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标准化尘螨变应原皮下免疫疗法治疗儿童变应性鼻炎的疗效及安全性

[The efficacy and safety of standardized dust mite allergen subcutaneous immunotherapy in children with allergic rhinitis during treatment].

作者信息

Yuan X, Xie S B, Zhang H, Zhang J Y, Wang F J, Liu Y Z, Meng L, Zhong W, Jiang W H, Xie Z H

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital of Central South University, Hunan Province Key Laboratory of Otorhinolaryngology Critical Diseases, Changsha 410008, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Sep 7;58(9):878-884. doi: 10.3760/cma.j.cn115330-20230331-00146.

Abstract

To evaluate the efficacy and safety of standardized dust mite allergen subcutaneous immunotherapy (SCIT) in children with allergic rhinitis (AR) during treatment. A total of 283 children with AR diagnosed with definite dust mite allergy and completed 2 to 3 years of SCIT who attended the Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, from August 2019 to October 2021 were included, including 205 males and 78 females, with a mean age of 10.8 years. The total nasal symptoms score (TNSS), symptom medication score (SMS), rhinoconjunctivitis quality of life questionnaire (RQLQ) and visual analogue scale (VAS) before and after 2 to 3 years' treatment were recorded, and the differences before and after treatment were compared. Adverse reactions during SCIT were recorded to evaluate its safety. SPSS 22.0 software was used for statistical analysis. The overall effectiveness rate during SCIT in 283 children with AR was 89.4% (253/283). Compared with baseline, all symptom scores, medication scores and quality of life scores were significantly lower after 2 to 3 years of SCIT (all 0.05). Further group comparisons showed positive efficacy in patients with different clinical characteristics, including age, gender, smoking status, family history of AR, symptom severity, mono-or poly-allergy, and second immunization, with no statistically significant differences between groups (all 0.05). A total of 12 735 injections were administered during the SCIT, and a total of 213 (1.67%) injections of local adverse reactions occurred, mainly in the initial treatment phase, and the diameter of the local air mass was mostly 5 to 20 mm; 71 (0.56%) injections of systemic adverse reactions occurred, mainly in the initial treatment phase, and most of them were grade 1 reactions with no serious systemic adverse reaction such as shock. Standardized dust mite SCIT has a good safety profile and definite efficacy in treating AR children with different clinical characteristics. It can significantly improve all symptoms, reduce the use of symptomatic drugs and improve their quality of life.

摘要

评估标准化尘螨变应原皮下免疫疗法(SCIT)在治疗儿童过敏性鼻炎(AR)期间的疗效和安全性。纳入2019年8月至2021年10月在中南大学湘雅医院耳鼻咽喉头颈外科就诊、确诊为明确尘螨过敏且完成2至3年SCIT的283例AR儿童,其中男性205例,女性78例,平均年龄10.8岁。记录治疗2至3年前后的总鼻症状评分(TNSS)、症状用药评分(SMS)、鼻结膜炎生活质量问卷(RQLQ)和视觉模拟量表(VAS),并比较治疗前后的差异。记录SCIT期间的不良反应以评估其安全性。采用SPSS 22.0软件进行统计分析。283例AR儿童SCIT期间的总有效率为89.4%(253/283)。与基线相比,SCIT 2至3年后所有症状评分、用药评分和生活质量评分均显著降低(均P<0.05)。进一步的组间比较显示,在不同临床特征的患者中,包括年龄、性别、吸烟状况、AR家族史、症状严重程度、单过敏或多过敏以及二次免疫,均有积极疗效,组间差异无统计学意义(均P>0.05)。SCIT期间共注射12 735针,共发生213例(1.67%)局部不良反应注射,主要发生在初始治疗阶段,局部气团直径大多为5至20 mm;发生71例(0.56%)全身不良反应注射,主要发生在初始治疗阶段,大多数为1级反应,无休克等严重全身不良反应。标准化尘螨SCIT在治疗不同临床特征的AR儿童方面具有良好的安全性和确切疗效。它可以显著改善所有症状,减少对症药物的使用并提高其生活质量。

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