Peng Wansheng, Liu Enmei
Department of Pediatrics, First Affiliation Hospital of Bengbu Medical College, Bengbu, China.
Pediatr Int. 2013 Dec;55(6):680-4. doi: 10.1111/ped.12175. Epub 2013 Sep 20.
The aim of this study was to evaluate the factors predicting the response to allergen-specific immunotherapy (ASIT) in children with asthma.
The case notes of children with asthma who received ASIT for 2 years were retrospectively reviewed. The cases were then divided into an effective clinical response group, defined as absence of asthma symptoms without requirement for medication for at least 6 months during follow up; and an ineffective clinical response group. At the time of initiating treatment, blood was collected for analysis of serum total IgE. Family history of atopy, history of passive smoking, onset age of wheezing and so on was obtained from each patient. Ten factors that may influence children's response were analyzed on logistic regression analysis and compared between groups.
A total of 99 children with asthma received ASIT s.c. for 2 years during September 2007-February 2010. The average age was 8.66 ± 0.30 years. Good response to ASIT was found in 72 cases, while an inadequate response was found in 27 cases. Of the 10 factors tested for correlation with clinical response to ASIT, a significant correlation was found with onset age of wheezing and airway hyperresponsiveness (AHR). The odds ratio for the onset age of wheezing was 2.81 (95% confidence interval [CI]: 1.40-5.65, P = 0.004) and that for AHR was 1.33 (95%CI: 1.04-1.70, P = 0.021).
Potential predictors for the response to ASIT in children with asthma were identified. Onset age of wheezing and AHR may influence response to ASIT.
本研究旨在评估预测哮喘儿童对变应原特异性免疫疗法（ASIT）反应的因素。
回顾性分析接受ASIT治疗2年的哮喘儿童的病历。然后将病例分为有效临床反应组，定义为在随访期间至少6个月无哮喘症状且无需药物治疗；和无效临床反应组。在开始治疗时，采集血液分析血清总IgE。从每位患者处获取特应性家族史、被动吸烟史、喘息发作年龄等。对可能影响儿童反应的10个因素进行逻辑回归分析，并在组间进行比较。
2007年9月至2010年2月期间，共有99例哮喘儿童接受皮下注射ASIT治疗2年。平均年龄为8.66±0.30岁。72例对ASIT反应良好，27例反应不佳。在测试的与ASIT临床反应相关的10个因素中，发现与喘息发作年龄和气道高反应性（AHR）有显著相关性。喘息发作年龄的优势比为2.81（95%置信区间[CI]：1.40 - 5.65，P = 0.004），AHR的优势比为1.33（95%CI：1.04 - 1.70，P = 0.021）。
确定了哮喘儿童对ASIT反应的潜在预测因素。喘息发作年龄和AHR可能影响对ASIT的反应。
