舌下特异性免疫治疗对尘螨过敏性哮喘儿童的作用

Efficacy of sublingual immunotherapy in children with dust mite allergic asthma

摘要:

目的：观察舌下特异性免疫治疗(sublingual immunotherapy, SLIT)联合吸入糖皮质激素(inhaled corticosteroids, ICS)与单独ICS治疗尘螨过敏轻、中度哮喘儿童的临床疗效，为哮喘的联合治疗提供更多的选择方案。方法：对尘螨过敏的轻、中度哮喘患儿32例随机分为两组： SLIT组(SLIT联合ICS治疗，18例)和对照组(单独ICS治疗，14例)。两组共30例完成为期1年的临床观察。比较两组患儿ICS给药总量、哮喘日间和夜间症状评分、皮肤点刺试验、肺功能、血清sIgE和sIgG4值、VAS评分（visual analog scale）的差异。结果：SLIT组在1年治疗结束ICS给药总量较对照组显著减少;与对照组相比，SLIT组的日、夜间哮喘症状评分显著降低，肺功能FEF25- 75%值显著增加，sIgE值及VAS评分降低，差异有统计学意义（P<0.05）；皮肤点刺反应计分、FEV1及sIgG4值两组差异无统计学意义（P>0.05）。在整个随访期两组均无严重不良反应。结论：SLIT联合ICS治疗在改善尘螨致敏哮喘患儿的日、夜间哮喘症状、肺功能及VAS评分方面的疗效优于单独使用ICS治疗。［中国当代儿科杂志，2010，12（5）：344-347］

Abstract:

OBJECTIVE: To compare the efficacy of sublingual immunotherapy (SLIT) combined with inhaled corticosteroids (ICS) versus ICS alone in children with mild and moderate dust mite allergic asthma. METHODS: Thirty-two children with mild and moderate dust mite allergic asthma were randomly divided into two groups: SLIT+ICS (n=18) and ICS alone (n=14). A total of 30 children completed the one year clinical observation . The amount of ICS administration, the day and night symptom scores, skin-prick test and pulmonary function test results, serum specific immunoglobulin E (sIgE) and G4 (sIgG4) levels and visual analog scale (VAS) scores were compared between the two groups. RESULTS: By the end of one year the SLIT+ICS group had significantly decreased amount of ICS administration than the ICS alone group. Compared with the ICS alone group, the day and night symptom scores decreased, FEF25-75% increased significantly, and serum sIgE levels and VAS scores were significantly reduced in the SLIT+ICS group. There were no statistical differences in the skin-prick test results, and FEV1 and sIgG4 levels between the two groups. No severe adverse events occurred in both groups during the follow-up period. CONCLUSIONS: SLIT combined with ICS may produce a better efficacy than ICS alone in the improvement of day and night symptoms, pulmonary function and VAS scores in children with dust mite-allergic asthma.［Chin J Contemp Pediatr, 2010, 12 (5):344-347］