奥马珠单抗对中重度过敏性哮喘合并变应性鼻炎患者肺功能和生活质量的影响

Effects of omalizumab on pulmonary function and quality of life in patients with Moderate to severe allergic asthma complicated with allergic rhinitis

目的 探讨奥马珠单抗对中重度过敏性哮喘合并变应性鼻炎患者肺功能和生活质量的影响。方法 收集接受奥马珠单抗治疗16周以上的中重度过敏性哮喘合并变应性鼻炎患者的临床资料,观察患者治疗前及治疗16周时的哮喘控制评分(ACT)、哮喘生活质量迷你评分(MiniAQLQ)、鼻炎症状视觉模拟(VAS)评分、外周血嗜酸粒细胞计数、肺功能[第1秒用力呼气容积占预计值的百分比(FEV_(1)%pred)、最高呼气流量峰值占预计值的百分比(PEF%pred)、用力呼出75%肺活量时最大呼气流量占预计值的百分比(MEF75%pred)、用力呼出50%肺活量时最大呼气流量占预计值的百分比(MEF50%pred)、用力呼出25%肺活量时最大呼气流量占预计值的百分比(MEF25%pred)]、呼出气一氧化氮(FeNO)的变化,记录患者治疗过程中的不良反应发生情况。结果 纳入36例中重度过敏性哮喘合并变应性鼻炎的患者,其中,中度过敏性哮喘30例、重度过敏性哮喘6例;奥马珠单抗治疗16周时,ACT评分、MiniAQLQ评分、FEV_(1)%pred、PEF%pred、MEF75%pred、MEF50%pred及MEF25%pred较治疗前升高,VAS评分、急性发作次数较治疗前降低,差异有统计学意义(P<0.001);治疗过程中,仅2例次(0.94%)患者出现不良反应,表现为注射部位皮肤瘙痒及发红。结论 奥马珠单抗治疗中重度过敏性哮喘合并变应性鼻炎,能够改善患者哮喘症状和鼻炎症状,提高肺功能及生活质量。

Objective To explore the effect of omalizumab on pulmonary function and quality of life in patients with moderate to severe allergic asthma complicated with allergic rhinitis.Methods Clinical data of patients with moderate to severe allergic asthma complicated with allergic rhinitis who received omalizumab for more than 16 weeks were documented. Asthma control score( ACT), Mini asthma quality of Life questionnaire( MiniAQLQ), rhinitis symptom-based visual analog scale( VAS),peripheral blood eosinophil count, pulmonary functions including forced expiratory volume in the first second as a percentage of the predicted value(FEV_(1)% pred), peak expiratory flow as a percentage of the predicted value(PEF% pred), maximum expiratory flow as a percentage of the predicted value when forced to exhale 75% of lung capacity( MEF75% pred), MEF50% pred, MEF25% pred,fractional exhaled nitric oxide( FeNO). The incidence of adverse reactions during treatment was recorded. Results Among 36 patients with moderate and severe allergic asthma complicated with allergic rhinitis, 30 patients were diagnosed as moderate allergic asthma and 6 patients as severe allergic asthma. After 16 weeks of treatment with omalizumab, ACT score, MiniAQLQ score,FEV_(1)%pred,PEF% pred, MEF75% pred, MEF50% pred, and MEF25% pred were higher than those before treatment, while VAS and the numbers of acute attack were less than those before treatment(P<0. 001). During the treatment, only 2 patients(0. 94%) had adverse reactions, showing itching, and redness of the skin at the injection sites.Conclusion Omalizumab in treating moderate to severe allergic asthma complicated with allergic rhinitis can improve asthma symptoms, rhinitis symptoms,lung function, and quality of life.