舌下免疫和皮下免疫治疗儿童变应性鼻炎1年疗效观察

Curative effect analysis of sublingual immunotherapy and subcutaneous immunotherapy after 1 year in children with allergic rhinitis

目的观察并比较标准化尘螨变应原疫苗舌下免疫疗法和皮下免疫疗法治疗中重度儿童变应性鼻炎的疗效。方法回顾性分析进行特异性免疫治疗的71例尘螨过敏的变应性鼻炎患儿,其中41例接受舌下免疫治疗和30例进行皮下免疫治疗,治疗均满1年。两种免疫治疗组分别比较治疗前后的症状总评分、用药评分,患儿血清特异性IgE和特异性IgG4的改变,并且对舌下免疫疗法和皮下免疫疗法的疗效进行比较。结果两组治疗后症状总评分和用药评分较治疗前均显著减低(P<0.01),血清特异性IgG4浓度较治疗前明显升高差异有统计学意义(P<0.01),但血清特异性IgE较治疗前无明显改变(P>0.05)。两组间治疗后症状总评分和用药评分下降值,以及血清特异性IgG4下降值无显著差异(P>0.05)。结论标准化尘螨变应原疫苗舌下免疫治疗儿童变应性鼻炎和皮下免疫治疗疗效类似,使用方便,易于接受,宜在儿童患者普遍开展。

Objective To investigate and compare the efficacy of sublingual immunotherapy（SLIT） and subcutaneous immunotherapy（SCIT） with standardized dust mite-allergen extract on pediatric persistent allergic rhinitis.Methods Retrospective analysis was studied in 72 cases of house mite sensitized pediatric allergic rhinitis who received specific immunotherapy,of which 41 cases were proceeded SLIT,and other 30 cases were received SCIT,and the course of treatment were more than one year.The symptom scores,medication scores,serum specific IgE,and serum specific IgG4 before and after the treatment were compared in two groups.The efficacy between the two groups was also compared.Results The total symptom scores and medication scores decreased,and serum specific IgG4 increased significantly（both P〈0.01） after treatment both in the two groups,while serum specific IgE did not decrease（P〈0.05） after treatment.However,the drop-out value of total symptom scores,medication scores,and serum specific IgG4 were not significantly different between the two groups.Conclusion The efficacy of SLIT is similar to SCIT.It＇s easy to use and acceptable.It will be suitable to children with allergic rhinitis.