哮喘患儿对标准化尘螨特异性免疫治疗剂量递增阶段的耐受性

目的了解哮喘患儿对尘螨特异性免疫治疗剂量递增阶段的耐受性。方法对2005-06—2005-09北京儿童医院哮喘专业门诊24例临床诊断哮喘的患儿,应用标准化屋尘螨提取液皮下注射,对24例尘螨过敏的哮喘患儿进行特异性免疫治疗。观察剂量递增阶段每次免疫注射后速发和迟发不良反应发生情况,同时在每次变应原注射前和注射30min后测定肺功能。结果剂量递增阶段24例患儿免疫注射总次数为370例次。14例(58.33%,14/24)发生27例次(7.3%,27/370)速发不良反应,其中26例次(96.3%,26/27)为轻度局部反应(肿胀直径小于5cm),1例次为轻度哮喘。21例(87.5%,21/24)发生38例次(10.27%)迟发不良反应,其中9例次为轻度全身反应(23.68%,9/27),包括哮喘、过敏性鼻炎、过敏性结膜炎、过敏性皮炎,1例次局部反应中度(肿胀直径5cm),其余均为轻度局部反应。各次免疫注射前后肺功能各参数变化率的差异无统计学意义。结论哮喘患儿对标准化屋尘螨提取液特异性免疫治疗耐受性良好,绝大多数局部不良反应为轻度,全身不良反应均为轻度,经及时调整剂量递增方案,可减少可控性不良反应的发生。各次免疫注射对肺通气功能无显著性影响。

Tolerance during dose-increase phase of specific immunotherapy with standardized house-dust mite extract in asthmatic children

Objective To determine the tolerance during dose-increase phase of specific immunotherapy(SIT)with standardized house-dust mite extract in asthmatic children.Methods Subcutaneous SIT with standardized house-dust mite extract was administrated to 24 asthmatic children with allergy to house-dust mite.The immediate and late side-effects after each allergen injection during dose-increase phase of immunotherapy treatment were monitored.Lung function test was done before and 30 minutes after each injection for every patient.Results All patients completed a total of 370 injections during dose-increase period.Twenty-seven injections(7.30% of all injections)caused immediate side-effects within 30 minutes after injection in 14 patiens(58.33% of all patients),in which 26 side-effects(96.3% of all early reactions)were mild local reactions(<5cm in diameter)and 1 episode of mild asthma occurred.Twenty-one patiens(87.50% of all patients)reported 38 late side-effects(10.27% of all injections)30 minutes after injection,9 late side effects which occurred in 7 patients were mild systemic reactions,which included asthma,allergic rhinitis,allergic conjunctivitis and allergic dermatitis;all those systemic reactions responded well to ordinary treatment.Conclusion Subcutaneous SIT with standardized house-dust mite extract show a good tolerance in asthmatic children.A majority of local reactions and all systemic reactions are mild and respond well to ordinary treatment and adjustment of dose-increase schedule.No significant change of lung function is observed during dose-increase phase of SIT.