东北地区夏秋季花粉症患者变应原特异性免疫治疗的长期疗效

目的探讨东北地区夏秋花粉症患者变应原特异性免疫治疗(ASIT)的长期临床疗效。方法选择2001年夏秋季豚草和蒿草致敏的花粉症患者226例,随机分为ASIT组(107例)及对症治疗组(ST)(119例)。ASIT组ASIT疗程3年,ST组仅行症状性药物治疗。在停止ASIT后进行6年长期随访。评价疗效指标包括:鼻炎和哮喘症状评分、用药评分、皮肤点刺试验(SPT)、肺功能、血清特异性IgE(sIgE)、外周血嗜酸性粒细胞(Eos)计数、鼻炎发展成哮喘和出现新的致敏原的比例。结果 ASIT组临床症状评分、肺功能指标、用药评分、血Eos计数和SPT的皮肤指数与ASIT前、ST组比较明显改善(均P<0.01);而停止ASIT后6年随访,分别与3年ASIT上述相同参数比较无明显差异(均P>0.05)。ASIT组无鼻炎患者发展为哮喘,8.64%的患者出现新的致敏原,2.43%的患者鼻炎症状复发。ST组85.89%的鼻炎患者发展为哮喘,69.23%的患者出现新的致敏原。结论 ASIT能明显地改善花粉症患者的临床症状,具有停药后持续而稳定的长期疗效,可以防止过敏性鼻炎发展为哮喘、防止出现新的致敏原。

Long-term Efficacy of Allergen Specific Immunotherapy for Pollinosis Patients in Northeast China

Objective To evaluate the long-term efficacy of allergen specific immunotberapy （ASIT） in patients with pollinosis in Northeast China. Methods A total of 226 patients with pollinosis （who was allergic to ragweed and/or mugwort） were include in the study in 2001, who were randomly divided into ASIT group （107 cases） and symptomatic treatment （ST） group （119 cases）. 6 years follow up study was continued after finishing of 3-year ASIT with standardized allergen vaccine or symptomatic treatment respectively. Rhinitis and asthma symptoms score, medication score, skin prick test （SPT） index, lung function, serum specific IgE （slgE）, peripheral blood eosinophil （Eos） count were evaluated as effectiveness index. The percentages of onset of asthma and the new allergens sensitizations were also assessed. Results The improvement was shown significantly by symptom scores, lung function, medication scores, Eos count and SPT index after ASIT, compared to before ASIT, and ST group （ all P 〈 0. 01 ）. There was no significant difference statistically in 6th year after stopping ASIT, compared to the end of 3-year ASIT （ P 〉 0.05 ） based on the same parameters. There was no onset of asthma among rhinitis patients in ASIT groups. New sensitizations and recurrence were shown among 8.64% and 2.43% of the patients in ASIT groups respectively. Whereas, onset of asthma was shown among 85.89% of rhinitis patients in ST group, and new sensitization were shown among 69.23% of patients in ST group. Conclusions The symptoms of the pollinosis patients can be improved obviously under ASIT. Long-term efficacy after stopping therapy, avoidance of onset asthma for rhinitis patients and new allergen sensitization can achieved by ASIT.