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皮下免疫治疗单致敏和多致敏变应性鼻炎儿童的长期疗效和安全性。

Long-Term Efficacy and Safety of Subcutaneous Immunotherapy in Monosensitized and Polysensitized Children With Allergic Rhinitis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, People's Republic of China.

Hunan Province Key Laboratory of Otolaryngology Critical Diseases, Xiangya Hospital of Central South University, Changsha, People's Republic of China.

出版信息

Otolaryngol Head Neck Surg. 2024 Mar;170(3):919-927. doi: 10.1002/ohn.614. Epub 2023 Dec 17.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of dust mite subcutaneous immunotherapy (SCIT) in monosensitized and polysensitized children with allergic rhinitis (AR).

STUDY DESIGN

Prospective cohort study.

SETTING

Tertiary referral center.

METHODS

One hundred thirty children were enrolled and categorized into 2 groups: monosensitized to only dust mites and polysensitized to at least 1 additional allergen beyond dust mites. All patients received SCIT targeting dust mites for 3 years, followed by a 5-year monitoring period. The Total Nasal Symptom Score (TNSS), Symptom and Medication Score (SMS), Visual Analogue Scale (VAS), and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were assessed before SCIT (T0); at 1 (T1) and 2 (T2) years of SCIT; immediately after SCIT (T3); and 2 years post-SCIT (T5). Safety was assessed based on adverse events (AEs).

RESULTS

Fifty-one monosensitized and 50 polysensitized children completed the study. At T3, 47 monosensitized and 46 polysensitized children were effectively treated, with no significant between-group difference in efficacy (P > .05). The TNSS, SMS, VAS scores, and RQLQ score were significantly lower at T1, T2, T3, and T5 than at T0 in both groups (P < .05). The differences in the TNSS, SMS, VAS score, and RQLQ score between the 2 groups were nonsignificant at T0, T1, T2, and T3 (P > .05), but significant at T5 (P < .05). No serious AEs were reported.

CONCLUSION

Monosensitized and polysensitized children exhibited similar beneficial efficacy and safety after 3 years of dust mite SCIT. Monosensitized children derived more benefits 2 years after discontinuation.

摘要

目的

评估尘螨皮下免疫治疗(SCIT)对单一过敏原致敏和多过敏原致敏的过敏性鼻炎(AR)患儿的疗效和安全性。

研究设计

前瞻性队列研究。

设置

三级转诊中心。

方法

共纳入 130 名患儿,并分为两组:仅对尘螨单一过敏组和除尘螨外至少对 1 种其他过敏原过敏的多过敏组。所有患者接受尘螨靶向 SCIT 治疗 3 年,随后进行 5 年监测期。在 SCIT 前(T0)、治疗 1 年(T1)、2 年(T2)、SCIT 结束后即刻(T3)以及 SCIT 结束后 2 年(T5)评估总鼻部症状评分(TNSS)、症状和药物评分(SMS)、视觉模拟评分(VAS)和鼻结膜炎生活质量问卷(RQLQ)。根据不良反应(AE)评估安全性。

结果

51 名单一过敏患儿和 50 名多过敏患儿完成了研究。在 T3 时,47 名单一过敏患儿和 46 名多过敏患儿治疗有效,两组间疗效无显著差异(P>.05)。两组在 T1、T2、T3 和 T5 时 TNSS、SMS、VAS 评分和 RQLQ 评分均显著低于 T0(P<.05)。两组在 T0、T1、T2 和 T3 时 TNSS、SMS、VAS 评分和 RQLQ 评分差异无统计学意义(P>.05),但在 T5 时差异有统计学意义(P<.05)。未报告严重 AE。

结论

尘螨 SCIT 治疗 3 年后,单一过敏和多过敏患儿均显示出相似的疗效和安全性。尘螨脱敏结束后 2 年,单一过敏患儿获益更多。

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