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目的探讨抗原特异性免疫治疗花粉症与细胞因子的相关性。方法将蒿草花粉过敏的60例患者随机分为快速免疫治疗和常规免疫治疗2组,用蒿草花粉变应原进行季节前减敏治疗。分别测定细胞因子白介素-4(IL-4)、γ-干扰素(γ-IFN)和总IgE(tIgE)、特异性IgE(sIgE)血清中含量。比较治疗前、治疗后、维持治疗1个月后水平变化和临床效果。结果与治疗前比较,花粉症快速组治疗后血清中tIgE、sIgE、IL-4、γ-IFN含量变化,差异无统计学意义(P1>0.05)。维持治疗1个月后,sIgE升高差异仍然无统计学意义(P2>0.05),而IL-4水平明显降低(P2<0.01),tIgE、γ-IFN水平明显升高(P2<0.01)。常规免疫治疗组:治疗后血清中tIgE、γ-IFN明显升高(P1<0.01),sIgE、IL-4没有明显变化(P1>0.05)。维持治疗1个月后与治疗前比较,tIgE、sIgE、γ-IFN明显升高(P2<0.01),IL-4明显降低(P2<0.01)。2组抗原特异性免疫治疗均取得了显著临床效果,有效率比较,差异无统计学意义(P>0.05)。结论特异性免疫治疗能明显改善花粉症的临床症状和相关细胞因子、特异性抗体水平,IL-4、γ-IFN水平变化可以作为免疫治疗疗效观察的有效生物学指标。
Objective To investigate the association between antigen-specific hay fever and cytokines. Methods 60 patients with pollen allergy of Artemisia were randomly divided into two groups: rapid immunotherapy and routine immunotherapy. The contents of IL-4, γ-IFN and total IgE (tIgE), specific IgE (sIgE) in serum were determined. Before treatment, after treatment, maintain the level of change and clinical effect after 1 month. Results Compared with those before treatment, the serum levels of tIgE, sIgE, IL-4 and γ-IFN in the hay fever group were not significantly different (P> 0.05). After 1 month of maintenance treatment, the difference of sIgE was still not statistically significant (P> 0.05), while the level of IL-4 was significantly decreased (P <0.01). The levels of tIgE and γ-IFN were significantly increased (P <0.01). In routine immunotherapy group, serum tIgE and γ-IFN were significantly increased (P <0.01) and sIgE and IL-4 did not change significantly after treatment (P> 0.05). After 1 month of maintenance treatment, tIgE, sIgE and γ-IFN were significantly increased (P <0.01) and IL-4 significantly decreased (P <0.01). Two groups of antigen-specific immunotherapy have achieved significant clinical effects, the effective rate, the difference was not statistically significant (P> 0.05). Conclusion Specific immunotherapy can significantly improve the clinical symptoms of hay fever and related cytokines, specific antibody levels, IL-4, γ-IFN levels can be used as an effective biological indicators of immunotherapy efficacy.