特异性免疫治疗变应性鼻炎疗效的动态评估及其对哮喘的影响

【目的】探讨变应性鼻炎患者特异性免疫治疗(SIT)效果及其在防治支气管哮喘中的意义。【方法】对167例螨过敏的持续性变应性鼻炎患者,进行免疫治疗,检测各治疗时期患者血清总免疫球蛋白E(TIgE)、特异性免疫球蛋白E(SIgE)和嗜酸性粒细胞阳离子蛋白(ECP)浓度,并评估其过敏症状的变化。【结果】变应性鼻炎特异性免疫治疗后症状改善(P<0.01);儿童变应性鼻炎SIT效果较成人好(P<0.01)。此外,观察期满3年的49例接受系统免疫治疗的患者与未系统治疗患者23例发现,前者继发哮喘的几率低于后者,两者比较差异有统计学意义(P<0.01);对合并有哮喘的AR患者经SIT后,哮喘症状体征有改善;患者血清TIgE、SIgE和ECP在SIT治疗后水平逐渐降低。【结论】对儿童变应性鼻炎患者有明确变应原者,免疫治疗应予以考虑;检测患者血清TIgE、SIgE和ECP可了解SIT的疗效;对变应性鼻炎进行SIT对防治哮喘有重要意义。

Evaluation of Effect of Special Immunotherapy on Allergic Rhinitis and Its Influence of Asthma

[Objective] To investigate the therapeutic effect of special immunotherapy (SIT) on allergic rhinitis (AR) and its meaning of preventing and curing bronchial asthma(BA). [Method] One hundred and sixty-seven patients, who were suffered from AR and their allergens were mites, were treated with SIT. The total immunoglobulin E (TIgE), specific immunoglobulin E (SIgE) and eosinophil cationic protein (ECP) were detected and the variation of allergic symptom was evaluated in different periods of SIT. [Result] The symptom of AR has been significantly improved after SIT (P< 0.01). The effect of SIT on children was better than that on adults (P< 0.01). Moreover, after being followed up for 3 years, 49 patients who received regular SIT have less possibility to suffer from asthma than those of 23 cases patients who had irregular SIT, and the difference between them was statistically significant (P<0.01). For AR patients complicating with asthma, their asthmatic symptoms and physical signs had been improved after SIT. It was increasingly reduced for the level of TIgE, SIgE, and ECP in serum of AR patients after SIT. [Conclusion] In the case of AR of children who have obvious allergen, SIT should be more considerable. The curative effect of SIT can be known by the detection of the level of TIgE, SIgE, and ECP in serum of AR patients. SIT of AR makes for prevention and cure of asthma. It is very important for preventing and treating asthma to deal with AR by SIT.