粉尘螨滴剂舌下含服对过敏性哮喘儿童疗效分析及外周血CD4^+T细胞IFN-γ/IL-4的影响

The effect of sublingual immunotherapy with Dermatophagoides farinae drops on the ratio of IFN-γ/IL-4 in the peripheral blood CD4^+T cells from asthmatic children

目的探讨粉尘螨滴剂舌下含服脱敏治疗儿童支气管哮喘的疗效,及其对患儿外周血CD4+T细胞IFN-γ/IL-4比值、粉尘螨特异性IgE(sIgE)水平的影响。方法采用随机对照研究方法 ,将84例5～18岁粉尘螨过敏的哮喘患儿分为治疗组(42例)和安慰剂组(42例),分别给予舌下含服粉尘螨滴剂或安慰剂治疗48周,比较两组患儿治疗前后哮喘症状与体征记分、用药记分、直观模拟表评分(VAS)的差异,分析两组患儿治疗前后sIgE水平、外周血CD4+T细胞IFN-γ/IL-4比值的变化。结果治疗组患儿的症状记分、用药记分、VAS评分均较治疗前下降并低于安慰剂组,差异有统计学意义(P均<0.05)。治疗组患儿的CD4+T细胞IFN-γ/IL-4比值较治疗前升高,并高于安慰剂组,差异有统计学意义(P<0.05)。患儿治疗前后IFN-γ/IL-4比值改变与治疗前后症状记分改变具有相关性。治疗前、后两组患儿特异性IgE(sIgE)水平差异无统计学意义(P>0.05)。结论粉尘螨滴剂舌下含服免疫治疗儿童过敏性哮喘安全、有效。

Objective To examine the therapeutic effects of sublingual immunotherapy（SLIT）and to investigate the effect on the ratio of IFN-γ/IL-4 in the peripheral blood CD4＋T cells and the effect on antigen-specific IgE titer in D.farinae allergic asthma children.Methods In one-year double-blind,placebo-controlled trial,84 patients allergic to D.farinae were randomized to receive either D.farinae drops（n = 42）or placebo（n = 42）.Symptom,medication and visual analogue score（VAS）were collected.Skin prick test and antigen-specific IgE assessment were performed at baseline and one-year after treatment.In addition,the ratio of IFN-γ/IL-4 in peripheral blood CD4＋T cells were also assessed.Results The symptom score,total medication score and VAS were lower in SLIT group than in placebo group（P 〈 0.05）.The IFN-γ/IL-4 ratio in CD4＋T cells was higher in SLIT group than in placebo group（P 〈 0.05）.The ratio change of IFN-γ/IL-4 in CD4＋T cells was associated with asthma symptom score change.There was no difference in antigen-specific IgE level between SLIT group and placebo group（P 〉 0.05）.Conclusions D.farinae drop is effective in treating allergic asthma.