尘螨疫苗皮下注射治疗变应性鼻炎的疗效和安全性评估

Efficacy and safety of subcutaneous immunotherapy with house dust mite extract for allergic rhinitis

目的本研究旨在通过使用标准化尘螨疫苗对变应性鼻炎伴或不伴支气管哮喘的患者进行2年皮下免疫治疗,探讨尘螨皮下免疫治疗的疗效和安全性。方法纳入58例对尘螨过敏(单一过敏35例,多重过敏23例)的变应性鼻炎患者,伴或不伴支气管哮喘。在治疗前与治疗后的第6、12、24个月,分析症状评分、视觉模拟量表评分和生活质量评分的变化,观察记录发生的局部及全身不良反应。结果与治疗前相比,鼻部症状和哮喘症状评分在治疗6个月后均显著降低(P<0.05),并在2年治疗期内呈持续性下降。治疗2年后,单一过敏患者和多重过敏患者的症状评分差异无统计学意义(P>0.05)。皮下免疫治疗6、12、24个月后,鼻炎和哮喘的相关生活质量也得到了显著改善(P<0.05)。发生的不良反应以局部反应为主,未出现严重不良反应。结论皮下免疫治疗是针对尘螨引起的变应性鼻炎的一种安全、有效的治疗方法,对于变应性鼻炎合并支气管哮喘的患者,也能取得显著的疗效。

Objective Investigate the efficacy and safety of 2-year subcutaneous immunotherapy（ SCIT） with HDMextract for allergic rhinitis with / without asthma. Methods A total of 58 patients with HDM-induced AR（ 35 sensitized to HDMonly and 23 sensitized to HDMand other allergens simultaneously） with / without asthma were included. Symptom scores,visual analogue scale and quality of life were assessed before and after 6,12 and 24 months of SCIT. Local and systemic adverse events were recorded for safety. Results Symptom scores decreased significantly（ P〈0. 05） after 6 months of immunotherapy for both AR and asthma,and continued to decline until the end of the treatment. There was no statistical difference（ P〉0. 05） betw een monosensitized patients and polysensitized patients in symptom scores after 2-year SCIT. Marked improvements（ P〈0. 05） in quality of life were also observed after 6,12 and 24 months of SCIT. Most side-effects were local reactions,no serious adverse event was reported during the treatment. Conclusion For AR patients,especially accompanied with asthma,SCIT is an effective and safe treatment.