粉尘螨滴剂治疗儿童螨过敏性鼻炎疗效及对血清IL-4、IL-35水平的影响

Efficacy of dermatophagoides farinae drops in treatment of children with allergic rhinitis and its influence on serum IL-4 and IL-35 levels

目的探讨粉尘螨滴剂治疗儿童过敏性鼻炎疗效及其对血清白细胞介素6(IL-6)、IL-35水平的影响。方法选择2012年1月至2013年10月至河南省南阳市中心医院就诊的80例螨致敏过敏性鼻炎患儿为研究对象,按随机数字表法分为对照组和观察组,每组各40例;对照组给予对症治疗,观察组给予舌下含服粉尘螨滴剂,治疗18个月,观察两组疗效及症状积分、嗜酸性粒细胞(Eos)计数,ELISA法检测血清IL-4、IL-35水平。结果治疗后观察组总有效率为97.50%,高于对照组的92.50%,但两组比较差异无统计学意义(χ2=1.052 6,P=0.305);治疗后两组患儿症状积分、用药评分和Eos计数均显著低于治疗前(P<0.05),治疗后观察组症状积分、用药评分、Eos计数与对照组比较,差异均有统计学意义(P<0.05);治疗后两组患儿血清IL-4水平均显著低于治疗前(P<0.05),IL-35水平均显著高于治疗前(P<0.05),治疗后观察组血清IL-4、IL-35水平与对照组比较,差异有统计学意义(P<0.05);不良反应发生率两组比较差异无统计学意义(χ2=0.213 3,P=0.644)。结论粉尘螨滴剂舌下特异性免疫治疗可有效改善螨致敏过敏性鼻炎患儿症状,降低促炎因子IL-4水平,提高抑炎因子IL-35水平。

Objective To explore the efficacy of dermatophagoides farinae drops for treating allergic rhinitis in children and its influence on serum IL-4and IL-35 levels.Methods A total of 80 children with mite sensitized allergic rhinitis in the Central Hospital of Nanyang city from January 2012 to October 2013 were selected as the research subjects and randomly divided into the control group and the observation group according to random number table method,40 cases in each group.The control group was given the symptomatic treatment,while the observation group was given sublingual dermatophagoides farinae drops.The treatment lasted for 18 months.The efficacy,symptom score and eosinophil count value（Eos）were observed.ELISA was used to detect serum IL-4,IL-35 levels.Results The total effective rate after treatment in the observation group was 97.50%,which was higher than92.50%in the control group,but without statistically significant difference between them（χ^2=1.052 6,P=0.305）.After treatment,the symptom scores,medication scores and Eos count had statistical differences in the two groups were significantly lower than before（P〈0.05）,but which had statistical differences between the two groups after treatment（P〈0.05）;serum IL-4level after treatment in the two groups were significantly lower than before（P〈0.05）,while the IL-35 level was significantly higher than before（P〈0.05）,the serum IL-4and IL-35 levels after treatment had statistically significant differences between the two groups（P〈0.05）.The incidence rate of adverse reactions showed no statistically significant difference between the two groups（χ^2=0.213 3,P=0.644）.Conclusion Sublingual specific immunotherapy of dermatophagoides farinae drops can effectively improve the symptoms of mite sensitized allergic rhinitis in children,reduces proinflammatory cytokine IL-4level and increases suppressing inflammatory cytokine IL-35 level.