联合应用奥马珠单抗在儿童中重度变应性哮喘合并慢性鼻窦炎中的疗效观察

doi:10.6040/j.issn.1673-3770.0.2022.544

摘要/Abstract

摘要： 目的探讨奥马珠单抗在儿童中重度变应性哮喘合并慢性鼻窦炎治疗中的疗效。方法分析2020年9月至2022年4月间使用奥马珠单抗治疗的儿童中重度变应性哮喘合并慢性鼻窦炎的临床资料,比较治疗前后儿童哮喘控制评分(childhood asthma control test,C-ACT)、呼出气一氧化氮(fractional concentration of exhaled nitric oxide, FeNO)浓度、第1秒用力呼气量占预计值百分比(first second percentage to predicted value, FEV₁% pred)和小气道功能指标等肺功能检查的变化以及患儿慢性鼻窦炎症状改善情况。结果完成治疗随访的患儿共26例。奥马珠单抗治疗16周后患儿哮喘症状及肺功能均改善,C-ACT从(15.57±3.25)分升至(24.98±5.21)分(F=15.711 2,P<0.001);FeNO从(31.55±15.57)ppb降至(19.86±9.80)ppb(F=4.426 5,P=0.002 2);肺功能提示FEV₁%pred、1秒率(FEV₁/FVC)均升高,但差异无统计学意义(P=0.995 4,P=0.938 2);用力呼气峰流量占预计值百分比、呼出75%肺活量时的最大呼气流量占预计值百分比、呼出50%肺活量时的最大呼气流量占预计值百分比均升高,差异有统计学意义(P=0.047 7,P=0.0005,P<0.001)。患儿鼻窦炎症状显著改善,选择视觉模拟量表评分从(6.40±2.98)分降至(0.85±0.40)分(t=27.241 9,P<0.001)。结论奥马珠单抗可改善中重度变应性哮喘合并慢性鼻窦炎患儿的哮喘与鼻窦炎的临床表现、肺功能及生活质量。

关键词: 奥马珠单抗, 变应性哮喘, 慢性鼻窦炎, 肺功能

Abstract: Objective To investigate the efficacy of Omalizumab in the treatment of children with moderate to severe allergic asthma and chronic sinusitis. Methods The clinical data of children with moderate and severe allergic asthma and chronic sinusitis treated with Omalizumab from September 2020 to April 2022 were retrospectively analyzed. A comparison was performed on the changes of childhood asthma control test(C-ACT), fractional concentration of exhaled nitric oxide(FeNO), forced expiratory volume in the first second percentage to predicted value(FEV₁% pred)and small airway function, the improvement of chronic sinusitis symptoms,before and after treatment with Omalizumab. Results A total of 26 children completed treatment and follow-up. After 16 weeks of Omalizumab treatment, asthma symptoms and lung function were improved. Compared to pre-treatment, the C-ACT score increased from(15.57±3.25)score to(24.98±5.21)score(F=15.711 2, P<0.001)and FeNO decreased from(31.55±15.57)ppb to(19.86±9.80)ppb(F=4.426 5, P=0.002 2). Lung function indicators showed that FEV₁%pred and FEV₁/forced vital capacity(FEV₁/FVC)increased post-treatment, but the differences were not statistically significant(P=0.995 4, P=0.938 2). The maximal expiratory flow percentage of the predicted value, forced expiratory flow at 75% to predicted value, forced expiratory flow at 50% to predicted value all increased significantly(P=0.047 7, P=0.000 5, P<0.001). The symptoms of sinusitis were also significantly improved, and the visual analogue scale score increased from 6.40±2.98 pre-treatment to 0.85±0.40 post-treatment(t=27.241 9, P<0.001). Conclusion Omalizumab can significantly improve the clinical symptoms, lung function indicators and quality of life of children with moderate and severe allergic asthma and chronic sinusitis.

Key words: Omalizumab, Allergic asthma, Chronic sinusitis, Lung function

中图分类号:

R276.1

崇维琨,王娟. 联合应用奥马珠单抗在儿童中重度变应性哮喘合并慢性鼻窦炎中的疗效观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 21-26.

CHONG Weikun, WANG Juan. Efficacy of Omalizumab in children with moderate and severe allergic asthma and chronic sinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 21-26.

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