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多种过敏原皮下免疫治疗的安全性——对多敏患者的回顾性分析。

Safety aspects of subcutaneous immunotherapy with multiple allergens--a retrospective analysis on polysensitized patients.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2010 Dec;267(12):1873-9. doi: 10.1007/s00405-010-1262-7. Epub 2010 May 9.

Abstract

Polysensitization against a multitude of different allergens is a common problem in the treatment of allergies with specific immunotherapy (SIT). The aim of this retrospective study was to investigate the risk of simultaneous administration of two allergen extracts during SIT with a conventional or Cluster regimen. Local (LR) and systemic reactions (SR) in 147 patients receiving different forms of SIT were compared. Patients received a total number of 2,758 injections during dose-increase phase and 3,412 injections during maintenance phase. During dose-increase phase, a higher rate of LR (for 1A 0.7% and for 2A 1.5%) was found with parallel injections of two allergen extracts (2A). The increase of SR was, however, not significant with conventional (for 1A 0% and for 2A 0.3%) or Cluster therapy (for 1A 0.3% and for 2A 0.5%). No increment of SR with injections of two allergen extracts did occur during maintenance phase (for 1A 0.3% and for 2A 0.1%). In conclusion, the results of the present study indicate that a higher rate of LR and SR must be considered during dose-increase phase independent of the kind of induction regime used. The rate of adverse events (AE) with two different allergen extracts, however, seems tolerable. After reaching maintenance phase, a higher rate of AE with parallel allergen injections did not occur.

摘要

多过敏原过敏是特异性免疫治疗 (SIT) 治疗过敏的常见问题。本回顾性研究的目的是调查在常规或集群方案的 SIT 中同时给予两种过敏原提取物的风险。比较了接受不同形式 SIT 的 147 名患者的局部 (LR) 和全身反应 (SR)。患者在增量阶段接受了总共 2758 次注射,在维持阶段接受了 3412 次注射。在增量阶段,同时注射两种过敏原提取物 (2A) 时,LR 发生率更高(1A 为 0.7%,2A 为 1.5%)。然而,常规治疗(1A 为 0%,2A 为 0.3%)或集群治疗(1A 为 0.3%,2A 为 0.5%)的 SR 增加并不显著。在维持阶段,同时注射两种过敏原提取物不会导致 SR 增加(1A 为 0.3%,2A 为 0.1%)。总之,本研究结果表明,在增量阶段,无论使用何种诱导方案,都必须考虑更高的 LR 和 SR 发生率。然而,两种不同过敏原提取物的不良事件 (AE) 发生率似乎是可以耐受的。达到维持阶段后,同时注射平行过敏原不会导致 AE 发生率更高。

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