变应性鼻炎患者舌下免疫治疗的临床依从性192例分析

目的探讨变应性鼻炎患者舌下免疫治疗的临床依从性。方法电话随访武汉大学人民医院2014年4月～2016年5月接受舌下含服免疫治疗(SLIT)的348例尘螨过敏的变应性鼻炎患者,统计SLIT的依从性并调查影响依从性的因素。结果348例随访患者仅成功随访192例(55.17%),失访156例(44.83%),失访主要原因是患者所留电话无法拨通或拒绝接听电话。成功随访192例中,男128例、女64例,年龄3～69(17.08±13.71)岁。治疗时间1个月-3年以上(因部分患者未能准确表述具体用药时间,平均用药时间无法求出)。根据年龄分成A组(年龄<14岁) 101例和B组(年龄≥14岁) 91例,根据用药时间将依从性分为依从性好(时间≥2年)及依从性差(时间<2年)。上述成功随访的患者中,整体依从性好的比例为25.52%(49/192),依从性差的比例为74.48%(143/192),其中男3～55(15.04±11.69)岁,女3～69(21.13±16.27)岁。男性、女性SLIT依从性好的比例分别为30.47%(39/128)、15.63%(10/64),男女依从性比较,差异有统计学意义(χ2=4.945 9,P=0.026); A、B组依从性好的比例分别为31.68%(32/101)、18.68%(17/91),两组依从性比较,差异有统计学意义(χ2=4.257 4,P=0.039)。整体依从性差的患者143例中自觉免疫治疗效果不明显101例(70.63%)、自觉症状缓解或控制后终止治疗14例(9.79%)、个人因素(如治疗过程影响生活、居住外地、就诊交通不便等) 12例(8. 39%)、免疫治疗时出现轻度药物不良反应13例(9.09%)、家庭经济状况差2例(1.40%)、其他因素(改用中药治疗) 1例(0.70%)。结论变应性鼻炎患者SLIT的依从性不理想,与年龄、性别及主观因素有关。

Clinical compliance and related factors to sublingual immunotherapy in patients with allergic rhinitis

Objective To explore the clinical compliance to sublingual immunotherapy(SLIT)in patients with allergic rhinitis(AR). Methods From April 2014 to May 2016, 348 AR patients with dust mite allergy who received SLIT were followed up by telephone. Compliance to SLIT was statistically analyzed and factors influencing compliance were investigated. Results Among 348 patients, only 192 cases(55.17%)were successfully followed-up by telephone, while 156 cases(44.83%)did not return for additional examinations. The main reason for this loss was that patients’ phones were not accessible or they refused to answer the phone. The 192 successful follow-ups included 128 male patients and 64 female patients, with ages ranging from 3 to 69 years(17.08±13.71). The treatment time varied from one month to three years or more(because some patients could not describe accurately the specific medication time, the average medication time could not be calculated). Patients were divided by age into group A(age<14 years)and group B(age≥14 years). Concerning medication time, compliance was categorized into good compliance(time≥2 years)and poor compliance(time<2 years). Among the 192 successful follow-ups, the proportion of overall compliance was 25.52%(49/192), while the proportion of poor compliance was 74.48%(143/192).The age of male patients was 3-55(15.04±11.69)years, and that of female patients was 3-69(21.13±16.27)years. Compliance with SLIT was affected by gender(χ2=4.945 9, P=0.026). The proportion of male compliance was 30.47%(39/128), whereas the proportion of female compliance was 15.63%(10/64). In addition, compliance with SLIT was affected by age(χ2=4.257 4, P=0.039). Proportion of good compliance in groups A and B were 31.68%(32/101)and 18.68%(17/91), respectively. Among 143 patients with poor compliance, the effect of self-conscious immunotherapy was not obvious for 101 of them(70.63%). Reasons for terminating treatment included the following: symptomatic relief or control(14; 9.79%); personal reasons(12; 8.39%)as the treatment process affecting lifestyle, living in rural areas, and inconvenient traffic; mild adverse reactions to drugs during immunotherapy(13; 9.09%), family financial conditions(2; 1.40%), and other reasons(1, 0.70%), such as using Chinese Medicine instead. Conclusion Compliance to SLIT in patients with allergic rhinitis was not optimal, and was affected by age, gender, and subjective factors.