粉尘螨滴剂舌下特异性免疫治疗儿童哮喘的疗效及其对T淋巴细胞亚群的影响

Effect of Dermatophagoides Farinae Drops Sublingual Specific Immunotherapy in Children with Asthma and Its Influence on T Lymphocyte Subsets

目的:观察粉尘螨滴剂舌下特异性免疫治疗(SLIT)对支气管哮喘患儿T淋巴细胞亚群的影响,分析影响疗效的因素。方法:采用前瞻性随机对照研究方法,选取对粉尘螨过敏的轻度支气管哮喘患儿120例,按随机数表法分为观察组和对照组各60例。对照组给予常规药物治疗,观察组在对照组治疗基础上加用粉尘螨滴剂SLIT,疗程1年。分别于治疗前后采用流式细胞仪检测患儿的T淋巴细胞亚群,比较两组临床疗效并探讨影响疗效的因素。结果:治疗后两组患儿CD3^+、CD4^+、CD4^+/CD8^+均升高,且观察组均高于对照组(P均<0.05),CD8^+均降低,且观察组低于对照组(P均<0.05)。观察组总有效率为78.33%,高于对照组的58.33%(P<0.05)。观察组患儿中,治疗有效的患儿(n=47)和治疗无效的患儿(n=13)在年龄、病程、气道高反应、特异性免疫球蛋白E(s Ig E)水平、痰液嗜酸粒细胞(EOS)水平方面比较差异有统计学意义(P均<0.05)。结论:粉尘螨滴剂SLIT能有效纠正哮喘患儿T淋巴细胞亚群紊乱,提高疗效,可能影响其疗效的因素包括年龄、病程、气道高反应、s Ig E水平、痰液EOS水平等。

Objective： To observe the effect of sublingual specific immunotherapy with dermatophagoides farinae drops on T lymphocyte subsets in asthmatic children,and to analyze the influencing factors of effect. Methods： One hundred and twenty children with mild bronchial asthma allergic to dermatophagoides farinae were randomly divided into observation group（n = 60） and control group（n = 60）according to the randomized data table method by using prospective randomized controlled clinical research method. The control group was treated with conventional drugs,the observation group was given sublingual specific immunotherapy with dermatophagoides farinae drops on the basis of the control group for 1 year. T lymphocyte subsets were detected by flow cytometry before and after treatment,the efficacy of both groups were compared,the influencing factors of the curative effect were discussed. Results： The CD3^＋,CD4^＋,CD4^＋/CD8^＋levels of the two groups were significantly higher after treatment（P〈0. 05）,and these in observation group was higher than control group（P〈0. 05）. CD8^＋levels of the two groups were significantly lower after treatment（P〈0. 05）,and that in observation group was lower than control group（P〈0. 05）. The total effective rate of the observation group was 78. 33%,the control group was 58. 33%,the difference was statistically significant（P〈0. 05）. There were significant differences in the age,course of disease,airway hyperresponsiveness,specific immunoglobulin E and sputum eosinophils between the effective group（n = 47） and the ineffective group（n = 13）in the observation group（P〈0. 05）. Conclusion： Sublingual specific immunotherapy with dermatophagoides farinae drops can effectively correct the disorder of T lymphocyte subsets of asthmatic children,and the age,course of disease,airway hyperresponsiveness,specific immunoglobulin E,sputum eosinophils are the influencing factors of effect.