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尘螨皮下免疫治疗应用于儿童过敏性哮喘疗效OA北大核心CSTPCDMEDLINE

Efficacy and safety of dust mite subcutaneous immunotherapy in children with allergic asthma:a prospective randomized controlled study

中文摘要英文摘要

目的 探讨尘螨皮下免疫治疗(subcutaneous immunotherapy,SCIT)应用于儿童过敏性哮喘的疗效和安全性.方法 采用前瞻性随机对照研究,将98例尘螨过敏哮喘患儿按随机数字表法分为对照组和SCIT组,每组49例.对照组吸入激素治疗;SCIT组除吸入激素治疗外,加用3年标准化SCIT.比较两组治疗前、治疗后6个月、治疗后1年、治疗后2年、治疗后3年外周血嗜酸性粒细胞百分比、视觉模拟评分、总用药评分、哮喘控制测试评分/儿童哮喘控制测试评分、呼出气一氧化氮和肺功能的差异.记录注射后不良反应,评估SCIT的安全性.结果 与治疗前相比,SCIT组3年后外周血嗜酸性粒细胞百分比、视觉模拟评分、总用药评分和呼出气一氧化氮显著下降,肺功能显著改善,哮喘控制水平更佳(P<0.05);与对照组相比,SCIT组3年后各评估指标改善较对照组更明显(P<0.05).共完成2 744次注射,发生局部不良反应157次(5.72%),全身不良反应4次(0.15%),无严重全身不良反应发生.结论 SCIT是一种有效、安全的儿童过敏性哮喘治疗方法.

Objective To investigate the efficacy and safety of subcutaneous immunotherapy(SCIT)using dust mites in children with allergic asthma.Methods In a prospective randomized controlled study,98 children with dust mite-induced allergic asthma were randomly divided into a control group(n=49)and an SCIT group(n=49).The control group received inhaled corticosteroid treatment,while the SCIT group additionally received a standardized three-year SCIT regimen.The two groups were compared based on peripheral blood eosinophil percentage,visual analogue score(VAS),total medication score,Asthma Control Test/Childhood Asthma Control Test scores,fractional exhaled nitric oxide(FeNO),and lung function before treatment,and at 6 months,1 year,2 years,and 3 years after treatment.Adverse reactions were recorded post-injection to evaluate the safety of SCIT.Results Compared with pre-treatment levels,the SCIT group showed a significant reduction in the percentage of peripheral blood eosinophils,VAS,total medication score,and FeNO,while lung function significantly improved,and asthma control levels were better 3 years after treatment(P<0.05).Compared with the control group,the SCIT group showed more significant improvement in all evaluated indicators 3 years after treatment(P<0.05).A total of 2 744 injections were administered,resulting in 157 cases(5.72%)of local adverse reactions and 4 cases(0.15%)of systemic adverse reactions,with no severe systemic adverse events.Conclusions SCIT is an effective and safe treatment for allergic asthma in children.

王雅妮;鲁思琪;陈海;李玉勤;卢红艳;朱慧;常明

江苏大学附属医院儿科,江苏镇江 212001

皮下免疫治疗过敏性哮喘疗效安全性儿童

Subcutaneous immunotherapyAllergic asthmaEfficacySafetyChild

《中国当代儿科杂志》 2024 (006)

559-566 / 8

江苏省卫生健康委2022年度医学科研立项项目(M2022043);江苏省镇江市2023年度科技创新资金项目(SS2023012).

10.7499/j.issn.1008-8830.2309137

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