山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (1): 17-20.doi: 10.6040/j.issn.1673-3770.0.2015.360

• 论著 • 上一篇    下一篇

舌下免疫治疗变应性鼻炎的疗效分析

顾晓,陈彦林   

  1. 临沂市人民医院耳鼻咽喉科, 山东 临沂 276000
  • 收稿日期:2015-08-21 出版日期:2016-02-16 发布日期:2016-02-16
  • 通讯作者: 陈彦林. E-mail:ylch8616@163.com E-mail:gxyy1115@163.co
  • 作者简介:顾晓. E-mail:gxyy1115@163.co

Clinical efficacy of sublingual immunotherapy in patients with allergic rhinitis.

GU Xiao, CHEN Yanlin.   

  1. Department of Otolaryngology, Linyi Peoples Hospital, Linyi 276000, Shandong, China
  • Received:2015-08-21 Online:2016-02-16 Published:2016-02-16

摘要: 目的 评价标准化粉尘螨滴剂舌下免疫治疗(SLIT)中-重度持续性变应性鼻炎(AR)患者的临床效果。 方法 选择62例中-重度持续性AR患者,采用为期2年的SLIT治疗方案。所有患者变应原皮肤点刺试验粉尘螨和(或)屋尘螨皮肤指数≥3+。治疗前后对患者鼻部症状和小气道功能分别应用视觉模拟量表(VAS)和最大用力呼气流速-容量曲线(MEFV)进行评分测定,比较患者治疗前后鼻部症状和小气道功能的变化。 结果 SLIT治疗后AR患者喷嚏、流涕、鼻塞、鼻痒的VAS评分较治疗前均明显下降(P<0.01)。SLIT治疗后AR患者MEFV测定结果中最大呼气中期流量(MMEF),用力呼气25%、50%肺活量的瞬间流速(FEF25%、FEF50%)均较治疗前明显改善(P<0.01)。 结论 SLIT治疗中-重度持续性AR效果良好。

关键词: 免疫治疗, 变应性鼻炎, 小气道功能, 粉尘螨滴剂

Abstract: Objective To investigate the clinical efficacy of sublingual immunotherapy(SLIT)of standardized dermatophagoides farinae drops in patients with allergic rhinitis. Methods Totally 62 patients with moderate to severe persistent allergic rhinitis caused by dust mite received SLIT for two years. Dust mites and(or)house dust mite allergen skin prick index of all patients was ≥3+. Visual analog scale(visual analogue scale, VAS)and the maximum forced expiratory flow-volume curve(maximal expiratory flow-volume curve, MEFV)score were respectively applied to determine the nasal symptoms and small airway function before and after treatment. Results SLIT significantly reduced the individual symptoms like sneezing, rhinorrhea, nasal obstruction and pruritus after two years treatment when compared with the baseline, and the VAS scores of each symptom decreased significantly(P<0.01). The results of MEFV showed that MMEF, FEF25% and FEF50% were significantly improved after two years of SLIT treatment with significant differences(P<0.01). Conclusion SLIT of standardized dermatophagoides farinae drops has an favorite effect in patients with moderate to severe persistent allergic rhinitis.

Key words: Small airway function, Sublingual immunotherapy, Allergic rhinitis, Dermatophagoides farinae drops

中图分类号: 

