舌下特异性免疫治疗对变应性鼻炎Th2型免疫反应影响的临床观察

发布时间：2018-04-08 07:29

本文选题：鼻炎　切入点：变应性　出处：《临床耳鼻咽喉头颈外科杂志》2014年02期

【摘要】：目的:了解舌下特异性免疫治疗期间变应性鼻炎患者Th2型免疫反应的变化情况,结合临床分析,掌握舌下特异性免疫治疗对变应性鼻炎机体免疫系统产生的影响。方法:对43例行舌下特异性免疫治疗的变应性鼻炎患者进行1年的跟踪随访,收集相关的临床及实验数据,通过VAS评价临床症状的控制,鼻分泌物嗜酸细胞计数及鼻腔灌洗液IL-4、IL-13的表达评价鼻黏膜免疫情况,血清TIgE、sIgE评价全身系统免疫情况。结果:VAS在治疗1个月后开始明显下降,差异有统计学意义(t=3.343,P0.01);至6个月VAS下降28.36%,其后下降幅度减缓,至12个月VAS下降35.62%;12个月与6个月比较,差异无统计学意义(P0.05)。血清TIgE、sIgE在免疫治疗12个月前后差异无统计学意义(均P0.05)。鼻腔分泌物嗜酸细胞计数的变化趋势与VAS基本同步,治疗1个月后明显下降,6个月以后降幅减缓,治疗6个月与12个月比较,差异无统计学意义(P0.05)。治疗12个月鼻腔灌洗液IL-4、IL-13的表达也显著降低,差异有统计学意义(均P0.01)。结论:变应性鼻炎舌下特异性免疫治疗12个月,鼻腔黏膜免疫的Th2型免疫偏倚产生部分的纠正,但是未能发现对全身系统免疫的影响。
[Abstract]:Objective: to investigate the changes of Th2 type immune response in patients with allergic rhinitis during sublingual specific immunotherapy, and to understand the effect of sublingual specific immunotherapy on the immune system of allergic rhinitis.Methods: 43 patients with allergic rhinitis treated with sublingual specific immunotherapy were followed up for 1 year. The clinical and experimental data were collected and the control of clinical symptoms was evaluated by VAS.The count of eosinophils in nasal secretion and the expression of IL-4 and IL-13 in nasal lavage fluid were used to evaluate the immune status of nasal mucosa.Results after 1 month of treatment, VAS began to decrease significantly, the difference was statistically significant (P < 0.01); at 6 months, VAS decreased by 28.36g / L, then VAS decreased by 35.62a, and at 12 months after treatment, there was no significant difference between 12 months and 6 months (P 0.05).There was no significant difference in serum IgE before and after 12 months of immunotherapy (all P 0.05).The change trend of eosinophils in nasal secretion was similar to that of VAS. After 1 month of treatment, the decrease of eosinophils decreased significantly after 6 months of treatment, but the decrease slowed down after 6 months of treatment. There was no significant difference between 6 months and 12 months of treatment (P 0.05).After 12 months of treatment, the expression of IL-4 and IL-13 in nasal lavage fluid was significantly lower than that in control group (all P 0.01).Conclusion: after 12 months of specific immunotherapy for allergic rhinitis, Th2 immune bias of nasal mucosal immunity was partly corrected, but no effect on systemic immunity was found.
【作者单位】：南方医科大学附属南方医院耳鼻咽喉-头颈外科;广州市第一人民医院耳鼻咽喉科;广州市第一人民医院中心实验室;
【分类号】：R765.21

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