Liu J-L, Ning W-X, Li S-X, Xu Y-C, Wu L, Wang Y-S, Xu X-F, Jiang Y, Sheng Y-J, Zhou Y-L, Wang J-H, Tang L-F, Chen Z-M
Department of Respiratory Medicine, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Dermatology, Guangxing Hospital, Zhejiang Chinese Medical University, Hangzhou, China.
Allergol Immunopathol (Madr). 2017 Nov-Dec;45(6):541-548. doi: 10.1016/j.aller.2017.04.002. Epub 2017 Jun 17.
The aim of the current study is to evaluate the prevalence, severity and possible risk factors of systemic reactions (SRs) to subcutaneous allergen immunotherapy (SCIT) in children and adolescents with asthma in Hangzhou, east China's Zhejiang province.
From January 2011 to December 2016, this survey analysed the SCIT-related SRs involving 429 patients (265 children and 134 adolescents) affected by allergic asthma. Recorded data included demographics, diagnosis, patient statuses, pulmonary function testing results before and after each injection, allergen dosage, and details of SRs.
All patients finished the initial phase and six patients withdrew during the maintenance phase. There were 2.59% (328/12,655) SRs in all injections (3.28% in children and 1.47% in adolescents); 15.62% (67/429) patients experienced SRs (18.49% children and 10.98% adolescents). There were 54.57% SRs of grade 1; 42.37% SRs of grade 2; 3.05% SRs of grade 3; and no grades 4 or grade 5 SRs occurred in patients. Most reactions were mild, and were readily controlled by immediate emergency treatment. There was no need for hospitalisation. The occurrence of SRs was significantly higher in children than that in adolescents (p<0.01). A higher ratio of SRs was found among patients with moderate asthma.
This retrospective survey showed that properly-conducted SCIT was a safe treatment for children and adolescents with asthma in Hangzhou, East China. Children and patients with moderate asthma may be prone to develop SRs.
本研究旨在评估中国东部浙江省杭州市哮喘儿童和青少年皮下变应原免疫疗法（SCIT）引起的全身反应（SRs）的发生率、严重程度及可能的危险因素。
2011年1月至2016年12月，本调查分析了429例过敏性哮喘患者（265例儿童和134例青少年）与SCIT相关的SRs。记录的数据包括人口统计学信息、诊断、患者状态、每次注射前后的肺功能测试结果、变应原剂量以及SRs的详细情况。
所有患者均完成了初始阶段，6例患者在维持阶段退出。所有注射中SRs的发生率为2.59%（328/12,655）（儿童为3.28%，青少年为1.47%）；15.62%（67/429）的患者发生了SRs（儿童为18.49%，青少年为10.98%）。1级SRs占54.57%；2级SRs占42.37%；3级SRs占3.05%；患者中未出现4级或5级SRs。大多数反应为轻度，通过立即急救易于控制。无需住院治疗。儿童中SRs的发生率显著高于青少年（p<0.01）。中度哮喘患者中SRs的比例更高。
这项回顾性调查表明，在杭州，对哮喘儿童和青少年进行适当的SCIT是一种安全的治疗方法。儿童和中度哮喘患者可能更容易发生SRs。
