屋尘螨过敏原淋巴免疫治疗小儿特应性皮炎的临床研究

Clinical study on dermatophagoides allergen immunotherapy for atopic dermatitis in children

目的:探讨屋尘螨过敏原淋巴免疫治疗在小儿特应性皮炎(AD)治疗中的应用效果。方法:选取90例AD患儿为研究对象,按照随机数字表法分成对照组与观察组,每组各45例,两组均接受维生素B6软膏、氯雷他定片等基础治疗。在此基础上,对照组采用他克莫司软膏治疗,观察组采用屋尘螨过敏原淋巴免疫治疗,治疗20周后,采血检测两组治疗前、后的白介素-4(IL-4)、白介素-12(IL-12)、巨噬细胞来源趋化因子(MDC)、人噬酸性细胞趋化因子-2(Eotaxin-2)水平,并进行组间比较,同时分析治疗前后T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+、NK细胞)的变化情况。结果:观察组总有效率为95.56%,明显高于对照组的82.22%(P<0.05);治疗后,观察组血清IL-4、MDC水平均明显低于对照组(P<0.05),而IL-12、Eotaxin-2水平均明显高于对照组(P<0.05);CD4+、CD4+/CD8+明显高于对照组(P<0.05),CD8+明显低于对照组(P<0.05);观察组不良反应发生率为6.67%,与对照组的4.44%比较,差异无统计学意义(P>0.05)。结论:屋尘螨过敏原淋巴免疫治疗能进一步改善AD患儿的炎症状态,增强机体免疫,应用效果良好,且安全性较高。

Objective:To explore application effects of dermatophagoides allergen immunotherapy for atopic dermatitis(AD)in children.Methods:90 children with AD were selected as the study subjects.They were divided into control group(n=45)and observation group(n=45)according to the random number table method.Both groups received basic treatments such as vitamin B6 ointment and Loratadine tablets.Besides,the control group was treated with Tacrolimus ointment,while the observation group was treated with dermatophagoides allergen immunotherapy.The levels of interleukin-4(IL-4),interleukin-12(IL-12),macrophage-derived chemokine(MDC),human eotaxin-2(Eotaxin-2)of the two groups before and 20 weeks after the treatment were detected and compared.At the same time,the changes of T lymphocyte subsets(CD4+,CD8+,CD4+/CD8+,NK cells)before and after the treatment were analyzed.Results:The total effective rate in the observation group was 95.56%,which was significantly higher than that in the control group(82.22%,P<0.05).After the treatment,the serum levels of IL-4 and MDC in the observation group were significantly lower than those in the control group(P<0.05);the levels of Il-12 and Eotaxin-2 were significantly higher than those of the control group(P<0.05);the levels of CD4+,CD4+/CD8+were significantly higher than those of the control group(P<0.05);and the CD8+level was significantly lower than that of the control group(P<0.05).The incidences of adverse reaction of the observation group and control group were 6.67 and 4.44%,respectively,and the difference was statistically significant(P>0.05).Conclusions:The dermatophagoides allergen immunotherapy can further improve the inflammatory state of the children with AD,and enhance the body immunity.Moreover,its application effect is good with high safety.