变应性鼻炎脱敏治疗的效果观察

Investigation of efficiency of immunotherapy on allergic rhinitis and analysis of its correlative factors

目的观察变应性鼻炎(AR)脱敏治疗的效果,探讨影响变应性鼻炎脱敏治疗效果的相关因素。方法对185例AR患者通过皮肤试验,选择敏感变应原浸液,按递增剂量进行常规皮下脱敏治疗。根据患者治疗前后的症状和体征得分情况,分为显效、有效和无效。选择性别、年龄、病程、病情、伴慢性鼻窦炎、伴哮喘、脱敏治疗时间、皮试反应等8个影响变应性鼻炎脱敏治疗效果的可能因素进行多元回归分析,筛查影响脱敏治疗效果的因素。结果总有效率74.6%,其中显效22.9%,有效51.7%。影响脱敏治疗效果的主要因素是治疗时间,即时间越长,效果越好(P<0.01);其次是年龄因素,年龄越小,效果越好(P<0.05);伴慢性鼻窦炎和伴哮喘也可能影响脱敏治疗效果(P值分别为0.072和0.069)。结论变应性鼻炎脱敏治疗是有效的,脱敏治疗时间越长、年龄越小,效果越好。

Objective To observe the efficiency of immunotherapy on allergic rhinitis and explore its correlative factors. Methods 185 patients with AR were treated with immunotherapy in this department between 1993 and 2003. Specific allergens were selected through skin test. The patients were given subcutaneous injections with allergen extract produced by Xiehe Hospital. The doses were gradually increased to the maintenance dose. The clinical effectiveness evaluation based on the symptoms and signs before and after immunotherapy was judged as marked, moderated and poor response. The possible factors which affected the efficacy of immunotherapy were selected. These factors included sex, age, illness duration, disease condition, chronic sinusitis, asthma, duration of immunotherapy and reaction condition of the skin test. The correlative factors with efficacy were sifted with multifactorial stepwise regression analysis. Results The marked, moderated and poor responses were 22.9 %, 51.7 %, and 25.4 % respectively. The efficacy of immunotherapy correlated well with the duration of immunotherapy（P 〈 0.01） as well as the age of immunotherapy（ P 〈 0.05 ）, but not with sex, illness duration, disease condition and reaction condition of the skin test. Chronic sinusitis and asthma may influence the effect of immunotherapy（P = 0. 072, P = 0. 069）. Conclusion The immunotherapy is effective in the treatment of allergic rhinitis. The duration and age are the factors significantly influencing the efficacy of immunotherapy, which is better when the treatment is longer and the patient is younger.