中华临床免疫和变态反应杂志2017，Vol.11Issue(3)：216-227,12.DOI:10.3969∕j.issn.1673-8705.2017.03.005
真菌变应原制剂免疫治疗过敏性哮喘的疗效与安全性
Efficacy and Safety of Specific Immunotherapy for Treatment of Allergic Asthma by Using Fungal Allergen Extract
摘要
Abstract
Objective To evaluate the efficacy and safety of Specific Immunotherapy ( SIT ) for treatment of allergic asthma by using fungal allergen extract, and of multiallergen SIT by using fungal and dust mite allergen extracts. Methods Clinical data of asthmatic patients who were prescribed SIT with fungal allergen extracts during the past 7 years were collected and analyzed in this study. It was recorded to evaluate the efficacy of SIT that the level of asthma control, Asthma control test ( ACT) , Asthma Con-trol Questionnaire ( ACQ) , medication scores and the percentage of forced expiratory volume in first sec-ond to predicted value ( FEV1%) before and after SIT among the asthmatic patients. Adverse reactions were also recorded. Results Twenty-four asthmatic patients who were allergic to fungi were enrolled in the study. 18 patients were prescribed SIT with fungal and dust mite allergen extracts, and 6 patients with single fungal allergen extract. 62. 50% asthmatic patients achieved well-control after 1 year SIT, and 80. 00% after 2 years, significant higher statistically compared to baseline ( 33. 33%) . The change trends were similar for the other outcome index before and after immunotherapy among all patients and the mul-tiallergen SIT subgroup. ACT scores and ACQ scores were significantly increased, compared to baseline after 1-4 years of SIT ( P<0. 001) . The FEV1% at baseline increased significantly statistically compare to at the period before baseline, but the difference was not significant statistically compared to the FEV1%values after SIT ( P>0. 01) . The medicine scores after 2 years of SIT were significantly lower than of base-line ( P<0. 001) , the decline was continuous during SIT. There were totally 6203 injections among 24 patients, and the incidence of local adverse reactions was 1. 4%. Mild systemic adverse reactions were ob-served among 5 cases, 4 of which occurred in the multiallergen SIT subgroup. There was no severe adverse reaction. Conclusions SIT by using fungal allergen extracts is effective and safe for allergic asth-matic patients, which resulted in reducing of asthmatic symptoms and medication usage, well-maintenance of good pulmonary function, and low incidence of adverse reactions. The efficacy and safety of multialler-gen SIT by using fungal and dust mite allergen extracts also have been well-documented.关键词
哮喘/变应原/真菌/粉尘螨/免疫疗法/治疗结果/安全性Key words
asthma/allergen/fungi/house dust mite allergen/specific immunotherapy/efficacy/safety分类
医药卫生引用本文复制引用
高翔,尹佳..真菌变应原制剂免疫治疗过敏性哮喘的疗效与安全性[J].中华临床免疫和变态反应杂志,2017,11(3):216-227,12.基金项目
国家重大新药创制科技重大专项 (2014ZX09102041), 中国医学科学院医学与健康科技创新工程 (2016-I2M-1-003) （2014ZX09102041）
