屋尘螨和屋尘螨/粉尘螨变应原集群免疫治疗变应性鼻炎的安全性及疗效  

Safety and efficacy of cluster immunotherapy with Dermatophagoides pteronyssinus and Dermatophagoides pteronyssinus/Dermatophagoides farinae extracts for allergic rhinitis

作　　者：杨雅琪 陈浩[1] 黄南 李文静[1] 马东霞 汪茵 祝戎飞 YANG Yaqi;CHEN Hao;HUANG Nan;LI Wenjing;MA Dongxia;WANG Yin;ZHU Rongfei(Department of Allergy,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Institute of Allergy and Clinical Immunology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院过敏反应科,武汉430030 [2]华中科技大学同济医学院附属同济医院过敏和临床免疫研究所,武汉430030

出　　处：《中华临床免疫和变态反应杂志》2025年第1期18-25,共8页Chinese Journal of Allergy & Clinical Immunology

基　　金：武汉市知识创新专项项目(2023020201010157)。

摘　　要：目的比较屋尘螨(安脱达)和屋尘螨/粉尘螨(阿罗格)变应原集群免疫治疗递增期的安全性及疗效。方法回顾性分析2022年6月至2024年4月,在华中科技大学同济医学院附属同济医院过敏反应科接受安脱达(33例)和阿罗格(30例)集群免疫治疗的变应性鼻炎患者剂量递增期不良反应发生情况,并比较两组完成集群免疫治疗的患者递增期治疗前后鼻炎症状及生活质量评分。结果安脱达和阿罗格集群免疫治疗组递增期,速发型大局部反应发生率分别为0和0.35%,速发型全身反应发生率分别为0.24%和0.35%,迟发型大局部反应发生率分别为0和0.70%,迟发型全身反应发生率为2.41%和5.57%。两组速发型不良反应发生率差异无统计学意义(P>0.05),但阿罗格组迟发型全身反应发生率较安脱达组高(P=0.029)。阿罗格组出现全身反应者的屋尘螨特异性IgE/总IgE比值较未出现全身反应者高(P=0.044)。两组患者治疗后鼻炎症状评分和生活质量评分均较治疗前有改善(P<0.05),但两组间比较差异无统计学意义(P>0.05)结论屋尘螨和屋尘螨/粉尘螨变应原制剂集群免疫治疗递增期可快速起效,速发型不良反应发生率低,屋尘螨特异性IgE/总IgE比值高者需警惕全身反应发生。Objective The aim of this study was to compare safety and efficacy of dose escalation phase in cluster immunotherapy using Dermatophagoides pteronyssinus(Dp)extracts(Alutard SQ;ALK,H?rsholm,Denmark)and Dp/Dermatophagoides farinae(Df)extracts(NovoHelisen Depot,NHD)among patients with allergic rhinitis.Methods A retrospective analysis was conducted to evaluate the occurrence of adverse reactions during dose escalation phase,in which 33 patients who were prescribed cluster immunotherapy using Alutard SQ and another 30 patents using NHD were enrolled.Scores of nasal symptoms and quality of life of pre-and after escalation phase of cluster immunotherapy were evaluated in both treatment group.Results Incidence of immediate large local reactions(LLRs)during dose escalation phase was 0.00%and 0.35%in Alutard SQ and NHD group respectively,while incidence of immediate systemic reactions(SRs)was 0.24%and 0.35%in Alutard SQ and NHD group respectively.Incidence of delayed LLRs was 0.00%and 0.70%in Alutard SQ and NHD group respectively,whereas incidence of delayed SRs was 2.41%and 5.57%in Alutard SQ and NHD.The difference of incidence of immediate adverse reactions was not obvious statistically between two treatment groups(P>0.05),but incidence of delayed SRs was higher in NHD group,compared to Alutard SQ group(P=0.029).The Dp specific IgE/total IgE ratio of patients with SRs was higher than that of patients without SRs in NHD group(P=0.044).Improvement of nasal symptom and quality of life scores after treatment was demonstrated in both groups(P<0.05),while the difference was not significant statistically between two treatment groups(P>0.05).Conclusion Cluster immunotherapy using Alutard SQ and NHD extracts demonstrates rapid-onset,as well as low incidence of immediate adverse reactions during dose escalation phase.Patients with high Dp specific IgE/total IgE ratio should be paid more attention for SRs.

关 键 词：屋尘螨 粉尘螨 集群免疫治疗 安全性 疗效 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]