中山地区粉尘螨滴剂舌下含服治疗小年龄及多重过敏的变应性鼻炎患者的效果及安全性

Efficacy and Safety of Sublinguul Immunotherapy in Younger and Polysensitized Patients with Allergic Rhinitis in Zhongshan City

目的:评估粉尘螨滴剂舌下特异性免疫治疗(sublingual immunotherapy,SLIT)对小年龄及多重过敏的变应性鼻炎患者的疗效及安全性。方法:回顾分析130例接受粉尘螨滴剂SLIT治疗2年且随访资料完整的变应性鼻炎(allergic rhinitis,AR)患者资料。根据皮肤点刺试验或血清特异性过敏原检测,按照是否单纯尘螨(粉尘螨或/和屋尘螨)过敏分为单一过敏组及多重过敏组,按照年龄分为低年龄组(<5岁)、高年龄组(≥5岁),按照患者所在地区分为城市组、农村组,通过不同时点(治疗前,治疗后第3、6、12、18、24个月)鼻炎症状评分(total nasal symptoms score,TNSS)对疗效进行评价。结果:130例给予舌下含服脱敏治疗的变应性鼻炎中,滴药0.5 h内出现不良反应的有9例,发生率为6.92%(9/130),治疗前、治疗后第3、6个月,单一过敏组TNSS均明显低于多重过敏组(Z=-5.86、6.692、-5.803,P<0.05),治疗后第12个月开始,两组TNSS比较,差异均无统计学意义(Z=-0.804、-1.030、-0.455,P>0.05)。治疗前、治疗后第3个月,低年龄组TNSS均明显高于高年龄组(Z=-3.225、-2.955,P<0.05),治疗后第6个月开始,两组TNSS比较差异均无统计学意义(Z=-0.159、-0.100、-0.498、-1.493,P>0.05)。农村组和城市组治疗前后TNSS比较,差异均无统计学意义(P>0.05)。结论:粉尘螨滴剂舌下脱敏治疗对小年龄及多重过敏的变应性鼻炎患者有良好的疗效和安全性。

Objective： To evaluate the efficacy and safety of sublingnal immunotherapy （ SLIT ） in younger and polysensitized patients with allergic rhinitis.Method： The efficacy of SLIT in 130 patients who were sensitized to house dust mites and treated with Dermatophagoides farinae drops for 2.0 year with complete clinical data were analyzed retrospectively.According to the results of skin prick tests or Detection of serum specific allergen, these patients had been divided into the monoallergen sensitized group and polyallergen sensitized group. And divided into the low age group age （ 〈5 years old ） and high age group （ ≥5 years old ）, these patients had been divided into urban group and rural group according to the patient＇s location.The total nasal symptoms score （TNSS）were evaluated before and 3 months, 6 months, 12 months, 18 months and 24 months after SLIT treatment.Result： There were 9 eases of allergic rhinifis in the treatment of allergic rhinitis, and 130 eases of adverse reactions occurred within half an hour, the incidence rate was 6.92% （ 9/130 ） .Before treatment, 3 months, 6 months after treatment, TNSS in the monoallergen sensit!zed group were significantly lower than those in the polyallergen sensitized group （Z=-5.86, 6.692, -5.803, P〈0.05 ） .Whereas, there was no significant difference between two groups after 12 months tefer to the TNSS （Z=-0.804, -1.030, -0.455, P〉0.05 ） . Before treatment, 3 months after treatment, TNSS were significantly higher in the low age group than those in the high age group （ Z=-3.225, -2.955, P〈0.05 ） .After 6 months of treatment, there was no significant difference between two groups （Z=-0.159, -0.100, -0.498, -1.493, P〉0.05 ） .There was no significant difference of TNSS between rural and urban groups before and after treatment （P〉0.05） .Conclusion： SLIT with dermatophagoides farinae drops is effective and safe for younger and polysensitized patients with allergic rhinitis.