【摘要】 目的探讨淋巴结注射免疫治疗特应性皮炎的分子免疫学机制。方法 72例对屋尘螨过敏的特应性皮炎患者,随机分为治疗组和对照组,每组各36例,对照组给予0.1%糠酸莫米松乳膏、1.2%维生素B6软膏、氯雷他定片、富马酸酮替芬等基础药物治疗,治疗组在上述药物治疗的基础上,超声引导下分别于0周、4周、8周、12周、16周、20周行腹股沟淋巴结内注射屋尘螨过敏原制剂,除0周用药剂量为100 SQ-U外,其余5次剂量均为1 000 SQ-U。治疗前后采用荧光酶联免疫法检测特应性皮炎患者血清屋尘螨sIgE、采用酶联免疫吸附试验(ELISA)方法检测患者血清IL-4和INF-γ值。检测数据应用SPSS19.0统计学软件进行分析。结果 2组中所有患者均完成了20周的治疗。治疗后治疗组血清屋尘螨sIgE和IL-4值由治疗前的(5.06±2.30)KU/L和(16.41±0.91)ng/L分别降至(2.14±1.09)KU/L和(9.52±0.75)ng/L,且均明显低于治疗后对照组(4.63±1.13)KU/L和(16.40±0.92)ng/L,2组比较差异有显著统计学意义(P<0.01);治疗组血清INF-γ值由治疗前的(11.34±0.71)ng/L增至(14.78±0.68)ng/L,且明显高于对照组的值(11.32±0.58)ng/L,2组比较有显著性统计学差异(P<0.01)。结论屋尘螨过敏原淋巴结注射免疫治疗显著降低患者血清屋尘螨sIgE和IL-4值,同时使血清INF-γ值升高。降低血清sIgE、调节血清IL-4和INF-γ的平衡可能是淋巴结注射免疫治疗的分子免疫机制。更多还原

【Abstract】 To investigate molecular immune mechanism of intralymphatic immunotherapy for atopic dermatitis, fluorescent enzyme-linked immunoassay was applied to detect serum dermatophagoides pteronyssinus sIgE, while enzyme linked immunosorbent assay was used to measure interleukin-4(IL-4) and interferon-γ(INF-γ) levels in patients with atopic dermatitis before and after intralymphatic immunotherapy, which administrated in superficial lymph node with dermatophagoides pteronyssinus allergen vaccine(Alutard ALK, Denmark) by ultrasound-guide every 4 week. Total of 36 patients in treatment group and 36 patients in control group completed the study. We found that intralymphatic immunotherapy could reduce serum dermatophagoides pteronyssinus sIgE and IL-4 of patients, comparing with that of pre-treatment and control group(P < 0.01). We also found that comparing with pretreatment and control group, patients in treatment group demonstrated significant higher INF-γ level(P < 0.01). Thus we concluded that intralymphatic allergen administration can markedly reduce serum dermatophagoides pteronyssinus sIgE and IL-4 levels, but significantly increased serum INF-γ level in patients with atopic dermatitis, which may be the molecular immune mechanism of intralymphatic immunotherapy for atopic dermatitis.更多还原