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哮喘儿童特异性免疫疗法的3年随访

Specific immunotherapy 3 years follow-up in asthmatic children.

作者信息

Ferreira N, Trindade J C

机构信息

Unidade de Imuno-Alergologia, Serviço de Pediatria, Hospital de Santa Maria, Portugal.

出版信息

Allergol Immunopathol (Madr). 1993 Sep-Oct;21(5):185-92.

PMID:8160563
Abstract

Seventy seven children, aged 4-10 years with bronchial asthma and sensibilization to D.pt were included in this study, divided in two groups: group A included 42 children submitted during 3 years to Sl; group B included 35 children followed during the same time period but not submitted to Sl. This group was regarded as the control group. The clinical evolution was evaluated every three months by clinical assessment, medication scores and DEMI. Total IgE, RAST, D.pt and IgG4 have been determined every year. The obtained results showed a clear improvement of the clinical score and reduction of medication use in the group submitted to Sl. In this group there was a total absence of medication during the last 6 months of Sl in 45.2% of the patients, while in the control group only 5.7% of the patients went completely without symptomatic and prophilactic therapy during the same time period. None of the children presented acute systemic reactions that could constitute a risk for their lives. 4 children presented systemic reactions, 3 of them with a bronchial asthma crisis, reversible with bronchodilating therapy and a child presented a rash reaction; two of them abandoned Sl. 13 children presented grade IV local reactions and one of them abandoned Sl; the others continued Sl with a reduction of the maintenance dose. Sl proved to be a safe and efficient ethiopathogenic therapy for child bronchial asthma treatment, when based on a clear selection of the cases and fulfillment of the safety rules established by the Allergology and Clinical Immunology European Academy.

摘要

77名4至10岁的支气管哮喘且对百日咳博德特氏菌致敏的儿童纳入本研究,分为两组:A组包括42名在3年期间接受特异性免疫疗法(Sl)的儿童;B组包括35名在同一时期接受随访但未接受Sl的儿童。该组被视为对照组。每三个月通过临床评估、用药评分和疾病严重程度及发作频率指数(DEMI)评估临床进展。每年测定总IgE、放射性变应原吸附试验(RAST)、百日咳博德特氏菌和IgG4。所得结果显示,接受Sl的组临床评分明显改善,用药量减少。在该组中,45.2%的患者在Sl的最后6个月完全不用药,而在对照组中,同一时期只有5.7%的患者完全没有进行对症和预防性治疗。没有儿童出现可能危及生命的急性全身反应。4名儿童出现全身反应,其中3名出现支气管哮喘发作,使用支气管扩张剂治疗后可逆转,1名儿童出现皮疹反应;其中2名儿童停止了Sl。13名儿童出现IV级局部反应,其中1名儿童停止了Sl;其他儿童继续进行Sl,但维持剂量减少。当基于明确的病例选择和遵循欧洲变态反应学和临床免疫学学会制定的安全规则时,Sl被证明是治疗儿童支气管哮喘的一种安全有效的病因疗法。

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