舌下免疫治疗老年变应性鼻炎的临床疗效及对患者免疫功能、炎性因子的影响

Clinical efficacy of sublingual immunotherapy for elderly patients with allergic rhinitis and its influence on immune function and inflammatory factors

目的:分析舌下免疫治疗老年变应性鼻炎的临床疗效及对患者免疫功能、炎性因子的影响.方法:2018年9月~2019年9月武汉市红十字会医院耳鼻咽喉科收治的老年变应性鼻炎患者84例,通过随机数字表法分为研究组(n=42)及对照组(n=42).对照组按指南阶梯治疗方案进行升级或降级治疗,研究组在对照组基础上接受舌下粉尘螨滴剂治疗,两组均治疗18个月.比较两组治疗情况、治疗前后炎性因子、免疫功能及治疗后满意率.结果:治疗后,两组鼻炎控制测试(RCAT)、鼻炎相关生活质量问卷评分(RQLQ)、视觉模拟评分法(VAS)评分、全血CD4^(+)、CD4^(+)/CD8^(+)、血清免疫球蛋白E(IgE)水平较治疗前降低,且研究组明显低于对照组.治疗后研究组血清特异性免疫球蛋白G4(sIgG4)水平较治疗前升高,且研究组高于对照组.治疗后两组血清干扰素-γ(IFN-γ)、白介素-10(IL-10)、全血CD8^(+)水平较治疗前升高,且研究组高于对照组.治疗后研究组满意率明显高于对照.结论:舌下免疫治疗老年变应性鼻炎可改善临床症状及生活质量,分析可能与其调节炎性因子及免疫功能有关,取得患者认可,值得临床进一步研究与应用.

Objective To analyze the clinical efficacy of sublingual immunotherapy for elderly patients with allergic rhinitis and its effect on immune function and inflammatory factors.Methods From September 2018 to September 2019,84 elderly pa-tients with allergic rhinitis admitted to the department of otolaryngology of wuhan red cross hospital were divided into the study group(n=42)and the control group(n=42)by random number table method.The control group received escalation or de-esca-lation according to the guideline ladder treatment plan,and the study group received sublingual dust mite drops on the basis of the control group,and both groups were treated for 18 months.The treatment conditions,inflammatory factors,immune function before and after treatment and satisfaction rate after treatment were compared between the two groups.Results After treatment,the scores of rhinitis control assessment test(RCAT),rhinitis-related quality of life questionnaire(RQLQ),visual analogue scale(VAS),levels of whole blood CD4^(+),CD4^(+)/CD8^(+),serum level of immunoglobulin E(IgE)decreased compared with before treat-ment,and the study group was lower in the two groups.After treatment,the serum level of specific immunoglobulin G4(sIgG4)in the study group increased compared with before treatment,and the study group was higher in the two groups.The levels of serum interferon-γ(IFN-γ),interleukin-10(IL-10)and whole blood CD8^(+)in the two groups increased compared with before treat-ment,and the study group was higher in the two groups After treatment,the satisfaction rate in the study group was higher in the two groups.Conclusion Sublingual immunotherapy for elderly patients with allergic rhinitis could improve clinical symptoms and quality of life,might be related to the regulation of inflammatory factors and immune function,and had been recognized by patients and was worthy of further clinical research and application.