纯化花粉变应原免疫治疗的疗效观察

目的:观察纯化花粉(黄蒿、葎草、藜草花粉)变应原特异性免疫治疗(SIT)的疗效.方法:采取凝胶过滤方法分别提纯上述花粉变应原.采取随机、对照方法将102例确诊为季节性黄蒿、葎草、藜草花粉过敏性哮喘患者分为观察组(A组)及对照组(B组),应用纯化花粉变应原(PPA)及粗花粉变应原(CPA)分别对两组患者进行季节前SIT,疗程3 mo.临床疗效判断标准为显效、好转及无效.临床不良反应观察包括局部或全身皮疹、哮喘加重等.实验观察指标为两组SIT前后的皮肤试验(ID)风团直径、特异性IgE(sIgE)、A值均值.结果进行组内和组间比较.结果:A组SIT总有效率90%(47/52),B组78%(39/50),前者明显高于后者(P<0.05);A组仅3例轻度副反应,B组有13例(26%)出现副反应;A组及B组SIT后ID风团直径、sIgE, A值均值都较SIT前明显下降(P<0.01);A组SIT后上述指标下降程度较B组更明显(P<0.05).结论:PPA及CPA的SIT疗效均较满意,但用PPA进行SIT的安全性和疗效更好.

Effect of immunotherapy with purified pollen allergens

AIM: To study the effect of specific immunotherapy (SIT) with purified pollen allergens (caraway, humulus and chenopodium) on asthmatic patients. METHODS: The pollen allergens were purified by gelatin filtration. One hundred and two patients with seasonal asthma allergic to caraway, humulus or chenopodium pollen were divided randomly into 2 groups: observation group (group A) and control group (group B) and the 2 groups were given purified pollen allergens (PPA) and crude pollen allergens (CPA) respectively before the allergic season. The course was 3 months. The laboratory observation included the wheals' diameter of ID, specific IgE (sIgE) and mean A value before and after SIT. RESULTS: The general effective rate of SIT with purified allergens in group A was 90% (47/52) and that with crude allergens in group B was 78% (39/50). The former was significantly higher than the latter (P<0.05). Only 3 patients in group A had slight side-effects after SIT and 13 patients (26%) in group B had side-effects. A significant decrease in the diameter of skin wheal and sIgE (P<0.01) was observed after SIT in both groups and the decrease was more significant in group A than in group B (P<0.05). CONCLUSION: The effective rates of SIT with both PPA and CPA are satisfactory . But SIT with PPA is more effective and safer than that with CPA.