不同年龄段患者经舌下含服粉尘螨滴剂治疗变应性鼻炎的疗效评估

Therapeutic effect of sublingual specific immunotherapy on patients with allergic rhinitis in different ages

目的评价不同年龄段患者舌下含服标准化粉尘螨滴剂免疫治疗(sublingual immunotherapy,SLIT)尘螨引起的变应性鼻炎(allergic rhinitis,AR)的疗效。方法回顾性分析了199例接受舌下含服粉尘螨滴剂治疗(sublingual immunotherapy,SLIT)的变应性鼻炎患者的病例资料。其中有163例,年龄4~65岁,平均年龄(19.4±14.6)岁的患者接受了完整3年的治疗。将上述163例患者按照年龄段分为4~13岁年龄组(低龄组,107例,平均年龄为9.1±2.5)和14~65岁年龄组(高龄组,56例,平均年龄为30.7±14.1)。采用组间以及组内前后自身对照的方法,分别在治疗前和治疗后1年、3年评估患者的鼻部症状总评分(total nasal symptom score,TNSS)、药物评分(total medication score,TMS)、视觉模拟量表(visual analogue scale,VAS)评分以及体征评分的变化。采用SPSS 26.0软件对数据进行统计学分析。结果两组患者在经过3年的治疗后TNSS、TMS、VAS评分以及体征评分均无显著性差异。与基线相比,两组患者的TNSS、TMS、VAS评分以及体征评分在治疗1年和3年后均显著降低,差异具有统计学意义(低龄组:治疗1年时Z值分别为-4.750、-3.000、-5.188、-4.125,治疗3年时Z值分别为-6.688、-3.562、-6.812、-4.312;高龄组:治疗1年时Z值分别为-4.990、-4.267、-5.187、-3.414;治疗3年时Z值分别为-6.040、-4.793、-6.237、-4.464,P值均<0.05)。163例患者中有6例发生了轻微不良反应,都出现在免疫治疗的第一个月,且未经治疗自行好转。结论无论对于低龄组还是高龄组,在经过1年或3年舌下含服标准化粉尘螨滴剂治疗尘螨引起的AR均安全有效、耐受性良好。

Objective To evaluate the efficacy of SLIT with dermatophagoides farinae drops in patients of different ages caused by dermatophagoides farina.Methods The data of 199 patients with allergic rhinitis who were treated with SLIT dermatophagoides farinae were analyzed retrospectively.Among them,163 patients,aged 4~65 years,with an average age of(19.4±14.6)years,received complete treatment for 3 years.The 163 patients were divided into 4~13 years old age group(107 cases in the younger age group,with an average age of 9.1±2.5)and 14~65 years old age group(56 cases in the older age group,with an average age of 30.7±14.1).The changes of TNSS,TMS,VAS and physical sign score of patients were evaluated before treatment,1 year and 3 years after treatment by using the comparison method of self-circa and inter-contras.SPSS 26.0 software was used for data analysis.Result There was no significant difference in TNSS,TMS,VAS scores and physical sign scores between the two groups after 3 years of treatment.Compared with the baseline,the scores of TNSS,TMS,VAS and physical signs of the two groups of patients decreased after 1 year and 3 years of treatment,with statistically significant differences young group:Z-values at 1 year of treatment were-4.750,-3.000,-5.188,-4.125,respectively,after 3 years of treatment,Z values were-6.688,-3.562,-6.812 and-4.312 respectively;in the elderly group,the Z-values were-4.990,-4.267,-5.187 and-3.414 respectively at the first year of treatment;After 3 years of treatment,Z values were-6.040,-4.793,-6.237 and-4.464 respectively(P<0.05).Six of the 163 patients had mild adverse reactions,which occurred in the first month of immunotherapy and improved without treatment.Conclusion Whether for the younger group or the older group,afte one or three years of SLIT dermatophagoides farinae drops,the treatment of AR caused by dermatophagoides farinae was safe,effective and well tolerated.