Kochuyt A M, Stevens E A
Laboratory of Clinical Immunology, University Hospital St-Rafaël, Leuven, Belgium.
Clin Exp Allergy. 1994 Jan;24(1):35-41. doi: 10.1111/j.1365-2222.1994.tb00914.x.
It is currently recommended to administer a maintenance dose of 100 micrograms of venom at 4-6 week intervals for Hymenoptera venom immunotherapy (VIT). Because the optimal duration of therapy is not known, we decided to progressively prolong the interval between maintenance injections instead of accepting the risk of anaphylactic reactions when VIT is discontinued after a predetermined period. We report here on the results of a first phase of this interval extension programme, covering the gradual increase of the interval from 1-12 weeks over 19 months in 178 patients. A 12-week interval maintenance VIT could be achieved in 117/128 (91%) of yellow jacket venom (YJV) and in 35/50 (70%) of honeybee venom (HBV) allergic patients. At the time of the interview these 152 patients had been treated with 12-weekly 100 microgram venom injections for an average period of 2 years without any untoward reaction to VIT. During this period 48 YJV allergy sufferers experienced 77 field re-stings without systemic reaction (SR), and 17 HBV allergic subjects were restung at least 213 times in total, with one patient developing a very large local reaction and one a mild systemic reaction. In 26 of the 178 patients the interval of 12 weeks was not reached for various reasons, with a higher failure rate among the HBV allergic patients. Most Hymenoptera venom allergic patients can thus be safely and effectively treated with 12-weekly injections of 100 micrograms venom.
目前建议在进行膜翅目昆虫毒液免疫疗法（VIT）时，以4 - 6周的间隔给予100微克毒液的维持剂量。由于治疗的最佳持续时间尚不清楚，我们决定逐步延长维持注射之间的间隔，而不是在预定时间后停止VIT时承担过敏反应的风险。我们在此报告该间隔延长计划第一阶段的结果，该阶段涵盖了178名患者在19个月内将间隔从1周逐渐增加到12周的过程。128名黄夹克毒液（YJV）过敏患者中有117名（91%）和50名蜜蜂毒液（HBV）过敏患者中有35名（70%）可以实现12周间隔的维持VIT。在访谈时，这152名患者接受了每12周一次的100微克毒液注射，平均治疗时间为2年，对VIT没有任何不良反应。在此期间，48名YJV过敏患者经历了77次野外再次蜇刺，无全身反应（SR），17名HBV过敏受试者总共至少被再次蜇刺213次，其中1名患者出现非常严重的局部反应，1名患者出现轻度全身反应。在178名患者中，有26名因各种原因未达到12周的间隔，HBV过敏患者的失败率更高。因此，大多数膜翅目昆虫毒液过敏患者可以通过每12周注射100微克毒液进行安全有效的治疗。
