超重与正常体重过敏性哮喘儿童特异性免疫治疗前后尘螨皮肤点刺试验强度分析

An analysis of skin prick test reactivity to dust mite in overweight and normal weight children with allergic asthma before and after specific immunotherapy

摘要:

目的 对超重和正常体重过敏性哮喘患儿屋尘螨变应原标准化皮下注射特异性免疫治疗前后皮肤点刺试验(SPT)尘螨过敏原强度的分析.方法 215 例SPT 屋尘螨、粉尘螨均阳性的过敏性哮喘患儿纳入该研究,按照体重指数分为超重组(63 例)和正常体重组(152 例),比较两组标准化皮下注射特异性免疫治疗6 个月及1 年后屋尘螨、粉尘螨过敏原皮肤指数(SI)变化情况.结果 在控制检测时间点变异的情况下,超重组组胺皮丘直径大于正常体重组(P<0.05);在控制体重变异的情况下,患儿屋尘螨SI、粉尘螨SI 均随治疗时间的变化差异有统计学意义(P<0.05).治疗后6 个月及1 年,两组屋尘螨SI、粉尘螨SI 均可见明显下降,但超重组较正常组下降更显著.结论 超重过敏性哮喘患儿对组胺反应更强烈;特异性免疫治疗能降低哮喘患儿尘螨过敏强度;在特异性免疫治疗后1 年内,超重过敏性哮喘患儿尘螨过敏程度下降更明显.

Abstract:

Objective To study the skin prick test (SPT) reactivity to house dust mite allergens in overweight and normal weight children with allergic asthma before and after standard subcutaneous specific immunotherapy. Methods Two hundred and fifteen children with allergic asthma who had positive SPT responses to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) were enrolled. According to the weight index, they were classified into overweight (n=63) and normal weight groups (n=152). Skin indices (SI) to DP and DF were compared between the two groups at 6 months and 1 year after standard subcutaneous specific immunotherapy. Results The overweight group had a significantly larger histamine wheal diameter than the normal weight group after controlling the variation in testing time (P<0.05). After controlling the variation in weights, there were significant differences in the SIs to DP and DF before specific immunotherapy and at 6 months and 1 year after specific immunotherapy. At 6 months and 1 year after specific immunotherapy, the SIs to DP and DF were significantly reduced in both groups (P<0.05), and the overweight group had greater decreases in the SIs to DP and DF than the normal weight group. Conclusions The overweight children with allergic asthma have stronger responses to histamine than the normal weight patients. Specific immunotherapy can reduce the reactivity to dust mite allergens in children with allergic asthma. Within one year after specific immunotherapy, the overweight children with allergic asthma have a significantly greater decrease in the reactivity to dust mite allergens than the normal weight patients.