尘螨变应原免疫治疗联合药物治疗对哮喘合并变应性鼻炎患儿临床疗效及气道高反应性的影响

发布时间：2019-01-07 16:23

【摘要】：目的了解哮喘合并变应性鼻炎患儿经尘螨变应原免疫治疗联合药物治疗后的临床疗效及对气道高反应性的影响。方法选择2012年2月至2012年11月就诊于首都医科大学附属北京儿童医院确诊尘螨致敏的轻、中度哮喘合并变应性鼻炎患儿26例,采用病例自身对照研究,对其进行尘螨特异性免疫治疗联合哮喘及鼻炎药物治疗。结果 26例患儿3年按期监测气道反应性,患儿症状用药计分(Symptom and Medication Score,SMS)由治疗前的6.1±2.3显著减低为1年时的3.3±1.5,2年时的2.2±1.6和3年时的1.1±1.3(P0.05),自主哮喘控制评估(Children Asthma Control Test,C-ACT)由治疗前的22.2±3.3显著增高至1年时的24.7±2.6,并维持至2年时25.0±1.5和3年时的25.2±1.8(P0.05),视觉模拟评分(Visual Analog Scale,VAS)哮喘症状由治疗前的2.8±2.5显著下降为治疗1年时的1.1±1.7,2年时1.1±1.03和3年时的0.6±1.09(P0.05),变应性鼻炎症状的VAS由治疗前的4.7±2.0显著下降为1年时的1.7±1.9,2年时的1.9±1.7和3年时的1.2±1.3(P0.05),而肺功能指标无明显改善(P0.05);气道反应性特征中,气道阻力由1年时的8.176±2.634下降为2年时的7.461±2.464和3年时的6.957±2.440(P0.05);传导率(respiratory conductance,Grs)由1年时的0.135±0.045升高为2年时的0.151±0.062和3年时的0.163±0.067(P0.05),最小诱发累积剂量或反应阈值(minimum dose of bronchoconstrictor or the amount of the cumulative dose at the inflection point where the reciprocal of Rrs(Grs)decreases linearly,Dmin)由1年的7.110±10.865升高为2年时的9.558±9.487和3年时的19.640±12.379(P0.05)。结论变应原免疫治疗哮喘合并变应性鼻炎患儿的疗效显著,气道反应性及气道敏感性降低。
[Abstract]:Objective to investigate the clinical effect of dust mite allergen immunotherapy and its effect on airway hyperresponsiveness in children with asthma complicated with allergic rhinitis. Methods 26 children with mild and moderate asthma complicated with allergic rhinitis were selected from February 2012 to November 2012 in Beijing Children's Hospital affiliated to Capital Medical University. It was treated with specific immunotherapy combined with asthma and rhinitis. Results 26 cases were monitored for airway reactivity on schedule for 3 years, and the symptom drug scores were scored by (Symptom and Medication Score,. SMS decreased significantly from 6.1 卤2.3 before treatment to 3.3 卤1.5 at 1 year, 2.2 卤1.6 at 2 years and 1.1 卤1.3 at 3 years (P0.05). (Children Asthma Control Test, was evaluated by control of autonomic asthma. C-ACT increased significantly from 22.2 卤3.3 before treatment to 24.7 卤2.6 at 1 year, and maintained to 25.0 卤1.5 at 2 years and 25.2 卤1.8 at 3 years (P0.05). Visual analogue score (Visual Analog Scale,) VAS) Asthma symptoms decreased significantly from 2.8 卤2.5 before treatment to 1.1 卤1.7 at one year, 1.1 卤1.03 at 2 years and 0.6 卤1.09 at 3 years (P0.05). The VAS of allergic rhinitis was significantly decreased from 4.7 卤2.0 before treatment to 1.7 卤1.9 at 1 year, 1.9 卤1.7 at 2 years and 1.2 卤1.3 at 3 years (P0.05). The airway resistance decreased from 8.176 卤2.634 in 1 year to 7.461 卤2.464 in 2 years and 6.957 卤2.440 in 3 years (P0.05). The conductivity (respiratory conductance,Grs) increased from 0.135 卤0.045 in 1 year to 0.151 卤0.062 in 2 years and 0.163 卤0.067 in 3 years (P0.05). Minimum evoked cumulative dose or response threshold (minimum dose of bronchoconstrictor or the amount of the cumulative dose at the inflection point where the reciprocal of Rrs (Grs) decreases linearly, Dmin increased from 7.110 卤10.865 in 1 year to 9.558 卤9.487 in 2 years and 19.640 卤12.379 in 3 years (P0.05). Conclusion the effect of allergen immunotherapy on asthmatic children with allergic rhinitis is significant, airway responsiveness and airway sensitivity are decreased.
【作者单位】：首都医科大学附属北京儿童医院过敏反应科;
【基金】：首都临床特色应用研究(Z151100004015030) 北京市科技专项(Z131100006813044)~~
【分类号】：R725.6;R765.21

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