Scribner Troy A, Bernstein David I
Cincinnati Children's Hospital, Division of Allergy and Medical Center, Cincinnati, Ohio 45267, USA.
Curr Opin Allergy Clin Immunol. 2003 Aug;3(4):295-8. doi: 10.1097/00130832-200308000-00010.
This paper will review new indications for the administration of rapid or ultrarush venom immunotherapy and the advantages of pretreatment with antihistamines.
Rapid and ultrarush venom immunotherapy protocols have been successfully employed to achieve protective maintenance venom doses rapidly. These have been associated with systemic reactor rates as low as 5-7%. Recently, rapid venom immunotherapy protocols have been successfully employed to reach ultra-high maintenance doses for patients not previously protected with standard maintenance doses (i.e. 100 micro g). There is also evidence that pretreatment with antihistamines before venom injections during rapid venom immunotherapy may reduce the numbers and severity of injection-related systemic reactions, as well as improve long-term outcomes in preventing subsequent resting systemic reactions in the field.
Pretreatment with antihistamines should be considered in patients receiving rapid or ultrarush venom injections. Ultrarush or rapid immunotherapy regimens compare favorably with conventional modified rush protocols in terms of side-effects, and may be considered in order to achieve higher but effective maintenance venom doses in those rare patients who are treatment failures.
本文将综述快速或超快速毒液免疫疗法给药的新适应症以及使用抗组胺药进行预处理的优势。
快速和超快速毒液免疫疗法方案已成功用于快速达到保护性维持毒液剂量。这些方案的全身反应率低至5%-7%。最近，快速毒液免疫疗法方案已成功用于为以前未用标准维持剂量（即100微克）保护的患者达到超高维持剂量。也有证据表明，在快速毒液免疫疗法期间毒液注射前用抗组胺药进行预处理可能会减少注射相关全身反应的数量和严重程度，以及改善在野外预防后续静息全身反应的长期效果。
接受快速或超快速毒液注射的患者应考虑使用抗组胺药进行预处理。超快速或快速免疫疗法方案在副作用方面优于传统的改良快速方案，对于那些治疗失败的罕见患者，为了达到更高但有效的维持毒液剂量，可以考虑使用这些方案。
