影响变应性鼻炎特异性免疫治疗长期疗效的相关因素分析

发布时间：2018-02-24 19:36

本文关键词： 鼻炎变应性特异性免疫治疗长期疗效影响因素　出处：《临床耳鼻咽喉头颈外科杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的:探讨影响变应性鼻炎(AR)特异性免疫治疗(SIT)长期疗效的相关因素。方法:回顾分析219例AR患者在SIT治疗前及治疗结束后不同时期的随访VAS评分,通过等级Logistic回归分析和配对t检验分析和筛选影响预后的关键因素。结果:1SIT长期疗效与性别、SIT治疗前的VAS评分相关(P0.05),与家族史、免疫治疗年龄、过敏原总数、总针数、是否合并其他过敏性疾病无关(P0.05);2随访终点VAS评分与开始治疗VAS评分比较,随访6个月内总有效率为50.0%,6个月~1年总有效率为51.7%、1~2年总有效率为47.1%、2~3年总有效率为54.5%、3年以上总有效率为40.7%,各个观察点均与治疗前VAS评分差异有统计学意义(P0.05)。结论:除了性别和SIT前VAS评分影响AR患者SIT长期疗效外,遗传因素及其他因素对于AR患者SIT长期疗效无影响;SIT的疗效至少能维持3年;虽然增加SIT针数并不能延长长期疗效,但是可以巩固免疫治疗的疗效。随着时间的推移,SIT的长期疗效有减低趋势,SIT治疗前VAS评分越高,长期疗效越好,并且女性SIT长期疗效优于男性,因此推测环境因素与遗传因素的相互作用即表观遗传学对SIT长期疗效具有影响。
[Abstract]:Objective: to investigate the related factors influencing the long-term efficacy of specific immunotherapy with allergic rhinitis (ARA). Methods: the VAS scores of 219 patients with AR were retrospectively analyzed before and after SIT treatment. Results the long-term curative effect of 1: 1 sit was correlated with VAS score before treatment (P0.05), family history, age of immunotherapy, total number of allergens, total needle count, family history, age of immunotherapy, total number of allergens, total number of needles. The VAS score at the end of follow-up was compared with the VAS score at the beginning of treatment whether or not it was associated with other allergic diseases. The total effective rate was 50.0 in 6 months of follow-up, 51.7 in 6 months to 1 year, 47.1-2 years in total, 54.5 in 2-3 years and 40.7 in more than 3 years. There was a significant difference between the observation points and the VAS score before treatment (P0.055.Conclusion:. In addition to gender and VAS score before SIT, the long-term effect of SIT in AR patients was affected. Genetic factors and other factors had no effect on the long-term efficacy of SIT in AR patients. The efficacy of sit could be maintained for at least 3 years, although increasing the number of SIT needles could not prolong the long-term efficacy. But it can consolidate the efficacy of immunotherapy. Over time, the long-term efficacy of sit has a tendency to decrease. The higher the VAS score before sit treatment, the better the long-term efficacy, and the long-term efficacy of SIT in women is better than that in men. Therefore, it is assumed that the interaction between environmental and genetic factors, i.e. epigenetics, has an effect on the long-term efficacy of SIT.
【作者单位】：南方医科大学;广东省人民医院(广东省医学科学院)耳鼻咽喉-头颈外科;
【基金】：广东省自然科学基金项目(No:S2013010016130)
【分类号】：R765.21

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