舌下免疫治疗过敏性疾病患儿的人口学特征与依从性分析

Demographic features and compliance of children with allergic diseases receiving sublingual immunotherapy

摘要:

目的 探讨标准化舌下免疫治疗（sublingual immunotherapy，SLIT）过敏性疾病患儿的人口学特征，并分析依从性的影响因素。 方法 纳入江西省儿童医院2018年1月1日—2020年12月31日接受SLIT的1 789例过敏性疾病患儿为研究对象，回顾性分析患儿的人口学特征和随访资料，分析SLIT的依从性及其影响因素。 结果 共1 789例SLIT患儿，其中男性1 271例（71.05%），女性518例（28.95%），年龄4~14岁；完全依从777例（43.43%）；脱落1 012例（56.57%），因自觉使用不便脱落354例（34.98%），因疗效欠佳脱落346例（34.19%），因症状改善自行停用253例（25.00%），因不良反应停用的59例（5.83%）。脱落主要集中在开始治疗后1~4个月（74.31%，752/1 012）。女性患儿依从率低于男性患儿，患单一疾病者依从率低于患多种疾病者（P<0.05）。多因素分析结果显示，与男性相比，女性发生脱落的风险增加（OR=0.811，95%CI：0.658~0.998，P<0.05）；相对于患多种疾病者，患单一疾病者发生脱落的可能性增加（OR=1.313，95%CI：1.005~1.715，P<0.05）。 结论 过敏性疾病患儿SLIT依从性不理想，与患儿性别、所患疾病数量等特征有关；主要脱落原因为自觉使用不便和疗效欠佳。

Abstract:

Objective To study the demographic features of children with allergic diseases receiving standardized sublingual immunotherapy (SLIT) and the influencing factors for the compliance with SLIT. Methods A retrospective analysis was performed on the demographic features and follow-up data of 1 789 children with allergic diseases who received SLIT in Children's Hospital of Jiangxi Province from January 1, 2018 to December 31, 2020. The compliance with SLIT and its influencing factors were analyzed. Results A total of 1 789 children received SLIT, among whom there were 1 271 boys (71.05%) and 518 girls (28.95%), with an age range of 4-14 years. Among these children, 777 (43.43%) had complete compliance with SLIT and 1 012 (56.57%) withdrew from the treatment within one year. Among the 1 012 children, 354 (34.98%) withdrew from the treatment due to self-conscious inconvenient use, 346 (34.19%) withdrew due to unsatisfactory treatment outcome, 253 (25.00%) stopped the treatment due to the improvement in symptoms, and 59 (5.83%) terminated the treatment due to adverse reactions. Withdrawal was mainly observed within 1-4 months after treatment (74.31%, 752/1 012). Girls tended to have a lower compliance rate than boys, and the children with a single disease had a lower compliance rate than those with multiple diseases (P<0.05). The multivariate analysis showed that compared with boys, girls had an increased risk of withdrawal (OR=0.811, 95%CI: 0.658-0.998, P<0.05), and compared with the children with multiple diseases, the children with a single disease were more likely to withdraw from the treatment (OR=1.313, 95%CI: 1.005-1.715, P<0.05). Conclusions Children with allergic diseases tend to have poor compliance with SLIT, which is associated with sex and the number of diseases, and the main reasons for withdrawal are self-conscious inconvenient use and unsatisfactory treatment outcome.