奥马珠单抗治疗儿童过敏性疾病28例临床分析

Clinical analysis of Omalizumab in treatment of 28 children with allergic diseases

目的探讨奥马珠单抗在患多种过敏性疾病患儿中的治疗效果。方法回顾性分析2018年9月至2020年12月在北京大学第三医院儿科收治的应用奥马珠单抗治疗的患多种过敏性疾病患儿的临床资料。分析患儿性别、年龄、过敏疾病的种类、治疗前血清总IgE(TIgE)和血清过敏原特异性IgE(sIgE)水平、奥马珠单抗应用剂量、治疗效果及药物不良反应情况。结果接受奥马珠单抗治疗的28例患儿,男/女为17/11;年龄(9.6±2.7)岁。患过敏性疾病种类:哮喘24例(85.7%)、过敏性鼻炎24例(85.7%)、食物过敏9例(32.1%)、特应性皮炎7例(25.0%)、慢性荨麻疹2例(7.1%),其中26例(92.8%)有2种以上过敏性疾病。28例患儿均有TIgE或sIgE升高。血清TIgE 39.5~3826.0 kU/L,中位数611 kU/L。治疗后24例哮喘患儿喘息发作次数均减少,24例过敏性鼻炎患儿鼻部症状均减轻,特应性皮炎患儿6例皮肤瘙痒减轻,1例改善不佳,慢性荨麻疹2例症状减轻,9例食物过敏患儿3例达耐受。结论奥马珠单抗在儿童过敏性疾病治疗中,除哮喘外,也适用于过敏性鼻炎、特应性皮炎、慢性荨麻疹的治疗。在食物过敏治疗中也有提高食物过敏原耐受阈值作用。对同时存在多种过敏性疾病或存在对多种过敏原过敏的患儿,有明显治疗效果。

Objective To investigate the therapeutic effects of Omalizumab in children suffering from multiple allergic diseases.Methods All children who developed with multiple allergic diseases and were treated with Omalizumab in Department of Pediatrics,Peking University Third Hospital from September 2018 to December 2020 were retrospectively analyzed.Their gender,age,type of allergic disease,serum total IgE(TIgE)and serum allergen-specific IgE(sIgE)levels before treatment,Omalizumab dosage,therapeutic effect and adverse drug reactions were analyzed.Results In terms of the 28 children who were treated with Omalizumab,the male/female ratio was 17/11,and the age was(9.6±2.7)years.There were 24 cases of asthma(85.7%),24 cases of allergic rhinitis(85.7%),9 cases of food allergy(32.1%),7 cases of atopic dermatitis(25.0%),and 2 cases of chronic urticaria(7.1%),with 26 cases(92.8%)having more than two kinds of allergic diseases,and 28 children having elevated TIgE or sIgE.TIgE was between 39.5 to 3826.0 kU/L,and the median was 611 kU/L.After treatment,the frequency of wheezing attacks in 24 children with asthma was reduced,the nasal symptoms in 24 children with allergic rhinitis were alleviated,the skin it-ching in 6 children with atopic dermatitis was alleviated,and 1 case had poor improvement,the symptoms in 2 cases with chronic urticaria were alleviated,9 children had food allergy and 3 cases reached tolerance.Conclusions The treatment of allergic diseases in children,apart from asthma,Omalizumab is suitable for allergic rhinitis,atopic dermatitis and chronic urticaria.In the treatment of food allergy,it also has the function of increasing the threshold of food allergen tolerance.There are significant therapeutic benefits in children with multiple allergic diseases or being allergic to multiple allergens.