【摘要】 目的分析过敏性疾病儿童舌下免疫治疗(SLIT)的依从性,并制定应对策略。方法选择2016年5月至2018年12月于南京医科大学第一附属医院儿科门诊诊治的明确诊断粉尘螨过敏且接受SLIT的275例患儿为研究对象,根据用药时间将依从性分为依从性好(时间≥2年)及依从性差(时间<2年),分析影响因素。结果 275例患儿依从性好的比例为30.9%(85/275),依从性差的比例为69.1%(190/275),依从性差的原因分布前三位为自觉症状已缓解22.6%(43/190)、担心长时间用药的副作用16.3%(31/190)、自觉效果不佳14.7%(28/190);家长学历不同,患儿依从性不完全相同(χ~2=12.663,P<0.05),两两比较发现,大学及以上组最高,与初中及以下组、高中组相比差异都有统计学差异(Bonferroni法多重检验校正,均P<0.017),而高中组与初中及以下组之间无统计学差异;家长年龄不同,患儿依从性不完全相同(χ~2=28.352,P<0.05),两两比较发现,25～34岁组最高,与<25岁、35～45岁、≥45岁组相比差异均有统计学意义(Bonferroni法多重检验校正,均P<0.008),而其他组之间差异均无统计学意义;患儿年龄不同,依从性也不完全相同(χ~2=26.358,P<0.05),两两比较发现,6～10岁组最高,与3～5岁、11～14岁组相比有差异(Bonferroni法多重检验校正,均P<0.017),而3～5岁和11～14岁组之间依从性无显著差异。结论过敏性疾病儿童SLIT的依从性尚不理想,针对性制定应对策略提高依从性至关重要。更多还原

【Abstract】 Objective To analyze compliance to sublingual immunotherapy(SLIT) of children with allergic diseases and formulate coping strategies.Methods 275 children with dust mite allergy who received SLIT over a period from May 2016 to December 2018 in Clinic of Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University were enrolled in this study.According to duration of medication, the children were divided into good compliance group(≥2 years) and poor compliance group(<2 years),and influencing factors of the compliance were analyzed.Results The proportion of children with good compliance was 30.9%(85/275),and that of children with poor compliance was 69.1%(190/275).The top three causes of poor compliance included: the symptoms having had relieved(22.6%,43/190),worrying about side effects of long-term medication(16.3%,31/190),and perceiving poor effect(14.7%,28/190).The children whose parents had different educational backgrounds had different compliance(χ~2=12.663,P<0.05),and the pairwise comparison found that the compliance of the children whose parents had college and above educational backgrounds was the highest, and the difference was significant compared with that in the junior high school and below group and senior high school group(Bonferroni multiple test correction, both P<0.017),while there was no significant difference between the senior high school group and the junior high school and below group(P>0.05).The children with different parents’ ages had different compliance(χ~2=28.352,P<0.05),and the pairwise comparison found that the compliance of the children with parents’ ages of 25～34 years was the highest, and there were significant differences compared with those in parents’ ages of <25 years, 35～45 years and ≥45 years groups(Bonferroni multiple test correction, all P<0.008),but there were no significant differences among the other three parents’ age groups.The children of different ages had different compliance(χ~2=26.358,P<0.05),and the highest compliance was found in 6～10 year-old age group, there were significant differences compared with those in the 3～5 year-old age group and the 11～14 year-old age group(Bonferroni multiple test correction, both P<0.017),while there was no significant difference in the compliance between the 3～5 year-old age group and the 11～14 year-old age group(P>0.05).Conclusion Compliance to SLIT of the children with allergic diseases is not optimal, so it is most important to formulate coping strategies to improve the compliance of the children to SLIT.更多还原