【摘要】 目的观察变应性鼻炎(AR)患者使用标准化尘螨变应原制剂进行特异性皮下免疫治疗(SCIT)的不良反应,探索SCIT治疗的安全性及不良反应的特点。方法收集2016年6月～2018年9月使用阿罗格标准化尘螨变应原制剂进行SCIT治疗的362例患者,观察局部和全身不良反应发生情况,并分析不良反应的表现、全身不良反应与患者注射剂量及年龄、性别、合并哮喘的关系。结果 362例患者中轻度局部不良反应发生率为85.1%,严重局部不良反应发生率为2.2%,全身不良反应发生率为8.8%,其中轻度全身反应发生率为7.7%,中度、严重全身反应发生率均为0.6%,无患者发生过敏性休克,不良反应大多发生在剂量递增阶段中后期及维持治疗阶段早期。全身不良反应发生率男女间差异无统计学意义,全身不良反应主要发生于5～11岁,占全身不良反应总发生率的56.3%,伴有哮喘患者与不伴哮喘患者呼吸道不良反应发生率差异有统计学意义,年龄≤14岁与> 14岁患者呼吸道不良反应发生率差异有统计学意义。结论 AR患者标准化尘螨变应原制剂SCIT治疗中的不良反应多为轻度局部反应,全身反应多为轻中度,男女发病率无明显差异,多发生于伴有哮喘的儿童,哮喘控制稳定、每次注射前对患者进行全面仔细的风险评估、以及优化的治疗方案可以降低不良反应的发生。更多还原

【Abstract】 Objective To observe the adverse reactions(ADRs) of allergic rhinitis(AR) patients using standardized dust mite allergen preparations for specific subcutaneous immunotherapy(SCIT), and to explore the safety of SCIT treatment and the characteristics of the ADRs. Methods 362 patients who were treated with NHD standardized dust mite allergen preparation for SCIT from June 2016 to September 2018 were collected. The occurrence of local and systemic ADRs were observed, and the manifestations of ADRs, as well as the relationship between systemic ADRs and patients’ injection dose, age, gender and combined asthma, were analyzed. Results Among 362 patients, the incidence of mild local ADRs was 85.1%, the incidence of severe local ADRs was 2.2%, and the incidence of systemic ADRs was 8.8%; The incidence of mild systemic ADRs was 7.7%, the incidences of moderate and severe systemic ADRs were both 0.6%; No patients had anaphylactic shock; Most ADRs occurred in the middle and late stages of dose increase and the early stage of maintenance treatment. There was no significant difference in the incidence of systemic ADRs between men and women. Systemic ADRs mainly occurred to the patients aged 5 to 11, accounting for 56.3% of the total incidence of systemic ADRs. There was statistically significant difference in the incidence of respiratory ADRs between patients with asthma and patients without asthma, and there was also statistically significant difference in the incidence of respiratory ADRs between patients aged ≤ 14 years and > 14 years. Conclusion The ADRs in SCIT treatment of AR patients with standardized dust mite allergen preparation are mostly mild local reactions, and the systemic reactions are mostly mild to moderate, with no significant difference between incidences of male and female patients. Most of them occur to children with both AR and asthma. Stable asthma control, comprehensive and careful risk assessment of the patients before each injection, and optimized treatment scheme can reduce the occurrence of ADRs.更多还原