屋尘螨皮下免疫治疗儿童变应性鼻炎的全身不良反应分析  

Analysis of systemic reactions during house dust mite subcutaneous immunotherapy in children with allergic rhinitis

作　　者：王贤诚 王龙飞 郑晓顺 肖晓雄 李立浩 莫丽华 WANG Xiancheng;WANG Longfei;ZHENG Xiaoshun;XIAO Xiaoxiong;LI Lihao;MO Lihua(Department of Pediatric,Shenzhen Hospital,Southern Medical University,Shenzhen 518100,China;Department of Pediatric Otolaryngology,Shenzhen Hospital,Southern Medical University,Shenzhen 518100,China)

机构地区：[1]南方医科大学深圳医院儿科,广东深圳518101 [2]南方医科大学深圳医院儿童耳鼻喉科,广东深圳518101

出　　处：《新医学》2024年第7期534-540,共7页Journal of New Medicine

基　　金：广东省自然科学基金(2023A1515030299)。

摘　　要：目的观察屋尘螨变应原皮下免疫治疗(SCIT)的全身不良反应(SRs),分析可能的危险因素。方法回顾性分析2019年12月至2022年12月230例接受屋尘螨变应原SCIT的变应性鼻炎(AR)患儿的SRs发生情况及其危险因素。结果230例患儿共接受5422次注射,SRs发生率占总注射次数2.4%,占治疗例数20.0%。SRs以Ⅰ级(51.9%)为主,无致死的SRs发生,症状主要累及呼吸系统111次(84.7%)。外周血高嗜酸性粒细胞计数[OR(95%CI)=6.02(1.76,20.60),P=0.004]和屋尘螨特异性IgE水平[OR(95%CI)=1.01(1.00,1.01),P=0.016]为发生SRs的危险因素。结论尘螨过敏的AR患儿应用标准化屋尘螨变应原制剂行SCIT过程可能发生SRs,SCIT总体安全性良好。高嗜酸性粒细胞计数、屋尘螨特异性IgE水平是SCIT过程出现SRs的危险因素。Objective To observe the systemic reactions(SRs)associated with subcutaneous immunotherapy(SCIT)using dust mite allergen and to analyze potential risk factors.Methods The occurrence of SRs among 230 patients with allergic rhinitis(AR)who received house dust mite SCIT from December 2019 to December 2022 was retrospectively analyzed,and related risk factors were identified.Results A total of 5422 injections were given to 230 patients,with an SRs incidence rate of 2.4%per injection and 20.0%per patient.Most SRs were grade I(51.9%),and no fatal SRs occurred.Symptoms primarily affected the respiratory system for 111 times(84.7%).Elevated peripheral blood eosinophil count(OR(95%CI)=6.02(1.76,20.60),P=0.004)and high levels of house dust mite-specific IgE(OR(95%CI)=1.01(1.00,1.01),P=0.016)were identified as risk factors for SRs,respectively.Conclusions Children with AR allergic to dust mites may experience SRs during SCIT with standardized dust mite allergen preparations,whereas the overall safety of SCIT is good.High eosinophil count and high levels of house dust mite-specific IgE are risk factors for SRs during SCIT.

关 键 词：变应性鼻炎 尘螨 皮下免疫治疗 全身不良反应 儿童 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]