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草花粉免疫疗法:一项针对草花粉诱发的哮喘和鼻炎患者的单年度双盲、安慰剂对照研究。

Grass pollen immunotherapy: a single year double-blind, placebo-controlled study in patients with grass pollen-induced asthma and rhinitis.

作者信息

Ortolani C, Pastorello E, Moss R B, Hsu Y P, Restuccia M, Joppolo G, Miadonna A, Cornelli U, Halpern G, Zanussi C

出版信息

J Allergy Clin Immunol. 1984 Feb;73(2):283-90. doi: 10.1016/s0091-6749(84)80021-4.

Abstract

Fifteen grass pollen--sensitive asthmatic patients were selected from 200 patients with grass pollenosis on the basis of positive SPTs and RASTs that were restricted to grass pollens (except Bermuda grass), no previous IT, and residence and occupation in an area monitored by serial pollen counts. They underwent a double-blind trial of specific IT with a mixture of three grass pollen--aqueous extracts (velvet, sweet vernal, and timothy) or placebo. After 10 mo, the mean maintenance dose of pollen extract (assayed by RAST inhibition) in eight actively treated patients was 6000 RAST units (range 3000 to 8000) and the mean total dose was 18,700 RAST units (range 10,200 to 30,000). Results were assessment done by the following clinical and immunological data: (1) during the pollen season, daily symptom scores; (2) PD 20% FEV1, IgE antibody to timothy by RAST in serum and in nasal secretions, serum IgG antibody to purified timothy allergen D by solid-phase radioimmunoassay, and the four IgG subclass antibodies by enzyme immunoassay were all measured before treatment and before and after the pollen season. Symptom scores of both treated patients and controls correlated with pollen counts (R = 0.88, p less than 0.05 and R = 0.71, p less than 0.05, respectively). There was a significant difference between the mean symptom score values of treated patients versus controls (Kruskal-Wallis test, p less than 0.001). No significant differences or changes either in the PD 20% FEV1 or IgE antibody to timothy in serum and nasal secretions were found in the two groups before or after IT.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

从200例草花粉症患者中选取了15例对草花粉敏感的哮喘患者,入选标准为:皮肤点刺试验(SPT)和放射变应原吸附试验(RAST)对草花粉(除百慕大草外)呈阳性反应、既往未进行过免疫治疗(IT)、居住和工作在有连续花粉计数监测的地区。他们接受了一项双盲试验,使用三种草花粉水提取物(绒毛草、早熟禾和梯牧草)混合物或安慰剂进行特异性IT治疗。10个月后,8例接受积极治疗患者的花粉提取物平均维持剂量(通过RAST抑制法测定)为6000 RAST单位(范围为3000至8000),平均总剂量为18700 RAST单位(范围为10200至30000)。通过以下临床和免疫学数据进行结果评估:(1)在花粉季节,每日症状评分;(2)治疗前以及花粉季节前后均测量20% 一秒用力呼气容积(PD20% FEV1)、血清和鼻分泌物中针对梯牧草的RAST IgE抗体、固相放射免疫测定法检测的针对纯化梯牧草变应原D的血清IgG抗体以及酶免疫测定法检测的四种IgG亚类抗体。治疗组和对照组的症状评分均与花粉计数相关(分别为R = 0.88,p < 0.05和R = 0.71,p < 0.05)。治疗组与对照组的平均症状评分值之间存在显著差异(Kruskal-Wallis检验,p < 0.001)。免疫治疗前后两组在PD20% FEV1或血清和鼻分泌物中针对梯牧草的IgE抗体方面均未发现显著差异或变化。(摘要截取自250字)

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