变应性鼻炎合并哮喘特异性免疫治疗起始阶段成人与儿童患者不良反应的观察与分析

Observation and Analysis of Adverse Effects in Adult and Childhood Patients with Allergic Rhinitis with Asthma at the Initiation of Specific Immunotherapy

摘要: 目的：观察对尘螨过敏的变应性鼻炎伴哮喘的患者特异性免疫治疗期间的不良反应，对成人和儿童患者的不良反应情况进行分析。方法：选取2018年7月到2019年9月期间就诊青岛大学附属医院变态(过敏)反应科，年龄在5~55岁的124例变应性鼻炎伴哮喘患者为研究对象，分为儿童组和成人组，采用标准化屋尘螨变应原进行免疫治疗，首先采取常规治疗，遇不良反应者根据情况给予分针、退针或减量注射。在起始阶段(即剂量递增阶段)内，统计注射针次及不良反应发生情况，进行对比分析。结果：124例患者包括72例儿童与52例成人，接受免疫治疗注射总针数1792针，不良反应总计253针次，发生率14.12%，其中局部不良反应发生率为11.44%，全身不良反应发生率2.68%。儿童组局部不良反应发生率为9.65%，成人组为14.07%，两组比较存在统计学差异(P < 0.05)；儿童组全身不良反应发生率为3.84%，成人组为0.97%，两组比较存在统计学差异(P < 0.05)。结论：在变应性鼻炎伴哮喘的患者采用皮下注射特异性免疫治疗的剂量递增阶段，成人患者局部不良反应发生率高于儿童患者，而儿童的全身不良反应发生率高于成人患者。

Abstract: Objective: To observe adverse reactions during sub-cutaneous specific immunotherapy (SCIT) in mite allergic children and adults who have rhinitis with asthma and analyze the deference between them. Method: Data were collected and analyzed in 124 patients who were prescribed subcutane-ous specific immunotherapy from July 2018 to September 2019 who were aged 5 to 55 and had rhi-nitis with asthma. They were divided into children group and adult group according their age. SCIT with standardized house-dust mite extract was administrated to the groups with allergy to dust mite by positive results from SPT (skin-prick test) or serum IgE. The immediate and late adverse reactions after each allergen injection during dose-increase phase of immunotherapy treatment were monitored. Result: Among 1792 injections of 124 patients who received SCIT, adverse reac-tions occurred in 253 (14.12%), local immediate and late reactions were shown in 11.44% and sys-temic reactions in 2.68%. The prevalence of local adverse reaction in children was 9.65% and in adults was 14.07% (P < 0.05). The prevalence of systemic adverse reaction in children was 3.84% and in adults was 0.97% (P < 0.01). The difference of incidence of local or systemic adverse reaction was significant between the two groups. Conclusions: The prevalence of systemic reactions in chil-dren was significantly higher than that in adults whereas higher in adults than children in local re-actions during up-dosing phase of conventional immunotherapy.