舌下脱敏治疗对变应性鼻炎患者血清IgG4水平的影响探讨

Effect of sublingual immunotherapy on serum IgG4 levels in patients with allergic rhinitis

目的探讨舌下脱敏(SLIT)治疗对变应性鼻炎(AR)患者血清免疫球蛋白G4(IgG4)水平的影响。方法107例AR患者,按照治疗方法不同分为对照组(52例)和治疗组(55例)。对照组采用单纯抗组胺与鼻用糖皮质激素药物对症治疗,治疗组使用SLIT治疗。比较两组患者治疗前后视觉模拟评分法(VAS)评分、用药评分及血清IgG4水平。结果治疗1年后,两组VAS评分均低于治疗前,差异有统计学意义(P<0.05);两组组间比较,差异无统计学意义(P>0.05)。治疗1年后,两组用药评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗前,对照组IgG4水平为(710.62±264.33)ng/ml,治疗1年后为(851.10±258.08)ng/ml;治疗前,治疗组IgG4水平为(712.62±230.61)ng/ml,治疗1年后为(1246.34±375.45)ng/ml。治疗1年后,两组IgG4水平均高于治疗前,且治疗组明显高于对照组,差异有统计学意义(P<0.05)。结论SLIT治疗和单纯药物对症治疗均能改善AR患者的临床症状,但SLIT疗效明显优于单纯药物对症治疗,且SLIT治疗有利于提高患者的血清IgG4水平。

Objective To discuss the effect of sublingual immunotherapy(SLIT)on serum immunoglobulin G4(IgG4)levels in patients with allergic rhinitis.Methods A total of 107 patients with AR were divided into control group(52 cases)and treatment group(55 cases)according to different treatment methods.The control group received simple antihistamine and nasal corticosteroids for symptomatic treatment,and the treatment group received SLIT treatment.The visual analogue scale(VAS)score,medication score and serum IgG4 level before and after treatment were compared between the two groups.Results After 1 year of treatment,the VAS scores of both groups were lower than those of this group before treatment,and the difference was statistically significant(P<0.05);there was no statistically significant between the two groups(P>0.05).After 1 year of treatment,the medication scores of the two groups were lower than those of this group before treatment,and the treatment group was lower than the control group.All the differences were statistically significant(P<0.05).In the control group,the IgG4 level was(710.62±264.33)ng/ml before treatment and(851.10±258.08)ng/ml after 1 year of treatment;in the treatment group,the IgG4 level was(712.62±230.61)ng/ml before treatment and(1246.34±375.45)ng/ml after 1 year of treatment.After 1 year of treatment,the levels of IgG4 in the two groups were higher than before treatment in this group,and the treatment group was significantly higher than the control group.All the differences were statistically significant(P<0.05).Conclusion Both SLIT and symptomatic treatment can improve the clinical symptoms of AR patients,but the efficacy of SLIT is significantly better than symptomatic treatment alone,and SLIT treatment is beneficial to improve the serum IgG4 level of patients.