协和变应原制剂冲击免疫治疗应用于过敏性鼻炎和哮喘的安全性  

Safety of Rush Immunotherapy with Allergen Products of Peking Union Medical College Hospital in Allergic Rhinitis and Asthma

作　　者：徐迎阳 徐松江 郑卉爽 关凯 XU Yingyang;XU Songjiang;ZHENG Huishuang(Department of Allergy,Chinese Academy of Medical Sciences&Peking Union Medical College,Peking Union Medical College Hospital,Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases,National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID),Beijing 100730,China)

机构地区：[1]中国医学科学院/北京协和医学院北京协和医院变态(过敏)反应科、过敏性疾病精准诊疗研究北京市重点实验室、国家免疫性疾病临床医学研究中心,100730 [2]烟台鲁东医院过敏反应科,246000

出　　处：《医学研究杂志》2025年第3期23-27,33,共6页Journal of Medical Research

基　　金：国家自然科学基金面上项目(82370041);中央高水平医院临床科研业务费资助项目(2022-PUMCH-B-088)。

摘　　要：目的评价协和变应原制剂冲击免疫治疗在过敏性鼻炎伴/不伴哮喘患者中的安全性。方法回顾性分析108例接受协和变应原制剂冲击免疫治疗的过敏性鼻炎伴/不伴哮喘患者的病例资料,总结不良反应的发生特点及危险因素。结果108例患者共进行840次皮下注射。57例(52.8%)患者57次(6.8%)注射出现局部不良反应。3例(2.8%)患者、3次(0.4%)注射出现全身不良反应,1次为Ⅱ级,2次为Ⅲ级。免疫治疗方案中含有花粉变应原的患者局部不良反应发生率明显高于不含花粉者(48.1%vs 4.6%,P=0.001)。在79例使用花粉变应原制剂的患者中,过敏花粉季节内实施冲击免疫治疗局部不良反应发生率明显高于在非花粉季节治疗患者(54.4%vs 11.4%,P=0.001)。将花粉变应原皮试“+”数量累加,即花粉皮试阳性级别。树木花粉(P<0.05,OR=1.631)和杂草花粉(P<0.05,OR=1.334)皮试阳性级别越高,对局部不良反应的发生越具有促进作用。结论使用单一或混合变应原制剂进行冲击免疫治疗可显著缩短免疫治疗剂量递增阶段、减少就医及注射次数,且全身不良反应发生率较低,有助于提高患者对免疫治疗的依从性。Objective To evaluate the safety of rush immunotherapy(RIT)with allergen products of Peking Union Medical College Hospital in allergic rhinitis with/without asthma.Methods One hundred and eight patients with allergic rhinitis with/without asthma who received RIT with allergen products of Peking Union Medical College Hospital were retrospectively analyzed.The occurrence characteristics of adverse reactions and their risk factors of RIT were summarized.Results A total of 840 injections were administered to 108 patients.Local reactions occurred in 57(52.8%)patients and 57(6.8%)injections.Systemic reactions were observed in 3(2.8%)patients and 3(0.4%)injections.One of systemic reactions was gradeⅡand the other two were gradeⅢ.The incidence of adverse reactions in patients using pollen RIT was significantly higher than those using house dust mite or mold(48.1%vs 4.6%,P=0.001).Among 79 patients receiving pollen RIT,the incidence of local reactions was higher in patients who initiated RIT during pollen season than those out of pollen season(54.4%vs 11.4%,P=0.001).The skin test strength of pollen was defined as the sum of“+”in pollen pollen allergenic skin test.Greater strength of tree(P<0.05,OR=1.631)and weed(P<0.05,OR=1.334)pollen seemed to promote local reactions.Conclusion RIT with single or multiple allergens significantly reduces the build-up phase and frequency of hospital visits,and has low occurrence of systemic reactions.Thus,RIT can improve the compliance for allergen immunotherapy.

关 键 词：冲击免疫治疗 安全性 过敏性鼻炎 哮喘 危险因素 

分 类 号：R765[医药卫生—耳鼻咽喉科] R593[医药卫生—临床医学]