摘要目的 探讨变应性鼻炎(allergic rhinitis,AR)患者应用屋尘螨皮下免疫治疗(subcutaneous immunotherapy,SCIT)的远期临床疗效.方法 选择AR不伴哮喘的患者102例,随机数字表法分为SCIT组和对症治疗组(symptomatic therapy,ST).SCIT组在药物对症治疗的基础上加用3年标准化屋尘螨变应原疫苗治疗,在停止SCIT后再进行2年随访.疗效评价指标包括:鼻部症状评分、用药评分、皮肤指数、血清特异性IgE(specific IgE,sIgE)、鼻炎发展成哮喘和出现新致敏原的情况.以SPSS 11.0软件进行统计学处理.结果 SCIT组治疗后鼻部症状评分、用药评分、皮肤指数与治疗前相比明显改善,差异有统计学意义(P值均＜0.01);与ST组比较明显改善,差异有统计学意义(P值均＜0.01).停止SCIT后2年随访,将上述相同参数分别与刚结束3年SCIT治疗时比较,差异无统计学意义(P值均＞0.05).SCIT组没有患者发展为哮喘,只有4.7％ (2/43)的患者出现新的致敏原;而ST组22.0％ (9/41)的患者发展为哮喘,41.5％(17/41)的患者出现新的致敏原.治疗过程中未发生严重不良反应.结论 SCIT能明显地改善AR患者的临床症状,远期疗效佳.早期应用SCIT,可以防止AR发展为哮喘.

abstractsObjective To evaluate the long-term effect of house dust mite subcutaneous immunotherapy (SCIT) in patients with allergic rhinitis (AR).Methods A total of 102 patients with allergic rhinitis (not associated asthma) were recruited into the study.These patients were randomly divided into two groups:SCIT group and ST (symptomatic therapy) group.The patients were investigated for SCIT with standardized allergen vaccine for 3 years or no SIT only symptomatic therapy respectively.After the termination of SCIT,these patients were followed-up continuously for another 2 years.The therapeutic evaluation index included:rhinitis symptoms score,drug score,skin prick test,serum specific IgE (sIgE),as well as the number of development of asthma and the new sensitization.SPSS 11.0 software was used to analyze the data.Results Clinical symptom scores,drug scores,and skin test result all improved significantly after the treatment with SCIT compared to SCIT before and ST group (P ＜ 0.01).Two years after the termination of SCIT,the same parameters showed no significant difference compared to 3 years before (P ＞ 0.05).No rhinitis patients in SCIT group developed to asthma,only 4.7％ of patients had been found to have new allergen.In the meantime,22.0％ of the patients with rhinitis in ST group developed asthma,and 41.5％ patients were found to have new allergen.No severe adverse events occurred.Conclusions The symptoms of the patients with allergic rhinitis were obviously improved by SCIT and a long-term curative effect could be maintained.It should be early applicated,which could prevent allergic rhinitis developed to asthma.