奥马珠单抗治疗变应性支气管肺曲霉菌病患者的临床疗效

Clinical Effect of Omazumab in the Treatment of Patients with Allergic Bronchopulmonary Aspergillosis

目的探讨奥马珠单抗治疗变应性支气管肺曲霉菌病患者的临床疗效。方法选取2018年2—10月中一东北国际医院有限公司收治的41例变应性支气管肺曲霉菌病患者为研究对象,按照治疗方法不同分为对照组(16例)和观察组(25例)。对照组给予泼尼松+伊曲康唑治疗,观察组患者在对照组基础上联合注射用奥马珠单抗治疗。观察两组患者治疗前后血液指标变化,比较两组患者治疗前后肺功能指标,根据患者病灶吸收情况和IgE水平判断疗效。结果两组患者治疗前烟曲霉特异性IgE、总IgE和嗜酸性粒细胞比较,差异无统计学意义(P>0.05);治疗后,两组患者烟曲霉特异性IgE、总IgE和嗜酸性粒细胞明显降低,观察组患者各项指标下降程度显著多于对照组,差异有统计学意义(P<0.05)。两组患者治疗前肺功能指标第一秒钟用力呼气容积占预计值百分比(FEV1/pred)、FEV1/用力肺活量(FVC)比较,差异无统计学意义(P>0.05);治疗后,两组患者FEV1/pred、FEV1/FVC明显升高,且观察组患者FEV1/pred、FEV1/FVC显著高于对照组,差异有统计学意义(P<0.05)。观察组治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。结论奥马珠单抗治疗变应性支气管肺曲霉病,能有效降低患者的烟曲霉特异性IgE、总IgE和嗜酸性粒细胞水平,改善肺功能,疗效显著。

Objective To investigate the clinical treatment of patients with allergic bronchopulmonary aspergillosis with omazumab.Methods A total of 41 patients with allergic bronchopulmonary aspergillosis admitted to Zhongyi Northeast International Hospital Co.,Ltd.from February 2018 to October 2018 were selected as study subjects,and were assigned into a control group(n=16)and an observation group(n=25)according to different treatment methods.The control group was given prednisolone plus itraconazole treatment.And the observation group was given omazumab plus prednisolone and itraconazole.Pulmonary function indicators before and after treatment were compared between the 2 groups according to the lesion absorption and IgE level of the patients.Results There was no significant difference in specific IgE,total IgE and eosinophils between the 2 groups before treatment and there was no statistical significance(P>0.05).After treatment,aspergillus fumigae specific IgE,total IgE and eosinophilia in both groups were significantly reduced.The degree of decline of various indicators in the observation group was significantly more than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in lung function indexes FEV1/PRED and FEV1/FVC between the 2 groups before treatment(P>0.05).After treatment,FEV1/PRED and FEV1/FVC were significantly increased in both groups.The FEV1/pred and FEV1/FVC of the observation group were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Omalizumab in the treatment of allergic bronchopulmonary aspergillosis can effectively reduce the level of Aspergillus fumigatus-specific IgE,total IgE and eosinophils,improve lung function,and have a significant effect.