舌下免疫治疗对变应性鼻炎患儿免疫球蛋白及T细胞亚群水平的影响

Effects of sublingual immunotherapy on immunoglobulin and T lymphocyte subset levels in children with allergic rhinitis

目的:观察舌下免疫治疗(SLIT)对变应性鼻炎(AR)患儿免疫球蛋白及T细胞亚群水平的影响。方法:选取2017年4月至2018年4月该院收治的72例AR患儿进行前瞻性研究,按照随机数字表法分为研究组和对照组各36例。对照组采用常规治疗,研究组在对照组基础上采用SLIT治疗。治疗2年后,比较两组治疗前后临床症状评分、免疫球蛋白[血清尘螨特异性IgE(sIgE)、总IgE(T-IgE)、特异性IgG4(sIgG4)]水平、T细胞亚群[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平和不良反应发生率。结果:治疗后,两组喷嚏、流涕、鼻痒及鼻塞等临床症状评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组血清尘螨sIgE和T-IgE水平均低于治疗前,且研究组低于对照组,两组血清尘螨sIgG4水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)值均高于治疗前,且研究组高于对照组,两组CD8^(+)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在常规治疗基础上采用SLIT治疗AR患儿,可改善免疫球蛋白和T细胞亚群水平,降低临床症状评分,效果优于单纯常规治疗。

Objective:To observe effects of sublingual immunotherapy(SLIT)on immunoglobulin and T lymphocyte subset levels in children with allergic rhinitis(AR).Methods:A prospective study was conducted on 72 children with AR admitted to the hospital from April 2017 to April 2018.They were divided into study group and control group according to the random number table method,36 cases in each.The control group was treated with conventional therapy,while the study group was treated with SLIT on the basis of that of the control group.After 2 years of treatment,the clinical symptom scores,the immunoglobulin[serum dust mite specific IgE(sIgE),total IgE(T-IgE),specific IgG4(sIgG4)]levels,the T cell subsets[CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]levels,and incidence of adverse reactions were compared between the two groups before and after the treatment.Results:After the treatment,the scores of clinical symptoms such as sneezing,runny nose,nasal itching and nasal congestion in the two groups were lower than those before the treatment,those of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).The levels of serum dust mite sIgE and T-IgE in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;the levels of serum dust mite sIgG4 in the two groups were higher than those before the treatment,and that in the study group was higher than that in the control group;and the differences were statistically significant(P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were higher than those before the treatment,and those in the study group were higher than those in the control group;the levels of CD8^(+)in the two groups were lower than those before the treatment,and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:On the basis of the conventional treatment,SLIT can improve the levels of immunoglobulin index and the T cell subsets and reduce the clinical symptom scores in the children with AR.Moreover,it is superior to single conventional treatment.