舌下免疫治疗对尘螨过敏哮喘患儿呼出气一氧化氮及免疫指标影响观察

Change of FeNO and serum SIgG4,IL-4 and INF-γ levels using SILT in children with mites allergic asthma

目的观察尘螨过敏哮喘患儿舌下免疫治疗(SLIT)1年后,呼出气一氧化氮(Fe NO)及血清尘螨免疫球蛋白G(SIg G4)、血清白细胞介素-4(IL-4)、干扰素-γ(INF-γ)水平的变化。方法分析2013年12月至2015年12月义乌市中心医院儿科118例门诊及住院确诊尘螨过敏哮喘患儿的临床资料。随机分为观察组和对照组各59例。两组均根据病情升降阶使用吸入性糖皮质激素,观察组加用粉尘螨滴剂舌下含服,治疗1年。治疗前后分别检测Fe NO、血清尘螨SIg G4、IL-4及INF-γ水平。结果观察组治疗后Fe NO及IL-4较治疗前显著降低(均P<0.05),血清尘螨SIg G4水平、INF-γ水及INF-γ/IL-4较治疗前显著升高(均P<0.05);与对照组比较,观察组治疗后Fe NO及IL-4显著降低(均P<0.05),血清尘螨SIg G4、INF-γ及INF-γ/IL-4显著升高(均P<0.05);观察组治疗后日间及夜间哮喘症状评分较治疗前显著缓解(均P<0.05)。结论粉尘螨滴剂可减轻尘螨过敏哮喘患儿气道炎症及纠正免疫失衡。

Objective To investigate the change of FeNO and serum SIgG4, IL-4 and INF-γ levels before and after SLIT in children with mites allergie asthma. Methods All 118 cases with mites allergic asthma were randomly divided into two groups：the control group（59 cases） was treated with ladder type inhalation, and the treatment group （59 cases） was administered dust mite drops on the basis of conventional treatment. FeNO and serum SIgG4, IL-4 and INF-γ levels were measured before and after treatment. Results After treatment,the levels of FeNO and serum IL-4 were decreased in treatment group than before treatment （P 〈 0.05）, the levels of serum SIgG4, INF-γ and the ratio of INF-γ IL-4 were increased （P 〈 0.05）. Compared with the control group, the levels of FeNO and serum IL-4 were decreased in treatment group after treatment （P 〈 0.05）, the levels of serum SIgG4 and INF-γ and the ratio of INF-γ IL-4 were increased（P 〈 0.05）. After treatment, the scores of allergic asthma symptom were decreased significantly in treatment group than before treatment （P 〈 0.05）. Conclusion SLIT can decrease airway inflamation and correct immune imbalance in children with mites allergic asthma.