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尘螨变应性鼻炎患者皮下特异性免疫治疗的局部不良反应 预览 被引量:9

Local Adverse Reactions in Patients with Allergic Rhinitis to Dust Mite during Subcutaneous Immunotherapy
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摘要 目的分析应用标准化尘螨变应原疫苗(德国默克,阿罗格)对尘螨变应性鼻炎患者行皮下特异性免疫治疗的局部不良反应。方法对280例尘螨变应性鼻炎患者行皮下特异性免疫治疗过程中出现的注射部位不良反应,按照欧洲变态反应和临床免疫学会不良反应判定标准进行评定,记录首次不良反应并输入数据库进行统计分析。结果皮下特异性免疫治疗的尘螨变应性鼻炎患者出现不良反应82例(29.29%),其中局部不良反应74例(26.43%,速发60例,迟发14例),主要不良反应表现为硬结、皮丘、红晕、红肿,其阳性率分别为10.00%、6.07%、5.71%和4.64%。患者过敏程度/注射与局部不良反应的频度分析:(1)皮肤点刺试验反应强度(从++++至+)/不良反应频度,阳性率分别为46.67%(14/30)、30.00%(33/110)、27.28%(25/90)、4.00%(2/50);(2)血清IgE等级(超重度、重度、中度、轻度)/不良反应频度,阳性率分别为48.89%(22/45)、30.36%(34/112)、17.89(17/95)、3.57%(1/28);(3)特异性免疫治疗注射浓度(从5000TU至5TU)/不良反应频度分析,阳性率分别为16.26%(40/246)、7.52%(20/266)、4.66%(13/279)、0.36%(1/280);(4)特异性免疫治疗注射部位浅深/不良反应频度分析,阳性率分别为23.07%(18/78)、3.47%(7/202)。除点刺试验(+++~++,P〉0.05)外,其他等级之间不良反应的频度均P〈0.05,差异具有统计学意义。结论皮下特异性免疫治疗出现局部皮肤不良反应以硬结为主要表现,且局部皮肤不良反应的频度与患者过敏强度、皮下特异性免疫治疗注射浓度及注射部位的深浅有密切关系,特别是重度过敏患者从高浓度疫苗初次注射时就应给予高度关注。 Objective To analyze local adverse reactions in mite allergic rhinitis p atients during subcutaneous specific immunotherapy by standardized dust mite allergen vaccine (Merck, NHD). Methods Local adverse reaction in 280 dust mite allergic rhinitis patients were observed and recorded, according to the criteria of European Academy of Allergology and Clinical Immunology (EAACI). Data were input into the databanks and analyzed statistically. Results Adverse reactions were found in 82 ( 29.29% =82/280) patients after subcutaneous injection immunotherapy. Local adverse reactions were observed in 74 ( 26.43% =74/280) patients (including rapid reaction in 60 patients, delayed reaction in 14 patients). Most of adverse reactions manifested as induration, colliculus, flare and edema, the positive rates were 10.00% (28/280), 6.07% ( 17/280) , 5.71% ( 16/280) , and 4.64% ( 13/280) , respectively. Incidence of local adverse reactions inallergic patients and allergic severity, concentration of vaccine were analyzed as following. (1) According to the response (from ++++ , +++, ++ to +) of skin prick test, the positive rate of adverse reactions were 46.67% (14/30), 30.00% (33/110), 27.28% (25/90), 4.00% (2/50), respectively. (2) According to the level of serum sIgE (super severe, severe, moderate, mild) , the positive rate of adverse reactions were 48.89% (22/45), 30.36% (34/112), 17.89 (17/95), 3.57% (1/28), respectively. (3) According to the concentration (from 5 000 u to 5 u) of vaccine, the positive 16.26% (40/246), 7.52% (20/266), 4.66% ( 13/279) , 0.36% ( 1/280) , respectively. ( 4) According to the depth of the injection site, the positive 23.07% (18/78), 3.47% (7/202), respectively. Except the skin prick test response (++++~++ , P 0.05), there were significant differences with the other groups (P 0.05), including the level of serum SIgE, the concentration of vaccine
作者 林志斌 李添应 陈彦球 LIN Zhi-bin, LI Tian-ying, CHEN Yan-qiu# (Allergy Division of Hospital of Otorhinolaryngology , The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
出处 《中华临床免疫和变态反应杂志》 2010年第3期 212-215,共4页 Chinese Journal of Allergy & Clinical Immunology
关键词 变应性鼻炎 皮下特异性免疫治疗 局部不良反应 allergic rhinitis subcutaneous immunotherapy local adverse reactions
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