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目的:探讨标准化皮下特异性免疫治疗(SCIT)变应性鼻炎(AR)的临床疗效和安全性。方法:收集2006-01-2009-01应用阿罗格尘螨疫苗进行3年标准化SCIT并有完整随访资料的425例AR患者的资料进行回顾性分析,其共完成31088次尘螨变应原疫苗注射。通过比较治疗前后患者的生活质量评分,治疗前及免疫治疗后每6周记录的鼻症状VAS评分及药物评分,评估该疗法的临床疗效。分析剂量递增期和剂量维持期的局部及全身不良反应的发生情况,评估疗法的安全性。结果:免疫治疗前总体生活质量评分[中位数(25分位数;75分位数),下同]为3.8(2.9;4.5)分,3年免疫治疗后为1.1(1.0;2.0)分,差异有统计学意义(P<0.01);治疗前鼻部症状VAS评分(0~40分)及药物评分分别为23.7(20.5;27.8)分及3.9(3.2;4.7)分,治疗后分别为2.1(1.6;2.2)分及0(0;0)分,差异有统计学意义(均P<0.01)。在剂量维持阶段,患者的症状及药物评分基本稳定,局部不良反应发生率为3.15%,全身不良反应发生率为0.90%。结论:SCIT是治疗尘螨引起AR的一种安全、有效的治疗方法。
Objective: To investigate the clinical efficacy and safety of standardized subcutaneous immunotherapy (SCIT) allergic rhinitis (AR). Methods: A retrospective analysis was performed on the data of 425 patients with AR who were treated with the Atrog-Dust Mite Vaccine for 3 years and from January 2006 to January 2009 with complete follow-up data. A total of 31,088 dust mite allergen vaccines injection. The clinical efficacy of the therapy was evaluated by comparing the quality of life scores of patients before and after treatment, VAS scores of nasal symptoms and drug scores recorded before treatment and every 6 weeks after immunotherapy. Analyze the occurrence of local and systemic adverse events during dose escalation and dose maintenance to assess the safety of the therapy. Results: The overall quality of life scores before immunotherapy [median (25th percentile; 75th percentile), 3.8 (2.9; 4.5) for the same below] were 1.1 (1.0; 2.0) after 3 years of immunotherapy , The difference was statistically significant (P <0.01). The VAS scores (0-40) and drug scores of nasal symptoms before treatment were 23.7 (20.5; 27.8) and 3.9 (3.2; 4.7) 2.1 (1.6; 2.2) points and 0 (0; 0) points, the difference was statistically significant (P <0.01). During the dose maintenance phase, the patient’s symptoms and drug scores were basically stable. The incidence of local adverse reactions was 3.15% and the incidence of systemic adverse reactions was 0.90%. Conclusion: SCIT is a safe and effective treatment for AR caused by dust mite.