标准化螨变应原免疫治疗儿童变应性鼻炎和(或)哮喘的安全性研究

Study on safty of standardized specific mite-allergen immunotherapy to children with allergic rhinitis and/or asthma

目的:评估标准化特异性变应原免疫治疗的不良反应。方法:152例患者来源于本院儿科免疫治疗中心,按剂量递增治疗方案进行标准化特异性变应原注射治疗,在每次治疗前、治疗30min后分别进行简易呼气峰流速仪检查PEF或肺功能仪检查肺最大通气功能,询问检查及记录各种不良反应情况。结果:随机记录免疫注射治疗681例次,出现速发型不良反应84例次(12.3%),其中轻度局部速发型不良反应64例次(9.4%),中度局部速发型不良反应2例次(0.3%),全身性速发型不良反应18例次(2.6%),均为轻度哮喘,未见变应性休克等致命性严重不良反应。迟发型不良反应50例次(7.3%),均为轻度局部不良反应。维持治疗期速发型局部不良反应和全身不良反应均明显高于起始治疗期(P<0.05或P<0.01),迟发型局部不良反应在起始治疗期和维持治疗期无明显差异(P>0.05)。所有患儿均在治疗前后进行呼气峰流速或肺功能的检测,681例次PEF变化率(-0.000 2±0.085 9)和109例次MMEF变化率(0.275±0.206)均无统计学差异(t=-0.047,1.39;P>0.05)。结论:标准化特异性变应原免疫治疗儿童变应性鼻炎和(或)哮喘是安全的。

Objective：To evaluate the adverse reaction of standardized specific mite-allergen immunotherapy.Method：One hundred and fifty-two patients diagnosed by the pediatric immunotherapy center of our hospital were treated with increasing doses of standardized specific mite-allergen injection.Before and 30 minutes after treatment,the peak expiratory flow（PEF） and pulmonary function for the maximum lung ventilation function were checked,and the adverse reactions were recorded.Result：Six hundred and eighty-one injections were recorded.84 injections（12.3%） caused immediate side effects,including 64 mild local adverse reactions（9.4%）,2 moderate local adverse reactions（0.3 %）,18 systemic adverse reactions（2.6%） which were mild asthma,and no fatal anaphylactic shock and other serious adverse reactions were found.50 injections（7.3%） cased delayed adverse reactions,all of which were mild local adverse reactions.The rate of immediate local adverse reactions and systemic adverse reactions in the maintenance treatment period was significantly higher than that in the initial treatment period（χ2=4.59,19.82 respectively;P0.05,0.01 respectively）.The rate of delayed adverse reactions was no significant differences（χ2=2.30;P0.05）.The PEF change rate（-0.000 2±0.085 9） of the childs at 681 injections and the MMEF change rate of the childs at 109 injections（0.275±0.206） were not statistically different（t=-0.047,1.39;P=0.963,0.166）.Conclusion：Standardized specific mite-allergen immunotherapy is safe for children with allergic rhinitis and/or asthma.