粉尘螨滴剂舌下免疫治疗对支气管哮喘儿童肺通气功能的影响

Effects of sublingual immunotherapy with dust mite drops on pulmonary ventilation function in children with bronchial asthma

目的探讨粉尘螨滴剂舌下免疫治疗对支气管哮喘儿童肺通气功能、炎症因子、免疫功能及不良反应的影响。方法选择2015年3月至2016年9月在河南省儿童医院呼吸内科接受治疗的儿童支气管哮喘患者96例进行回顾性分析。根据患者入院时间将其分为两组,2015年3月至2016年1月入组的患者入对照组共48例,实施常规治疗;2016年2月至2016年9月入组的患者入观察组共48例,常规治疗基础上加以粉尘螨滴剂治疗。以哮喘症状评分、肺通气功能、炎症因子、免疫功能及不良反应发生等作为评价指标。结果两组患者日间哮喘评分、夜间哮喘评分、FEV1、FEV1/FVC、PEF治疗后均较治疗前有明显改善(P<0.05),观察组改善程度较对照组更为明显(P<0.05)。两组CD4/CD8、IL-4、IL-35治疗后均有明显改善(P<0.05),观察组改善程度优于对照组(P<0.05),对照组SIgG4治疗前后无差异(P>0.05),观察组治疗后SIgG4明显升高(P<0.05)。疗过程中,两组均出现一定的不良反应,未予治疗自行缓解,经统计两组不良反应发生率差异无统计学意义(P>0.05)。结论粉尘螨滴剂舌下免疫治疗可明显改善支气管哮喘儿童临床症状、改善肺通气功能、提高患者免疫功能、抑制炎症因子释放,效果确切,不良反应发生率低。

Objective To investigate the effect of sublingual immunotherapy with dust mite drops on pulmonary ventilation function,inflammatory factors,immune function and adverse reactions in children with bronchial asthma.Methods A total of 96 patients with bronchial asthma who underwent treatment in our hospital from March 2015 to September 2016 were retrospectively analyzed.Patients were divided into two groups according to the time of admission.Patients from March 2015 to January 2016 were enrolled in a total of 48 patients in the control group.Routine treatment was performed.Patients from February 2016 to September 2016 were divided into two groups Into the observation group a total of 48 cases,based on conventional treatment to be dust mite drops treatment.The asthma symptoms score,pulmonary ventilation function,inflammatory factors,immune function and adverse events were taken as evaluation indexes.Results Two groups of patients with daytime asthma score,nocturnal asthma score,FEV1,FEV1/FVC,PEF after treatment were significantly improved compared with before treatment（P 0.05）,but the observation group improved more obviously than that in control group（P 0.05）.Two groups of CD4/CD8,IL-4 and IL-35 were significantly improved after treatment（P 0.05）,but the observation group was better than control group（P 0.05）,the control group before and after SIgG4 treatment had no significant difference（P 0.05）,SIgG4 increased significantly after treatment in observation group（P 0.05）.In the course of treatment,two group showed adverse reactions,all the patients were not treated with spontaneous remission.There was no significant difference in the incidence of adverse reactions between the two groups（P 0.05）.Conclusion Sublingual immunotherapy of dust mite drops can improve the symptoms of children with bronchial asthma,improve pulmonary ventilation function,improve the immune function,inhibit the release of inflammatory factors,and the low incidence of adverse reactions.