Nagata M, Tabe K, Yamamoto H, Maruo H, Kiuch H, Sakamoto Y, Yamamoto K, Dohi Y
Second Department of Internal Medicine, Saitama Medical School.
Arerugi. 1993 May;42(5):628-34.
In order to establish guidelines for the optimal use of rush immunotherapy (RI) in mite-sensitive adult bronchial asthmatics, we clinically analyzed 38 cases treated with RI. In all cases, it was possible to reach a maintenance dose greater than 0.10 ml of 1/10 solution of house dust (HD) within 10 days. Most of the systemic reactions occurred after doses greater than 0.15 ml of 1/10 solution. The patients who showed the maximum size of skin reaction > or = 8 cm were susceptible to systemic reactions. Prior to the occurrence of asthma, most cases complained of some prodrome of airway irritation. The clinical efficacy of RI was significantly lower in patients whose FEV1% was < 70%, and no difference was observed between patients whose maintenance dose was 0.10 ml and those whose maintenance dose was greater than 0.20 ml. These results suggest: 1) RI should be performed on patients whose FEV1% is > or = 70%, 2) 0.10 ml of 1/10 solution is an optimal dose, 3) when a local skin reaction is > or = 8 cm in diameter and/or a prodrome of airway irritation occurs, one should be careful when increasing the dosage.
为了制定对尘螨敏感的成年支气管哮喘患者进行快速免疫疗法（RI）的最佳使用指南，我们对38例接受RI治疗的患者进行了临床分析。在所有病例中，均有可能在10天内达到大于0.10 ml的屋尘（HD）1/10溶液的维持剂量。大多数全身反应发生在剂量大于0.15 ml的1/10溶液之后。皮肤反应最大尺寸≥8 cm的患者易发生全身反应。在哮喘发作之前，大多数病例主诉有一些气道刺激的前驱症状。FEV1%<70%的患者中RI的临床疗效显著较低，维持剂量为0.10 ml的患者与维持剂量大于0.20 ml的患者之间未观察到差异。这些结果表明：1）RI应在FEV1%≥70%的患者中进行；2）0.10 ml的1/10溶液是最佳剂量；3）当局部皮肤反应直径≥8 cm和/或出现气道刺激的前驱症状时，增加剂量时应谨慎。
