阿罗格变应原皮试及特异性脱敏在变应性鼻炎诊治中的意义

目的探讨变应性鼻炎患者的吸入变应原,谱及标准化变应原脱敏治疗的效果。方法选用阿罗格吸入性过敏原14类57种对290例变应性鼻炎患者进行皮肤点刺试验,选择相应敏感的典型过敏原阿罗格脱敏试剂进行脱敏治疗;类固醇药喷鼻治疗做为治疗对照组。结果最常见的变应原依次为屋尘螨（59.7%）、粉尘螨（54.1%）、禾本科草（27.4%）、花（24.9%）、杂草（20.9%）、霉菌I（20.9%）,其中屋尘螨和粉尘螨占72.0%。145例皮肤点刺试验典型阳性（＋＋＋）的变应性鼻炎患者,选择相应敏感的典型过敏原进行特异性脱敏治疗。76例完成71周的疗程,疗程结束时显效28例（36.8%）,有效42例（55.3%）,总有效率为92.1%,无效6例（7.9%）;总有效率明显高于对照组（P〈0.01）。此76例共行2872次脱敏治疗,21例（27.6%）患者在治疗过程中有110次（3.8%）局部反应;4例（5.3%）发生全身反应,共5次（0.2%）。结论屋尘螨和粉尘螨是变应性鼻炎最常见的过敏原,其次为禾本科草和花粉。阿罗格变应原脱敏疗法是治疗变应性鼻炎一种安全有效的方法,疗效高于类固醇药喷鼻,但需注意在实践中的个体化方案。

Clinical analysis of allergovit aeroallergens and allergovit immunotherapy in patients with allergic rhinitis

Objective To investigate the prevalence of aeroallergens and the therapeutic effect of desensitization treatment with allergovit allergens in patients with allergic rhinitis in Changsha,Hunan Province.Methods 290 patients diagnosed as allergic rhinitis by history and clinical presentations underwent skin prick tests with 14 groups(57 kinds) of standardized aeroallergens.Those with positive(+++) results in skin prick tests were given allergovit immunotherapy.Results The most common aeroallergen found in the patients was dermatophagoides pteronyssinus(59.7%),followed by dermatophagoides farinae(54.1%),gramineae herbs(27.4%),flower pollen(24.9%),Herbs(20.9%),mycetes(20.9%).The positive rate of D.pteronyssinus and/or D.farinae in all patients was 72.0%.145 cases received allergovit immunotherapy and 76 finished treatment for a course of 71-weeks.Of the 76 cases,28(36.8%) were cured,42(55.3%) were improved,and 6 were of no effect(7.9%).Of the total 2872 intramuscular injections in 76 patients during the immunotherapy,110(110/2872,3.8%) injections in 21(21/76,27.6%) cases had local side effects and 5(5/2872,0.2%) injections in 4(4/76,5.3%) patients had systemic side effects.All the side effects were light.Conclusion Mites(D.pteronyssinus and D.farinae) are the most common aeroallergens resulting in allergic rhinitis in Changsha region,followed by gramineae herbs and flower pollen.Individualized desensitization treatment with allergovit allergen is an effective and safe regimen for allergic rhinitis.