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目的观察标准化屋尘螨变应原制剂治疗儿童变应性哮喘及变应性鼻炎的耐受性和安全性。方法对112例临床诊断螨过敏性儿童哮喘伴或不伴变应性鼻炎患儿,应用标准化屋尘螨提取液皮下注射进行特异性免疫治疗,观察记录每次免疫注射后的不良反应发生情况,同时监测每次变应原注射前及注射后30分钟PEF变化情况。结果经过1年的治疗观察,112例患儿共注射2649次,共发生全身反应15/2649例次(0.57%),局部不良反应436/2649(16.46%)。其中速发全身反应11/2649例次(0.42%),均为Ⅰ级,包括咳嗽、胸闷、喘息发作、皮肤瘙痒、荨麻疹及头痛;迟发全身反应4/2649(0.15%),包括胸闷、喘息、荨麻疹及鼻炎;速发局部反应432/2649(16.31%),绝大多数为轻度局部反应,表现为局部皮肤潮红、肿胀(d<5cm),皮肤痒,仅有3例次局部红肿(d>5cm),未发现1例严重全身反应。注射前后30分钟的PEF平均值变化差异无统计学意义,注射27周后及1年的PEF与注射前差异有显著性。结论螨过敏性儿童哮喘及变应性鼻炎患儿对标准化屋尘螨变应原制剂特异性皮下免疫治疗的耐受性良好,治疗安全,治疗后的肺功能PEF值改善。
Objective To observe the tolerability and safety of standard house dust mite allergen preparations in children with allergic asthma and allergic rhinitis. Methods A total of 112 children with clinically diagnosed allergic mite allergic asthma with or without allergic rhinitis were immunized with subcutaneous injection of standardized house dust mite extract. The incidence of adverse reactions after each immunization was observed and recorded. At the same time, the changes of PEF before each allergy injection and 30 minutes after injection were monitored. Results After 1 year of treatment, 112 children were injected with 2649 times. There were 15/2649 cases (0.57%) of systemic reactions and 436/2649 (16.46%) of local adverse reactions. Among them, 11/2649 cases (0.42%) of immediate reaction were immediate grade I, including cough, chest tightness, wheezing, pruritus, urticaria and headache. Delayed systemic reaction 4/2649 (0.15%), including chest tightness , Wheezing, urticaria and rhinitis; local reaction speed 432/2649 (16.31%), the vast majority of mild local reactions, manifested as local skin flushing, swelling (d <5cm), itchy skin, only 3 times Local redness (d> 5cm), did not find a case of severe systemic reaction. There was no significant difference in mean PEF at 30 minutes before and after injection, PEF after 27 weeks and 1 year after injection were significantly different from those before injection. Conclusions Children with mite allergic asthma and allergic rhinitis are well tolerated by standard subcutaneous immunotherapy of house dust mite allergen preparations. The treatment is safe and the PEF value of lung function after treatment is improved.