螨制剂舌下免疫治疗对单一和多重致敏变应性鼻炎的疗效评估

目的观察单一和多重变应性鼻炎患者舌下脱敏的疗效异同并分析原因。方法回顾性分析舌下脱敏治疗1年以上单一和多重变应性鼻炎患者终止治疗1年后的疗效,并对粉尘螨变应原组分与其他点刺变应原作同源进化树分析。结果纳入患者50例,舌下免疫治疗显效22例,有效15例,无效13例,总有效率为74%。50例患者中30例(60%)为多重变态反应患者,阳性率最高的前3种变应原依次为蟑螂(83%)、冬季花粉(70%)和蚕丝(63%)。用有序多分类资料比较的秩和检验分析舌下脱敏治疗1年以上单一尘螨过敏患者与多重变态反应患者的疗效,两组总体分布相同。结论使用舌下含服粉尘螨滴剂治疗变应性鼻炎,多重与单一尘螨变态反应患者治疗效果相当。粉尘螨滴剂亦可用于多重变态反应患者常规治疗。

Clinical Evaluation of Efficacy of Sublingual Immunotherapy with Dermatophagoides farinae Extract among Monosensitized and Polysensitized Patients with Allergic Rhinitis

To investigate the potential difference of efficacy of sublingual immunotherapy between monosensitized and polysensitized allergic rhinitis patients. Methods Clinical efficacy of sublingual immunotherapy was evaluated among monosensitized patients and polysensitized patients who were treated with sublingual immunotherapy more than 1 year.20 cases of monosensitized patients who were sensitized to house dust mite and 30 cases of polysensitized patients who were sensitized to house dust mites and other allergens were involved in this study.The phylogenetic tree of the allergenic components of house dust mite and other allergens used in skin prick test was constructed.Results Among 50 cases involved in this study,evident effect shown in 22 cases,moderate effect in 1 5 cases,and inefficacy in 1 3 cases.The total effective rate was 74%.Of all 50 patients with allergic rhinitis,30 cases （60%）were polysensitized patients.The top three kinds of allergens with the highest positive rate were cockroach （83%）,winter pollen （70%）,and silk （63%）respectively.There was no significant difference statistically between the efficacy of sublingual immunotherapy in dust mite-monosensitized patients and polysensitized patients with sublingual immunotherapy more than one year.Conclusions There was no difference between the efficacy of sublingual immunotherapy with Dermatophagoides farinae drops in house dust mite-monosensitized and polysensitized allergic rhinitis patients.Sublingual immunotherapy using Dermatophagoides farinae drops can be used as conventional treatment in polysensitized patients.