颈部淋巴结内特异性免疫治疗变应性鼻炎疗效及安全性的研究

Clinical efficacy and safety of specific immunotherapy for allergic rhinitis with cervical lymph node injection

目的:探讨颈部淋巴结内特异性免疫治疗变应性鼻炎(AR)的疗效及安全性。方法:回顾性分析81例完成颈部淋巴结内特异性免疫治疗的尘螨致敏AR患者,行彩超引导下颈部淋巴结免疫治疗共3次,每次50Tu(阿罗格螨变应原注射液)。详细记录患者治疗前后鼻部及眼部症状评分、生活质量评分、药物评分以及治疗过程中发生的不良反应情况,观察其疗效及安全性。结果:81例尘螨致敏AR患者治疗前鼻部症状评分为7.00±1.65,经颈部淋巴结免疫治疗1、2、3次后鼻部症状评分分别为4.37±1.88、4.26±1.80、4.22±1.80,完成治疗1年后症状评分为4.09±2.10,较治疗前明显降低(P<0.01);治疗前生活质量评分为53.68±9.28,治疗完成1年后生活质量评分为23.01±13.28,差异有统计学意义(P<0.01);治疗前药物评分为3.27±1.17,治疗完成1年后药物评分为1.00±1.05,差异有统计学意义(P<0.01);81例患者治疗过程中及随访1年仅有8例发生轻微局部不良反应,均未发生全身不良反应。结论:颈部淋巴结内特异性免疫治疗能显著缓解尘螨致敏AR患者的症状,治疗有效且安全性高,并极大程度地缩短了免疫治疗周期。

Objective:To evaluate the clinical efficacy and safety of intralymphatic immunotherapy with cervical lymph node injection for allergic rhinitis.Method:A retrospective analysis of 81 patients with allergic rhinitis(AR)who had received specific immunotherapy with cervical lymph node injection in 2016 in the first people’s Hospital of Foshan was conducted.The neck lymph node immunotherapy under the guidance of color Doppler ultrasound consisted of three sessions,and in each session 50 Tu(Arog)was delivered.The scores of nasal and ocular symptoms,drug score and adverse reactions during treatment were recorded before and after treatment,and the efficacy and safety were observed.Result:Before treatment,the nasal symptoms score of 81 AR cases of mite allergy was 7.00±1.65.After 1,2 and 3 sessions of cervical lymph node immune therapy and 1 year after completion of treatment,the nasal symptom scores were 4.37±1.88,4.26±1.80,4.22±1.80,and 4.09±2.10,respectively,which were significantly lower than that before treatment(P<0.01).The quality of life score was53.68±9.28 before treatment,which decreased to 23.01±13.28 one year after treatment,and the difference was statistically significant(P<0.01).The drug score was 3.27±1.17 before treatment,which decreased to 1.00±1.05 1 years after treatment,and the difference was statistically significant(P<0.01).During treatment and 1-year follow-up,only 8 cases had mild local reactions,and no systemic adverse reactions occurred.Conclusion:Cervical lymph node injection specific immunotherapy can significantly relieve the symptoms of dust mite allergic rhinitis.The treatment is effective and safe,and greatly shortens the duration of immune treatment.