山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (4): 50-55.doi: 10.6040/j.issn.1673-3770.0.2016.292

• 变应性鼻炎 • 上一篇    下一篇

尘螨疫苗皮下注射治疗变应性鼻炎的疗效和安全性评估

屠燕怡1,2,史丽1,2,赵莉1,2,金鹏1,2,訾晓雪1,2,李昂1,2,金义炫1,2,郅莉莉3   

  1. 1.山东大学医学院, 山东 济南 250012;
    2.山东大学第二医院耳鼻喉科, 山东 济南 250033;
    3.淄博市中心医院耳鼻喉科, 山东 淄博 255031
  • 收稿日期:2016-06-27 出版日期:2016-08-16 发布日期:2016-08-16
  • 通讯作者: 郅莉莉. E-mail:8wy3390410@163.com E-mail:tuyanyi001@126.co
  • 作者简介:屠燕怡. E-mail:tuyanyi001@126.co
  • 基金资助:
    国家自然科学基金(81441028);山东省科技发展计划项目(2010G0020258)

Efficacy and safety of subcutaneous immunotherapy with house dust mite extract for allergic rhinitis.

TU Yanyi1,2, SHI Li1,2, ZHAO Li1,2, JIN Peng1,2, ZI Xiaoxue1,2, LI Ang1,2, JIN Yixuan1,2, ZHI Lili   

  1. 1. School of Medicine, Shandong University, Jinan 250012, Shandong, China;2. Department of Otolaryngology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;3. Department of Otolaryngology, Central Hospital of Zibo, Zibo 255031, Shandong, China
  • Received:2016-06-27 Online:2016-08-16 Published:2016-08-16

摘要: 目的 本研究旨在通过使用标准化尘螨疫苗对变应性鼻炎伴或不伴支气管哮喘的患者进行2年皮下免疫治疗,探讨尘螨皮下免疫治疗的疗效和安全性。 方法 纳入58例对尘螨过敏(单一过敏35例,多重过敏23例)的变应性鼻炎患者,伴或不伴支气管哮喘。在治疗前与治疗后的第6、12、24个月,分析症状评分、视觉模拟量表评分和生活质量评分的变化,观察记录发生的局部及全身不良反应。 结果 与治疗前相比,鼻部症状和哮喘症状评分在治疗6个月后均显著降低(P<0.05),并在2年治疗期内呈持续性下降。治疗2年后,单一过敏患者和多重过敏患者的症状评分差异无统计学意义(P>0.05)。皮下免疫治疗6、12、24个月后,鼻炎和哮喘的相关生活质量也得到了显著改善(P<0.05)。发生的不良反应以局部反应为主,未出现严重不良反应。 结论 皮下免疫治疗是针对尘螨引起的变应性鼻炎的一种安全、有效的治疗方法,对于变应性鼻炎合并支气管哮喘的患者,也能取得显著的疗效。

关键词: 免疫治疗,皮下, 哮喘, 疗效, 鼻炎,变应性, 屋尘螨

Abstract: Objective Investigate the efficacy and safety of 2-year subcutaneous immunotherapy(SCIT)with HDM extract for allergic rhinitis with/without asthma. Methods A total of 58 patients with HDM-induced AR(35 sensitized to HDM only and 23 sensitized to HDM and other allergens simultaneously)with/without asthma were included. Symptom scores, visual analogue scale and quality of life were assessed before and after 6, 12 and 24 months of SCIT. Local and systemic adverse events were recorded for safety. Results Symptom scores decreased significantly(P<0.05)after 6 months of immunotherapy for both AR and asthma, and continued to decline until the end of the treatment. There was no statistical difference(P>0.05)between monosensitized patients and polysensitized patients in symptom scores after 2-year SCIT. Marked improvements(P<0.05)in quality of life were also observed after 6, 12 and 24 months of SCIT. Most side-effects were local reactions, no serious adverse event was reported during the treatment. Conclusion For AR patients, especially accompanied with asthma, SCIT is an effective and safe treatment.

Key words: Subcutaneous immunotherapy, House dust mite, Efficacy, Asthma, Allergic rhinitis

中图分类号: 

  • R765.21
[1] 韩德民,张罗,黄丹,等.我国11个城市变应性鼻炎自报患病率调查[J].中华耳鼻咽喉头颈外科杂志,2007,42(5):378-384. HAN Demin, ZHANG Luo, HUANG Dan, et al. Self-reported prevalence of allergic rhinitis in eleven cities in China[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2007, 42(5):378-384.
[2] Law M, Morris JK, Wald N, et al: Changes in atopy over a quarter of a century, based on cross-sectional data at three time periods[J]. BMJ, 2005, 330(7501):1187-1188.
[3] Bousquet J, Khaltaev N, Cruz AA, et al. Allergic rhinitis and its impact on asthma(ARIA)2008 update[J]. Allergy, 2008, 63(Suppl 86):8-160.
[4] Pichler C E, Marquardsen A, Sparholt S, et al. Specific immunotherapy with Dermatophagoides pteronyssinus and D. farinae results in decreased bronchial hyperreactivity[J]. Allergy, 1997, 52(3):274-283.
[5] Noon L. Prophylactic inoculation against hay fever[J]. Int Arch Allergy Appl Immunol, 1953, 4:285-288.
[6] 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. 变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24.
[7] Canonica G W. A survey of the burden of allergic rhinitis in Europe[J]. Allergy, 2007, 62(Suppl):17-25.
[8] 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.
[9] Juniper E F. Measuring health-related quality of life in rhinitis[J]. J Allergy Clin Immunol, 1997, 99(2):742-749.
[10] Juniper E F, Guyatt G H, Ferrie P J, et al. Measuring quality of life in asthma[J]. Am Rev Resp Dis, 1993, 147(4):832-838.
[11] Cox L, Wallace D. Specific allergy immunotherapy for allergic rhinitis: subcutaneous and sublingual[J]. Immunol Allergy Clin North Am, 2011, 31(3):561-599.
[12] 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. 变应性鼻炎特异性免疫治疗专家共识[J]. 中华耳鼻咽喉头颈外科杂志,2011,46(12):976-980.
[13] Sporik R, Holgate S T, Platts-Mills T A, et al. Exposure to house-dust mite allergen(Der pI)and the development of asthma in childhood. A prospective study[J]. N Engl J Med, 1990, 323(8):502-507.
[14] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.变应性鼻炎的诊治原则和推荐方案(2004年,兰州)[J].中华耳鼻咽喉头颈外科杂志,2005,40(3):166-167.
[15] Bousquet J, Braquemond P, Feinberg J, et al. Specific IgE response before and after rush immunotherapy with a standardized allergen or allergoid in grass pollen allergy[J]. Ann Allergy, 1986, 56(6):456-459.
[16] 孙劲旅, 陈军, 张宏誉. 尘螨过敏原的交叉反应性[J]. 昆虫学报, 2006, 49(4): 695-699. SUN Jinlu, CHEN Jun, ZHANG Hongyu. Allergenic cross-reactivity between house dust mites and other mites[J]. Acta Entomologica Sinica, 2006, 49(4):695-699.
[17] Chen J, Li B, Zhao Y, et al. A prospective multicenter study of systemic reactions in standardized specific immunotherapy for allergic rhinitis in China[J]. Am J Rrhinol Allergy, 2014, 28(1):e40-e44.
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