变应性鼻炎集群免疫治疗的疗效和安全性临床分析

目的 观察应用标准化螨变应原集群免疫治疗变应性鼻炎的疗效及安全性.方法 154例螨变应原导致的中重度持续性变应性鼻炎患者,在特异性变应原免疫治疗的剂量累加阶段采用集群注射方案,6周达到维持剂量,继续治疗1年.治疗期间通过鼻部症状总评分、药物用量评分、鼻炎相关生活质量评分评价临床疗效,同时观察治疗导致的全身不良反应以评价治疗的安全性.结果 所有患者在6周左右达到剂量维持阶段,缩短剂量累加阶段疗程60%以上的时间.经过1年集群免疫治疗后,鼻部症状总评分(5.43±1.31)和每日药物用量评分(0.44±0.12)均较治疗前明显减少(P值均＜0.01),总体生活质量和7个分项的生活质量明显改善(P值均＜0.01).154例中共9例(26次)出现全身反应,全身性不良反应的发生率占注射例数的5.9%(9/154)和注射针数的0.75%(26/3464).其中Ⅰ级反应10次,Ⅱ级反应12次,Ⅲ级反应4次,无Ⅳ级不良反应.结论 对中重度持续性变应性鼻炎而言,集群免疫治疗是一种快速、有效、安全的治疗方法.

Efficacy and safety of cluster immunotherapy for 154 patients with allergic rhinitis

OBJECTIVE: To evaluate the efficacy and safety of cluster immunotherapy with Dermatophagoides pteronyssinus for allergic rhinitis. METHODS: One huandred and fifty-four patients with allergic rhinitis to Dermatophagoides pteronyssinus were allocated to receive specific immunotherapy in a 6-week cluster schedule during the incremental-dose phase. Thereafter, these patients received maintenance-dose injection at 6-week intervals until the end of 1 year of treatment. Symptom scores and medication scores were used to evaluate the clinical efficacy and adverse reactions were recorded. A rhinoconjunctivitis quality of life questionnaire (RQLQ) was completed in the baseline and after one year treatment. RESULTS: Cluster immunotherapy significantly reduced the symptom scores and total medication score of patients enrolled (P < 0.01). The immunotherapy group also had a significant improvement in the Rhinoconjunctivitis Quality of Life Questionnaire. During the one-year of treatment, there were 26 systemic adverse reactions (0.75% of all injection) in 9 patients (5.9%) and no fatal systemic reactions occurred. CONCLUSIONS: The cluster immunotherapy is efficacious and safe to treat allergic rhinitis.