特异性免疫治疗对过敏性鼻炎患儿的临床疗效及对血清白细胞介素17和35水平的影响

The clinical effect of specific immune therapy for children with allergic rhinitis and its influence on the level of serum IL -17 and IL -35

目的：探讨特异性免疫治疗对过敏性鼻炎患儿（AR）的临床疗效及对血清白细胞介素17（IL-17）和白细胞介素35（IL-35）水平的影响。方法选取174例 AR 患儿为研究组，采用特异性免疫治疗，疗程为24个月；同期选取健康体检儿童110例为对照组。采用鼻炎症状总评分（TRSS）减分率评价疗效，采用鼻结膜炎相关生活质量问卷（RQLQ）评价生活质量；检测治疗前后的肺功能、血清嗜酸性粒细胞（Eos）计数、IL-17、IL-35。结果（1）研究组治疗2年后总有效率为89．66％，显著高于治疗1年后的71．26％，差异有统计学意义（χ2＝18．716，P ＜0．05）；（2）研究组治疗1年后和治疗后2年 TRSS 评分和 RQLQ 评分较治疗前降低（t ＝28．360、42．850、7．749、18．010，均 P ＜0．05），且治疗2年后低于治疗1年后（t ＝19．207、10．558，均P ＜0．05）；（3）研究组治疗1年和治疗2年 FEV1／预测值较治疗前升高，气道阻力值／预测值和 Eos 计数较治疗前降低（t ＝15.972、27．811、48．780、62．211、10．930、25．360，均 P ＜0．05），且治疗2年后 FEV1／预测值高于治疗1年后，气道阻力值／预测值和 Eos 计数低于治疗1年后（t ＝8．728、14．707、16．488，均 P ＜0．05）；（4）研究组治疗1年后和治疗2年后血清 IL-17降低，IL-35升高（t ＝9．162、14．522、10．235、16．390，均 P ＜0．05）；且治疗2年后 IL-17低于治疗1年后，IL-35高于治疗1年后（t ＝5．795、7．731，均 P ＜0．05）；（5）相关性分析显示，血清 IL-35与 IL-17水平间呈负相关（r ＝－0．36，P ＜0．05）。结论特异性免疫治疗 AR 患儿的效果较佳，可显著改善临床症状，抑制 IL-17释放，促进 IL-35表达，改善肺功能，提高患儿生活质量。

Objective To study the clinical effect of specific immune therapy for children with allergic rhini-tis（AR）and its influence on the level of serum IL -17 and IL -35.Methods 174 children with AR were chosen as the research group,who were used specific immune therapy for 24 months.In same period,110 cases of healthy chil-dren were selected as the control group.Curative effect was evaluated by rhinitis symptoms total score（TRSS）points rate.quality of life was evaluated by nasal conjunctivitis related quality of life questionnaire（RQLQ）score.Pulmonary function before and after treatment,serum Eos counting,IL -17,IL -35 were detected.Results （1 ）In research group,the total effective rate after treatment of 2 years was 89.66%,which was significantly higher than 71.26% after treatment of 1 year,there was statistically significant difference（χ^2 =18.716,P 〈0.05）.（2）In the research group, TRSS score and RQLQ score after treatment of 1 year and 2 years were lower than that before treatment（t =28.360, 42.850,7.749,42.850,all P 〈0.05 ）,and the data after treatment of 2 years were less than that after treatment 1 year（t =19.207,10.558,all P 〈0.05）.（3）In the research group,FEV1 /predictive value after treatment of 1 year and 2 years elevated compared to that before the treatment,the airway resistance value /forecast and Eos count were lower than that before the treatment（t =15.972,27.811,48.780,62.211,10.930,62.211,all P 〈0.05）.FEV1 /pre-dicted value after treatment of two years was higher than that after treatment of 1 year,airway resistance value /forecast and Eos counts were less than that after treatment of 1 year（t =8.728,14.707,16.488,all P 〈0.05 ）.（4）In research group,serum IL -17 after treatment of 1 year and 2 years reduced,while IL -35 rose （t =9.162,14.522, 10.235,14.522,all P 〈0.05）.And IL -17 after treatment of 2 years was lower than that after treatment of 1 year,IL-35 was higher than after treatment of 1 year（t =5.795,7.731,all P 〈0.05）.（5）Correlation analysis showed that the serum IL -35 and the level of IL -17 showed a negative correlation（r =-0.36,P 〈0.05）.Conclusion Effect of specific immune treatment on children with allergic rhinitis is better,specific immune treatment can improve the clinical symptoms,inhibit IL -17,promote IL35 and improve lung function and quality of life of patients.