皮下特异性免疫治疗支气管哮喘患儿的效果  

Effect of Subcutaneous Immunotherapy on Children with Bronchial Asthma

作　　者：卓艳霞 张永卓[1] 孙明昌[1] ZHUO Yanxia;ZHANG Yongzhuo;SUN Mingchang(Department of Pediatric,Puyang People’s Hospital,Puyang 457000,China)

机构地区：[1]濮阳市人民医院儿科,河南濮阳457000

出　　处：《河南医学研究》2025年第5期885-889,共5页Henan Medical Research

摘　　要：目的探究皮下特异性免疫治疗(SCIT)治疗支气管哮喘患儿的临床效果。方法将2020年1月至2023年1月濮阳市人民医院儿科收治的支气管哮喘患儿纳入研究,按治疗方案分为激素组与SCIT组,给予激素组吸入性糖皮质激素抗炎治疗,给予SCIT组吸入性糖皮质激素联合SCIT治疗,经倾向性匹配评分法排除基线资料混杂因素,最终两组各获31例患儿,比较治疗前与治疗后两组患儿临床症状改善情况[日间与夜间症状评分(DASS与NASS)及鼻炎症状评分(TRMS)]、儿童哮喘控制(C-ACT)评分、哮喘发作频次、肺功能恢复情况[肺活量(FVC)、第1秒用力呼吸量(FEV_(1))与呼出气一氧化氮量(FeNO)]、血清免疫学指标[屋尘螨特异性免疫球蛋白E(sIgE)与屋尘螨特异性免疫球蛋白G4(sIgG4)以及免疫球蛋白A(IgA)]、血清炎症因子包括白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)以及γ干扰素(IFN-γ)水平变化,记录并对比两组不良反应。结果匹配后,两组基线资料可比(P>0.05);治疗后,两组DASS、NASS、TRMS评分、哮喘每周频次及FeNO均降低(P<0.05),且SCIT组低于激素组(P<0.05),两组C-ACT、FVC、FEV_(1)均升高(P<0.05),且SCIT组高于激素组(P<0.05);治疗后,两组血清sIgE及IL-4、TNF-α水平均降低(P<0.05),且SCIT组低于激素组(P<0.05),两组血清sIgG4、IgA及IFN-γ水平均升高(P<0.05),且SCIT组sIgG4、IFN-γ水平高于激素组(P<0.05);两组治疗期间的不良反应发生率差异无统计学意义(P>0.05)。结论SCIT治疗支气管哮喘患儿的效果良好,对患儿临床症状起到了一定的改善作用,且较常规激素吸入治疗不增加不良反应,安全有效,有应用推广价值。Objective To explore the clinical effect of subcutaneous immunotherapy(SCIT)in the treatment of children with bronchial asthma.Methods Children with bronchial asthma admitted to Department of Pediatric of Puyang People’s Hospital from January 2020 to January 2023 were included in this study and divided into hormone group and SCIT group according to treatment regimens.The hormone group was given anti-inflammatory therapy with inhaled glucocorticoid,and the SCIT group was given inhaled glucocorticoid combined with SCIT.After excluding the confounding factors of baseline data by propensity score matching method,finally 31 children in each group were obtained.The clinical symptom improvement[daytime asthma symptom score and nighttime asthma symptom score(DASS and NASS)and total rhinitis medication score(TRMS)],child-asthma control test(C-ACT)score,asthma attack frequency,lung function recovery[forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1))and fractional exhaled nitric oxide(FeNO)],serum immunological indicators[house dust mite specific immunoglobulin E(sIgE),house dust mite specific immunoglobulin G4(sIgG4)and immunoglobulin A(IgA)]and serum inflammatory factors[interleukin-4(IL-4),tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)]were compared between the two groups before and after treatment,and the adverse reactions in the two groups were recorded and compared.Results After matching,the baseline data of the two groups were comparable(P>0.05).After treatment,the DASS,NASS,TRMS score,weekly asthma frequency and FeNO in both groups were decreased(P<0.05),and the above indicators in SCIT group were lower than those in hormone group(P<0.05),and the C-ACT,FVC and FEV_(1)in the two groups were increased(P<0.05),and the indicators were higher in SCIT group than those in hormone group(P<0.05).After treatment,serum sIgE,IL-4 and TNF-αlevels in the two groups were declined(P<0.05),and the levels in SCIT group were lower than those in hormone group(P<0.05),and serum sIgG4,IgA and I

关 键 词：支气管哮喘 皮下特异性免疫治疗 脱敏疗法 肺功能恢复 血清免疫学指标 

分 类 号：R725.6[医药卫生—儿科]