  • R765.21
[1] Bousquet J, Van Cauwenberge P, Khaltav N, et al. Allergic rhinitis and its impact on asthma[J]. J Allergy Clin Immunol, 2001, 108(5 suppl):S147-334.
[2] Bousquet J, Khaltaev N, Cruz A A, et al. Allergic Rhinitis andits Impact on Asthma(ARIR)2008 update(in collaboration with the World Health Organizaion, GA2LEN and AllerGen)[J]. Allergy, 2008, 63 Suppl 86:8-160.
[3] Zuberbier T, Bachert C, Bouequet P J, et al. GA2LEN/EAACI pocket guide for allergen-specific immunotherapy for allergic rhinitis and asthma[J]. Allergy, 2010, 65(12):1525-1530.
[4] 中华耳鼻咽喉头颈外科杂志编委会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2009年, 武夷山)[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(12):977-978.
[5] Bousquet P J, Combescure C, Neukirch F, et al. Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines[J]. Allergy, 2007, 62(4):376-372.
[6] Parker A L, Abu-Hijleh M, McCool F D. Ratio between forced expiratory flow between 25% and 75% of vital capacity and FVC is a determinant of airway reactivity and sensitivity to methacholine[J]. Chest, 2003, 124(1):63-69.
[7] 王成硕, 张伟, 王向东, 等. 儿童变应性鼻炎免疫治疗的临床疗效及免疫学机制研究[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(1):36-39. WANG Chengshuo, ZHANG Wei, WANG Xiangdong, et al. Clinical efficacy and immunological changes in children with allergic rhinitis receiving specific immunotherapy with Dermatophagoides pteronyssinus[J]. Chin J Otorhinol Head Neck Surgery, 2011, 46(1):36-39.
[8] Wang H, Lin X, Hao C, et al. A double-blind, placebocontrolled study of house dust mite immunotherapy in Chinese asthmatic patients[J]. Allergy, 2006, 61(2):191-197.
[9] Zhang L, Wang C, Han D, et al. Comparative study of cluster and conventional immunotherapy schedules with dermatophagoides pteronyssinue in the treatment of persistent allergic rhinitis[J]. Int Arch Allergy Immunol, 2009, 148(2):161-169.
[10] 朱亮, 陆纪红, 谢青, 等. 皮下免疫和舌下免疫治疗粉尘螨变应性鼻炎的安全性和依从性分析[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(6):444-449. ZHU Liang, LU Jihong, XIE Qing, et al. Compliance and safety evaluation of subcutaneous versus sublingual immunotherapy in mite sensitized patients with allergic rhinitis[J]. Chin J Otorhinol Head Neck Surgery, 2010, 45(6):444-449.
[11] Zock J P, Heinrich J, Jarvis D, et al. Distribution and determinants of house dust mite allergens in Europe:the European Community Respiratory Health Survey II[J]. J Allergy Clin Immunol, 2006, 118(3):682-690.
[12] Thomas W R, Smith W A, Hales B J, et al. Characterization and immunobiology of house duet mite allergens[J]. Int Arch Allergy Immunol, 2002, 129(1):1-18.
[13] 杨酉, 赵岩, 王成硕, 等. 变应性鼻炎患者10030例吸入性变应原谱分析 [J].中华耳鼻咽喉头颈外科杂志, 2011, 46(11):914-920. YANG You, ZHAO Yan, WANG Chengshuo, et al. Prevalence of sensitization to aeroallergens in 10030 patients with allergic rhinitis[J]. Chin J Otorhinol Head Neck Surgery, 2011, 46(11):914-920.
[14] Ciprandi G, Cirillo I. Monosensitization and polysensitization in allergic rhinitis[J]. Eur J Intern Med, 2011, 22(6):e75-79.
[15] Mete N, Sin A, Gulbahar O, et al. The determinants of bronchial hyperresponsiveness in patients with allergic rhinitis[J]. Ann Allergy Asthma Immunol, 2004, 93(2):193-199.
[16] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组、小儿学组, 中华儿科杂志编辑委员会. 儿童变应性鼻炎诊断和治疗指南(2010年, 重庆)[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(1):7-8.
[17] Ciprandi G, Cirillo I, Tosca M A, et al. Bronchial hyperreactivity and spirometric impairment in patients with perennial allergic rhinitis[J]. Int Arch Allergy Immunol, 2004, 133(1):14-18.
[18] Bavbek S, Saryal S, Karabiyikoglu G, et al. Pulmonary function parameters in patients with allergic rhinitis[J]. J Invest Allergy Clin Immunol, 2003, 13(4):252-258.
[19] Marseglia G L, Cirillo I, Vizzaccaro A, et al. Role of forced expiratory flow at 25-75% as an early marker of small airways impairment in subjects with allergic rhinitis[J]. Allergy Asthma Proc, 2007, 28(1):74-78.
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