Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Otolaryngol Head Neck Surg. 2013 Jul;149(1):40-6. doi: 10.1177/0194599813485222. Epub 2013 Apr 8.
Although the effect of specific immunotherapy (SIT) on allergic rhinitis (AR) has been well documented in developed countries, its long-term efficacy in patients in developing countries (such as China) is poorly understood. This study investigated the long-term therapeutic and preventive effects of SIT on house dust mite (HDM)-induced AR in patients from China.
Historical cohort study.
University hospital.
One hundred forty-six AR patients with/without asthma allergic to HDM were investigated for 5 years after initiation of a 3-year course of subcutaneous SIT (SIT group, n = 106) or no SIT (control group, n = 40). The clinical responses of all patients were evaluated at baseline, the stop point of SIT (third year), and 2 years after SIT termination (fifth year), by clinical index including symptom and rescue medication scores (SMS), visual analog scale (VAS), total immunoglobulin E (tIgE), and specific IgE (sIgE). Asthma was assessed by clinical evaluation.
The decrease of SMS and VAS from baseline was significantly improved in the SIT group compared with controls at both the third and fifth year. For patients without asthma at baseline, the odds ratio for no asthma was 3.57 (95% confidence interval, 1.05-12.91; P < .05) in favor of SIT. The serum sIgE/tIgE ratio was significantly increased after SIT treatment in the SIT group, but it was not related to SIT efficacy.
SIT has a long-term effect of improving clinical symptoms and reducing the risk of development of asthma in Chinese AR patients.
虽然特异性免疫治疗（SIT）对过敏性鼻炎（AR）的疗效在发达国家已有充分的记载，但在发展中国家（如中国）患者中的长期疗效却知之甚少。本研究旨在探讨 SIT 对屋尘螨（HDM）诱导的中国患者 AR 的长期治疗和预防作用。
历史队列研究。
大学医院。
对 146 例 AR 患者（伴或不伴哮喘，对 HDM 过敏）进行了为期 5 年的随访，这些患者在接受 3 年皮下 SIT（SIT 组，n=106）或未接受 SIT（对照组，n=40）治疗后。所有患者在基线、SIT 停止点（第 3 年）和 SIT 终止后 2 年（第 5 年）时，通过临床指标（包括症状和急救药物评分[SMS]、视觉模拟评分[VAS]、总免疫球蛋白 E[tIgE]和特异性 IgE[sIgE]）进行临床反应评估。哮喘通过临床评估进行评估。
与对照组相比，SIT 组在第 3 年和第 5 年时 SMS 和 VAS 均有显著降低。对于基线时无哮喘的患者，SIT 组无哮喘的优势比为 3.57（95%置信区间，1.05-12.91；P<0.05）。SIT 组治疗后血清 sIgE/tIgE 比值显著升高，但与 SIT 疗效无关。
SIT 对中国 AR 患者具有长期改善临床症状和降低哮喘发展风险的作用。
