标准化屋尘螨变应原特异性免疫治疗变应性鼻炎的疗效评估

目的：探讨标准化屋尘螨变应原特异性免疫治疗（SIT）变应性鼻炎（AR）的临床疗效。方法：将对屋尘螨过敏的102例AR患者随机分为2组,每组51例。SIT组：对症治疗基础上加用3年标准化屋尘螨变应原SIT;对症治疗组（ST组）：仅对症治疗。评价疗效指标包括：鼻炎症状评分、用药评分、皮肤反应指数、血清特异性IgE（sIgE）、外周血嗜酸粒细胞（Eos）计数,AR发展成哮喘和出现新的致敏原的比例。结果：SIT组经3年治疗后,患者血清Eos计数、皮肤反应指数、症状及药物评分均较ST组明显降低（均P〈0.01）;SIT后slgE有所下降,但差异无统计学意义。SIT组无AR患者发展为哮喘,2.1%出现新的致敏原;ST组17.4%的患者发展为哮喘,32.6%出现新的致敏原。治疗过程中未发生严重不良反应。结论：坚持长期SIT对螨致敏的AR安全有效,同时能减少新的过敏发生,阻止AR发展为哮喘。

Efficacy evaluation of standardized dust mite allergen specific immunotherapy to patients of allergic rhinitis

Objective：To evaluate the efficacy of mite allergen specific immunotherapy（SIT） to patients of al- lergic rhinitis. Method.. A total of 102 patients with mite allergy were recruited into the study. They were randomly divided ifito two groups.. SIT group （n= 51）and ST（symptomatic therapy）group （n = 51）. They were given SIT with standardized allergen vaccine for 3 years or only symptomatic therapy respectively. Observation items in- clude： rhinitis symptom scores, drug score, skin prick test result, serum specificity IgE（sIgE）, peripheral eosino- phil counting. The development of asthma and new allergens sensitization was also assessed. Result. The blood eo- sinophil numbers, skin test index, rhinitis symptom scores and drug scores were all decreased significantly after the treatment with SIT for 3 years compared to that of ST group（P〈0.01）. Although the level of serum slgE was de- creased, no statistic diferences were found. No patients developed asthma in SIT group, and only 2.1% of patients had new allergen sensitization; 17.4 % of those in ST group developedasthma, 32.6% had new sensitization. No severe adverse events occurred. Conclusion.. Keeping long term SIT is effective and safe for patients with allergic rhinitis induced by mite, which can also prevent new allergen sensitization and development for asthma.