科药学杂志》2024年第5期39-43,共5页Journal of Pediatric Pharmacy

基　　金：浙江省医药卫生科技计划项目,编号2021KY932。

摘　　要：目的:探讨屋尘螨过敏的支气管哮喘和(或)变应性鼻炎患儿接受屋尘螨皮下特异性免疫治疗发生全身不良反应的危险因素。方法:回顾性分析2020年1月至2022年3月杭州市儿童医院诊断为哮喘和(或)变应性鼻炎并进行屋尘螨皮下特异性免疫治疗的患儿共110例。记录皮下免疫治疗后出现不良反应的患儿相关病史资料并进行危险因素分析。结果:入组患儿中15例出现全身不良反应。共注射2 250例次,发生全身不良反应43例次(1.91%)。43例次全身不良反应中,Ⅰ级占79.07%(34/43),Ⅱ级占16.28%(7/43)。15例患儿共发生了43例次全身不良反应,其中97.67%发生在注射后30 min内,69.77%发生在剂量递增阶段,95.35%发生在高浓度变应原疫苗,注射阶段全身不良反应主要表现为呼吸道症状。合并哮喘组全身不良反应发生率高于非哮喘组,变应原检测高敏组高于非高敏组,4号瓶注射组高于1~3号瓶注射组,注射时发生局部不良反应组高于未发生局部不良反应组(P均<0.05)。结论:全身不良反应更易发生在合并哮喘组、高敏体质、既往发生过局部不良反应以及4号瓶注射患儿。此外,近期感染、药物中断、注射时间延长、注射前后发生特殊事件(剧烈运动、饥饿等)、新发过敏症状等可能和发生全身不良反应有关。Objective:To probe into the risk factors for systemic reactions in children with bronchial asthma and(or)atopic rhinitis treated with subcutaneous immunotherapy for house dust mite.Methods:A total of 110 children diagnosed with asthma and(or)allergic rhinitis and treated with subcutaneous immunotherapy for house dust mite in Hangzhou Children’s Hospital from Jan.2020 to Mar.2022 were retrospectively analyzed.History of adverse drug reactions after subcutaneous immunotherapy was recorded and risk factors were analyzed.Results:Systemic reactions were observed in 15 of the enrolled children.The total number of injections was 2,250,with a total of 43 systemic reactions(1.91%).Among 43 cases of systemic adverse reactions,79.07%(34/43)was gradeⅠand 16.28%(7/43)was gradeⅡ.A total of 43 sub-systemic reactions occurred in 15 children,97.67%of which occurred within 30 minutes of injection,69.77%in the dose-increasing phase,and 95.35%in the high-concentration allergen vaccine,and the systemic reactions in the injection phase were mainly characterized by respiratory symptoms.The incidence of systemic reactions in the asthma group was higher than that in the non-asthma group,the allergen detection in hypersensitive group was higher than that in non-hypersensitive group,the No.4 bottle injection group was higher than the No.1,No.2 and No.3 bottle injection group,and the group with local adverse drug reactions during injection was higher than that without local adverse drug reactions,the differences were statistically significant(P<0.05).Conclusion:Systemic reactions are more likely to occur in children with asthma,high sensitivity,previous local adverse drug reactions and No.4 bottle injection.In addition,recent infection,drug interruption,prolonged injection time,special events(violent exercise and hunger)before and after injection,and new allergic symptoms may be related to systemic reactions.

关 键 词：屋尘螨 特异性免疫治疗 全身不良反应 危险因素 

分 类 号：R725.6[医药卫生—儿科]