新医学2024,Vol.55Issue(7) :534-540.DOI:10.3969/j.issn.0253-9802.2024.07.007

屋尘螨皮下免疫治疗儿童变应性鼻炎的全身不良反应分析

Analysis of systemic reactions during house dust mite subcutaneous immunotherapy in children with allergic rhinitis

王贤诚 王龙飞 郑晓顺 肖晓雄 李立浩 莫丽华
新医学2024,Vol.55Issue(7) :534-540.DOI:10.3969/j.issn.0253-9802.2024.07.007

屋尘螨皮下免疫治疗儿童变应性鼻炎的全身不良反应分析

Analysis of systemic reactions during house dust mite subcutaneous immunotherapy in children with allergic rhinitis

王贤诚 1王龙飞 1郑晓顺 1肖晓雄 1李立浩 1莫丽华2
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作者信息

  • 1. 南方医科大学深圳医院儿科,广东 深圳 518101
  • 2. 南方医科大学深圳医院儿童耳鼻喉科,广东 深圳 518101
  • 折叠

摘要

目的 观察屋尘螨变应原皮下免疫治疗(SCIT)的全身不良反应(SRs),分析可能的危险因素.方法 回顾性分析 2019 年 12 月至 2022 年 12 月 230 例接受屋尘螨变应原SCIT的变应性鼻炎(AR)患儿的SRs发生情况及其危险因素.结果 230 例患儿共接受 5 422 次注射,SRs发生率占总注射次数 2.4%,占治疗例数 20.0%.SRs以Ⅰ级(51.9%)为主,无致死的SRs发生,症状主要累及呼吸系统 111 次(84.7%).外周血高嗜酸性粒细胞计数[OR(95%CI)=6.02(1.76,20.60),P=0.004])和屋尘螨特异性IgE水平[OR(95%CI)=1.01(1.00,1.01),P=0.016]为发生SRs的危险因素.结论 尘螨过敏的AR患儿应用标准化屋尘螨变应原制剂行SCIT过程可能发生SRs,SCIT总体安全性良好.高嗜酸性粒细胞计数、屋尘螨特异性IgE水平是SCIT过程出现SRs的危险因素.

Abstract

Objective To observe the systemic reactions(SRs)associated with subcutaneous immunotherapy(SCIT)using dust mite allergen and to analyze potential risk factors.Methods The occurrence of SRs among 230 patients with allergic rhinitis(AR)who received house dust mite SCIT from December 2019 to December 2022 was retrospectively analyzed,and related risk factors were identified.Results A total of 5 422 injections were given to 230 patients,with an SRs incidence rate of 2.4%per injection and 20.0%per patient.Most SRs were grade Ⅰ(51.9%),and no fatal SRs occurred.Symptoms primarily affected the respiratory system for 111 times(84.7%).Elevated peripheral blood eosinophil count(OR(95%CI)=6.02(1.76,20.60),P=0.004)and high levels of house dust mite-specific IgE(OR(95%CI)=1.01(1.00,1.01),P=0.016)were identified as risk factors for SRs,respectively.Conclusions Children with AR allergic to dust mites may experience SRs during SCIT with standardized dust mite allergen preparations,whereas the overall safety of SCIT is good.High eosinophil count and high levels of house dust mite-specific IgE are risk factors for SRs during SCIT.

关键词

变应性鼻炎/尘螨/皮下免疫治疗/全身不良反应/儿童

Key words

Allergic rhinitis/Dust mite/Subcutaneous immunotherapy/Systemic reaction/Children

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基金项目

广东省自然科学基金(2023A1515030299)

出版年

2024
新医学
中山大学

新医学

CSTPCD
影响因子:0.8
ISSN:0253-9802
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