奥马珠单抗联合布地奈德对变应性鼻炎患者临床疗效及外周血Eos、IgE的影响

Curative Efficacy of Omalizumab Combined with Budesonide in the Treatment of Allergic Rhinitis and Its Effects on the Peripheral Eosinophil Count and Serum IgE

目的探讨奥马珠单抗联合布地奈德治疗变应性鼻炎(allergic rhinitis,AR)患者临床疗效、外周血嗜酸性粒细胞(eosnphils,Eos)及免疫球蛋白E(immunoglobulin E,IgE)的影响。方法选择2017年1月至2019年10月于我院诊断为AR的患者150例,按照随机表法分为两组,各75例,对照组给予布地奈德治疗,研究组给予奥马珠单抗联合布地奈德治疗,比较两组患者临床疗效、外周血Eos及血清IgE变化。结果研究组治疗有效率较对照组高(P<0.05),且两组打喷嚏、流涕、鼻痒、鼻塞症状均较治疗前好转(P<0.05),治疗后研究组鼻部症状缓解明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者的RQLQ评分均较前下降(P<0.05),研究组的RQLQ评分(21.34±5.62)较对照组(31.52±8.95)下降更明显(P<0.05)。治疗后两组患者NR、MTT均较治疗前下降,MCV较治疗前上升,且研究组NR、MTT较对照组下降更明显,研究组MCV较对照组上升更明显。治疗后两组患者的Eos均较前下降(P<0.05),研究组(0.32±0.02)较对照组Eos(0.46±0.07)下降更明显(P<0.05)。治疗后两组患者血清IL-4、IL-10较治疗前下降,且研究组下降更明显(P<0.05),血清IL-2、IFN-γ较治疗前均上升,研究组上升更明显(P<0.05)。治疗后两组患者血清IgE均较前下降,研究组血清IgE(0.31±0.08)较对照组(0.42±0.09)下降更明显(P<0.05)。两组患者有出现鼻出血、腹痛、头痛症状,差异无统计学意义(χ^(2)=2.788,P>0.05)。结论奥马珠单抗联合布地奈德治疗变应性鼻炎较单用布地奈德能够提高临床疗效,改善生活质量、改善鼻功能,调整Th1/Th2失衡状态,降低外周血Eos及血清IgE水平。

Objective To study the curative efficacy of omalizumab combined with budesonide in the treatment of allergic rhinitis and its effects on the peripheral eosinophil count and serum IgE.Methods A total of 150 patients diagnosed with AR during hospitalization in our hospital from August,2018 to October,2019 were selected and divided into two groups according to the random table method,with 75 patients in each group.The control group was treated with budesonide,while the study group was treated with omalizumab combined with budesonide.The clinical efficacy,changes in peripheral blood Eos and serum IgE of both groups were compared.Results The effective rate of treatment in the study group was higher than that in the control group(P<0.05),and the symptoms of sneezing,runny nose,nasal itching and nasal congestion in both groups were improved compared with that of before treatment(P<0.05).The nasal symptoms of the study group were significantly relieved compared with the control group,with a statistically significant difference(P<0.05).After treatment,RQLQ score of both groups decreased compared with that of before(P<0.05),and the study group(21.34±5.62)decreased more significantly than that of the control group(31.52±8.95)(P<0.05).After treatment,NR and MTT of the two groups of patients decreased compared with before treatment,and MCV increased.Moreover,NR and MTT of the study group decreased more significantly than the control group,and MCV of the study group increased more significantly than the control group.After treatment,the peripheral Eos count in both groups was lower than that of before(P<0.05),and the decrease of Eos in the study group(0.32±0.02)was more significant than that in the control group(0.46±0.07)(P<0.05).After treatment,serum IL-4 and IL-10 of the two groups decreased compared with that of before treatment,and the study group declined more significantly(P<0.05);Serum IL-2 and IFN-increased compared with that of before treatment,and the increase was more significant in the study group(P<0.05).After treatment,serum IgE in both groups decreased compared with that of before,and serum IgE in the study group(0.31±0.08)decreased more significantly than that in the control group(0.42±0.09)(P<0.05).The symptoms of nosebleed,abdominal pain and headache in the two groups were not significantly different(χ^(2)=2.788,P>0.05).Conclusion Compared with budesonide alone,omalizumab combined with budesonide in the treatment of allergic rhinitis can improve clinical efficacy,living quality,nasal function,and Th1/Th2 imbalance,and also reduce peripheral blood Eos and serum IgE levels.