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目的:观察特异性免疫治疗常年性变应性鼻炎的临床疗效、安全性及可能机制。方法:回顾分析30例接受3年特异性免疫治疗的常年性变应性鼻炎患者(治疗组)的资料。2006年对其进行调查随访;取同期30例常年性变应性鼻炎患者为对照组,症状发作时服用抗组胺药物及鼻用激素联合治疗;10例健康人为健康组,观察治疗后临床疗效及免疫学指标(静脉血IL-2、IL-4、IL-5水平)的变化情况。结果:①变应性鼻炎免疫治疗临床疗效评定:治疗组治疗结束时总有效率90.00%,对照组总有效率86.67%,2组疗效比较差异无统计学意义(P>0.05)。免疫治疗后平均症状、体征积分为(3.88±2.71)分,与治疗前(11.10±1.53)比较,差异有统计学意义(P<0.01)。②血清IL-2、IL-4、IL-5测定:对照组患者存在免疫功能异常,表现为IL-2水平低下,IL-4、IL-5水平升高,与健康组比较差异有统计学意义(P<0.01);治疗组与对照组比较差异有统计学意义(P<0.01),治疗组与健康组比较差异无统计学意义(P>0.05)。③对30例变应性鼻炎患者进行脱敏治疗3530次,发生全身反应4例,共6例次,总发生率为0.17%(6/3530);局部反应发生12例,共54例次,总发生率为1.53%(54/3530)。局部及全身反应均较轻。结论:特异性免疫是治疗变应性鼻炎的有效方法,值得推广应用。
Objective: To observe the clinical efficacy, safety and possible mechanism of specific immunotherapy for perennial allergic rhinitis. Methods: The data of 30 patients with perennial allergic rhinitis (treatment group) who received 3 years of specific immunotherapy were retrospectively analyzed. In 2006, 30 cases of perennial allergic rhinitis patients were selected as the control group. Antihistamines and nasal hormones were used simultaneously in the onset of symptoms. Ten healthy people were selected as healthy group. The clinical effects were observed after treatment And immunological indicators (venous blood IL-2, IL-4, IL-5 levels) changes. Results: ① The clinical curative effect evaluation of allergic rhinitis immunotherapy: The total effective rate 90.00%, the control group 86.67% at the end of treatment, there was no significant difference between the two groups (P> 0.05). The mean scores of symptoms and signs after immunotherapy were (3.88 ± 2.71) points, which were significantly different from those before treatment (11.10 ± 1.53) (P <0.01). ② The levels of IL-2, IL-4 and IL-5 in the control group were significantly higher than those in the control group (P <0.01). The difference between the treatment group and the control group was statistically significant (P <0.01). There was no significant difference between the treatment group and the healthy group (P> 0.05). ③ In 30 patients with allergic rhinitis desensitization treatment 3530 times, 4 cases of systemic reactions occurred, a total of 6 cases, the overall incidence was 0.17% (6/3530); local reactions occurred in 12 cases, a total of 54 cases, The overall incidence was 1.53% (54/3530). Local and systemic reactions are lighter. Conclusion: Specific immunity is an effective method for the treatment of allergic rhinitis, which is worth popularizing and applying.