【摘要】 目的:通过观察特异性免疫治疗变应性鼻炎过程中效应细胞、抗体水平以及Th淋巴细胞亚群细胞因子的变化,来探讨其治疗机制。方法:随机选择25例变应性鼻炎患者进入特异性免疫治疗组,20例健康自愿者作正常对照组,评估和检测治疗组治疗前和治疗半年后以及正常对照组的症状体征评分、临床用药评分、外周血嗜酸球计数,血清ECP、TIgE、TIgG4、IL-4和IFN-γ等指标。比较治疗前后以及与正常对照组间各指标的差别及相关性。结果:①病例组比正常对照组显著性升高的指标包括症状体征评分、临床用药评分、外周血EOS、血清ECP、血清TIgE和血清TIgG4等;②病例组免疫治疗后显著性下降的指标有症状体征评分、临床用药评分、外周血EOS和血清ECP;③免疫治疗后的病例组血清TIgE比治疗前虽有减少,TIgG4有上升的趋势,但均无统计学意义;④治疗前症状体征评分与治疗前和治疗后的TIgG4对数均呈负相关;治疗前症状体征评分与外周血EOS和血清ECP均呈正相关。结论:①临床上可将外周血EOS计数和血清ECP结合起来,一起评价治疗或干预措施对变态反应性疾病的影响;②血清TIgG4与症状体征显著负相关,治疗后的TIgG4比正常对照显著升高,推测IgG4在变应性鼻炎的发生中起保护性抗体的作用。更多还原

【Abstract】 Objective: To study the changes of effector cells and antibodies and cytokine in T-cell in the treatment of allergic rhinitis with immunotherapy.Methods: In the present study,25 allergic rhinitis patients and 20 volunteers were designed in the immunotherapy group and the control group respectively,and the symptom scores,medication scores,peripheral blood eosinophil cells,serum ECP,serum TIgE,serum TIgG4,serum IL-4 and serum IFNγ were measured before and after immunotherapy for 6 months.The results were compared.Results:(①It was) a significant increase compared with the health control group io the scores of symptom,the scores of medication, the counts of peripheral blood EOS,serum ECP,serum TIgE and serum TIgG4 in the patients group before immunotherapy(P<0.05);②After six months treatment,the level of scores of symptom,the scores of medication,the counts of peripheral blood EOS,serum ECP were significant decreased compared with before treatment in the immunotherapy group;③there was no significant changes of serum TIgE between the before and the after treatment;④Both serum TIgG4 before and after treatment were negative correlation to symptom scores before treatment,and both serum ECP and peripheral blood EOS before treatment were positive correlation to symptom scores before treatment.Conclusions: ①Uniting both peripheral blood EOS and serum ECP can evaluate the efficiency of treatment or management to allergic diseases to be more objective and comprehensive;②level of serum TIgG4 after treatment was not significant increase compared with before treatment but it has a significant correlation to symptom.We think that the level of TIgG4 play a role on blocking antibodies and it could be a new monitor index in diagnosis and treatment of allergic rhinitis.更多还原