慢性荨麻疹过敏原分布及脱敏治疗疗效评估

The distribution of allergens and effect assessment of specific immunotherapy in chronic urticaria

目的了解慢性荨麻疹过敏原分布情况,评估脱敏治疗效果。方法收集2007年-2010年间120例慢性荨麻疹患者资料,脱敏治疗1年、2年后,按基本控制、显效、有效、无效4个等级评估治疗效果。结果吸入性过敏原前5名依次是粉尘螨(83%)、春季花粉(51%)、夏秋花粉(48%)、多价真菌(47%)、蟑螂(46%)。仅单一过敏原阳性23例(19%),2种过敏原阳性27例(23%),3种及以上过敏原阳性70例(58%),青少年和老年组单一过敏原比例(分别为40%、46%)较青中年高;不论病程长短,均是多种过敏原阳性多见。脱敏治疗1年后,总有效率为72%,脱敏治疗2年后无效组症状无明显改善。结论慢性荨麻疹过敏原主要以尘螨多见,其次是花粉、真菌、蟑螂,并且多种过敏原同时阳性多见。脱敏治疗1年效果评估,可以作为慢性荨麻疹脱敏治疗方案是否继续的重要依据。

Objective To investigate the distribution of allergens and evaluate the effect of specific immunotherapy in chronic urticaria. Methods Case records of 120 patients with chronic curticaria during the years 2007 to 2010 were re- viewed. The treatment effect of specific immunotherapy was respectively recorded after the first year and second year, and invided into 4 rating effect：basic control, markedly effect, effect, ineffect. Results The positive rate was 83% for dust mite,51% for spring pollen, 48% for autumnal pollen,47% for multivalent fungi, 46% for cockroach . 23 cases（ 19% ） of the patients had positive test responses to 1 allergen, 27 cases（23% ） to 2 allergens and 70 cases（58% ）to 3 or more aller- gens. the single-allergen rate of young adult and the elderly （40% ,46% ） was higher than adolescent （7%）. Regardless of disease duration, multiple allergens are most common. The total effective rate of specific immunotberapy after the first year was 72%, there was no significant improvement of symptoms after the second year. Conclusions Dust mites is com- mon allergens of chronic urticaria, followed by pollen, fungi and cockroaches. Multiple allergens are most common; the effect assessment of specific immunotherapy after the first year is the important basis, whether it continues specific immuno- therapy or not.