Zhang Xuan, Li Meng-rong, Wang Chao, Wang Xiao-ning, Zhang Hai-lin, Lin Jian, Jin Ke, Li Ying-chun
Pediatric Pneumology Department, Yuying Children's Hospital Affiliated to Wenzhou Medical College, Wenzhou 325003, China.
Zhonghua Er Ke Za Zhi. 2010 Jul;48(7):526-30.
The scientific basis and the clinical effectiveness of allergen specific immunotherapy (SIT) administered by subcutaneous injection are well established. This study aimed to observe the changes in amount of inhaled corticosteroids, total IgE, specific IgE, peak expiratory flow rate (PEF), etc. during a standardized SIT against house dust mite in allergic asthmatic children.
Children (5 - 13 years old) with mild to moderate allergic asthma seen from February 2005 to June 2008 were enrolled into this study. A non- randomized retrospective study was performed. All children were diagnosed sensitive to dust mites, the treatment group accepted standardized dust mite allergen specific immunotherapy. Each fourth injections were defined as observation points, the study took 3.4 years. The investigators recorded the treatment, the cumulative allergen extract, changes of daily doses of inhaled corticosteroid, peak expiratory flow (PEF), total IgE (TIgE), specific IgE (SIgE). The control group only received inhaled corticosteroids. The daily doses of inhaled corticosteroid and the number of asthma attacks, and the control rate were compared between the 2 groups.
Totally 85 children were treated with SIT [(7.6 ± 1.4) years], 45 males and 40 females; 50 children received only drug treatment [(7.7 ± 1.5) years], 28 males and 22 females. The cumulative dose of allergen was up to (69.7 ± 4.8) µg after the 20 times injection, the dose of inhaled corticosteroids was significantly less than that in the control group (t = 2.359, P < 0.05). PEF was significantly higher than that of pre-treatment level (F = 7.874, P < 0.05). TIgE and SIgE had no significant change (t = 0.313, P > 0.05, t(Derp) = 0.517, t(Derf) = 0.717, P > 0.05). After the treatment, the control rate of the SIT group was 85.5%, that of the control group was 62.0% (χ(2) = 10.150, P < 0.01).
The standardized SIT against house dust mite could reduce steroid use in mild to moderate allergic asthmatic children. After (38.7 ± 2.3) weeks, the cumulative dose of allergen was up to (69.7 ± 4.8) µg, inhaled corticosteroid was significantly reduced. At the end of SIT, 85% of patients obtained complete control of asthma. Total IgE and mite-specific IgE had no significant changes.
皮下注射变应原特异性免疫疗法（SIT）的科学依据和临床疗效已得到充分证实。本研究旨在观察标准化屋尘螨特异性免疫疗法治疗过敏性哮喘儿童过程中吸入性糖皮质激素用量、总IgE、特异性IgE、呼气峰值流速（PEF）等指标的变化。
选取2005年2月至2008年6月就诊的5 - 13岁轻至中度过敏性哮喘儿童纳入本研究。进行非随机回顾性研究。所有儿童均诊断为对尘螨过敏，治疗组接受标准化尘螨变应原特异性免疫疗法。每4次注射定义为观察点，研究历时3.4年。研究者记录治疗情况、变应原提取物累积量、吸入性糖皮质激素每日剂量变化、呼气峰值流速（PEF）、总IgE（TIgE）、特异性IgE（SIgE）。对照组仅接受吸入性糖皮质激素治疗。比较两组吸入性糖皮质激素每日剂量、哮喘发作次数及控制率。
共85例儿童接受特异性免疫疗法治疗[年龄（7.6±1.4）岁]，男45例，女40例；50例儿童仅接受药物治疗[年龄（7.7±1.5）岁]，男28例，女22例。注射20次后变应原累积剂量达（69.7±4.8）μg，吸入性糖皮质激素剂量显著低于对照组（t = 2.359，P < 0.05）。PEF显著高于治疗前水平（F = 7.874，P < 0.05）。TIgE和SIgE无显著变化（t = 0.313，P > 0.05，t（Derp） = 0.517，t（Derf） = 0.717，P > 0.05）。治疗后，特异性免疫疗法组控制率为85.5%，对照组为62.0%（χ² = 10.150，P < 0.01）。
标准化屋尘螨特异性免疫疗法可减少轻至中度过敏性哮喘儿童的糖皮质激素用量。（38.7±2.3）周后，变应原累积剂量达（69.7±4.8）μg，吸入性糖皮质激素显著减少。特异性免疫疗法结束时，85%的患者哮喘得到完全控制。总IgE和螨特异性IgE无显著变化。
