ENT Department, University of Genoa, Genoa, Italy.
Eur Arch Otorhinolaryngol. 2010 Aug;267(8):1313-8. doi: 10.1007/s00405-009-1193-3. Epub 2010 Jan 6.
The aim of this study was to evaluate the efficacy of an oral ribosomal immunotherapy in the management of children with recurrent acute adenoiditis (RAA). 60 children with RAA were included and randomly assigned into two groups (group A and B). Group A children underwent ribosomal prophylaxis, while group B received a placebo. Before, at the end and 6 months after start of the therapy, children underwent medical history, ENT examination, plasma levels of immunoglobulins class E, A, G, M (IgE, IgA, IgG, IgM), tympanometry, active anterior rhinomanometry and VAS scores by children' parents. After the treatment and at the end of the study, in the group A, the serum concentration of IgE was significantly (P < 0.05) lower than in group B (77.34 +/- 6.23 vs. 95.49 +/- 7.07 mg/dl; 74.82 +/- 6.26 vs. 94.44 +/- 7.44 mg/dl), IgA titers were significantly (P < 0.05) higher than in group B (312.04 +/- 18.41 vs. 213.20 +/- 11.82; 309.07 +/- 18.33 vs. 211.73 +/- 11.54 mg/dl) as well as serum concentration of IgG (1401.12 +/- 118.81 vs. 1101.81 +/- 109.64 mg/dl; 1412.19 +/- 116.43 vs. 1144.06 +/- 103.58 mg/dl). At the end of the study, comparison between the two groups showed, in group A: 77% of children (n = 23), versus 23% (n = 7) of group B, with a type A tympanogram; significant (P < 0.05) nasal flow decrease at the rhinomanometric measures; VAS scores were significantly (P < 0.05) improved (1.8 +/- 0.22 vs. 5.1 +/- 0.59) and frequency, severity and social impact of RAA episodes were significantly (P < 0.05) lower than group B. Our results show the therapeutic effectiveness of this approach in the prophylaxis of recurrent acute adenoiditis.
本研究旨在评估口服核糖体免疫疗法在儿童复发性急性腺样体炎（RAA）管理中的疗效。纳入 60 例 RAA 患儿，随机分为两组（A 组和 B 组）。A 组患儿行核糖体预防治疗，B 组患儿给予安慰剂。治疗前、治疗结束时和治疗开始后 6 个月，患儿均行病史、耳鼻喉检查、血浆免疫球蛋白 E、A、G、M 类（IgE、IgA、IgG、IgM）水平、鼓室压图、主动前鼻测压和患儿父母的视觉模拟评分（VAS）。治疗结束和研究结束时，A 组患儿血清 IgE 浓度明显低于 B 组（77.34±6.23 vs. 95.49±7.07 mg/dl；74.82±6.26 vs. 94.44±7.44 mg/dl），IgA 滴度明显高于 B 组（312.04±18.41 vs. 213.20±11.82；309.07±18.33 vs. 211.73±11.54 mg/dl），血清 IgG 浓度也明显高于 B 组（1401.12±118.81 vs. 1101.81±109.64 mg/dl；1412.19±116.43 vs. 1144.06±103.58 mg/dl）。研究结束时，A 组 77%（23 例）患儿与 B 组 23%（7 例）患儿的鼓室压图类型为 A 型，差异有统计学意义（P<0.05）；鼻测压时鼻流量明显下降（P<0.05）；VAS 评分明显改善（1.8±0.22 vs. 5.1±0.59），RAA 发作的频率、严重程度和社会影响明显低于 B 组（P<0.05）。本研究结果显示，该方法在预防复发性急性腺样体炎方面具有治疗作用。
