| 猫皮屑集群与常规免疫治疗安全性比较及不良反应影响因素分析 |
| 投稿时间：2024-12-16 修订日期：2025-01-13 点此下载全文 |
| 引用本文：茹一,李丽莎,关凯,王子熹,崔乐,徐迎阳.猫皮屑集群与常规免疫治疗安全性比较及不良反应影响因素分析[J].医学研究杂志,2025,54(6):49-56 |
| DOI：
10.11969/j.issn.1673-548X.2025.06.010 |
| 摘要点击次数: 223 |
| 全文下载次数: 80 |
|
| 基金项目:国家自然科学基金资助项目(82370041)；北京市自然科学基金资助项目(7222136)；中央高水平医院临床科研业务费(2022-PUMCH-B-088,2022-PUMCH-B-089)；中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-017) |
|
| 中文摘要:目的 比较猫皮屑集群免疫治疗与常规免疫治疗的安全性,并探究不良反应发生的主要影响因素。方法 招募猫皮屑单一过敏所致鼻炎伴或不伴哮喘患者,将其分为集群免疫治疗组和常规免疫治疗组。根据患者个体及注射针数(剂量递增期)比较两组不良反应发生率,并根据患者治疗开始前的基本信息分析导致不良反应发生的影响因素。结果 共招募78例患者,其中集群免疫治疗组45例,常规免疫治疗组33例。根据患者个体计算两组患者局部(P=0.648)及全身(P=1.000)不良反应发生率比较,差异无统计学意义；风团直径(P=0.321)比较差异无统计学意义；根据注射针数计算剂量递增阶段两组患者局部(P=0.705)及全身(P=0.237)不良反应发生率比较,差异亦无统计学意义。患者治疗开始前的T-IgE(OR=1.001,95% CI:1.000～1.003,P=0.032)、特异性免疫球蛋白E(specific immunoglobulin E, sIgE)/T-IgE(%)(OR=1.079,95% CI:1.003～1.161,P=0.042)、药物评分(OR=1.338,95% CI:1.055～1.696,P=0.016)、症状药物评分(OR=1.217,95% CI:1.028～1.440,P=0.022)均为局部不良反应发生的独立危险因素。猫皮屑单一过敏所致鼻炎伴哮喘患者的全身不良反应发生风险是不伴哮喘患者的16.393倍(OR=16.393,95% CI:1.076～249.752,P=0.044)。结论 集群免疫治疗组与常规免疫治疗组无论根据患者个体还是注射针数计算,局部及全身不良反应的发生率比较,差异均无统计学意义。患者治疗前的T-IgE、sIgE/T-IgE、药物评分、症状药物评分较高者需注意局部不良反应的发生,伴随哮喘症状的患者应警惕全身不良反应的发生。 |
| 中文关键词:猫皮屑 过敏性鼻炎 过敏性哮喘 变应原特异性免疫治疗 安全性 |
| |
| Comparison of Safety Between Cat Dander Cluster and Conventional Immunotherapy and Analysis of Factors Affecting Adverse Reactions. |
|
|
| Abstract:Objective To compare the safety of cluster immunotherapy versus conventional immunotherapy for cat dander-induced rhinitis, with or without asthma, and to explore the main influencing factors for the occurrence of adverse reactions. Methods Patients with cat dander-induced rhinitis with or without asthma were recruited. Patients were divided into cluster immunotherapy group (cluster group) and conventional immunotherapy group (conventional group). The incidence of adverse reactions in both groups was compared based on individual patients and the number of injections (dose escalation phase), and influencing factors for the occurrence of adverse reactions were analyzed based on the patients′ baseline information prior to treatment. Results A total of 78 patients were enrolled, with 45 in the cluster group and 33 in the conventional group. There was no statistically significant difference in the per-patient incidence of local (P=0.648) and systemic (P=1.000) adverse reactions between the two groups. The size of local reactions (P=0.321) also showed no significant difference. When the number of injections was considered during the dose escalation phase, no significant difference was observed in the per-shot incidence of local (P=0.705) and systemic adverse reactions (P=0.237) between the two groups. Pre-treatment levels of T-IgE (OR=1.001,95% CI:1.000-1.003, P=0.032), sIgE/T-IgE (%) (OR=1.079,95% CI:1.003-1.161, P=0.042), medication score (OR=1.338,95% CI:1.055-1.696, P=0.016), and symptom and medication score (OR=1.217,95% CI:1.028-1.440, P=0.022) were independent risk factors for the occurrence of local adverse reactions. Asthma patients had a 16.393-fold higher risk of systemic adverse reactions compared to non-asthma patients (OR=16.393,95% CI:1.076-249.752, P=0.044). Conclusion There were no significant differences in the per-patient or per-shot incidence of local or systemic adverse reactions between the cluster group and conventional group. Higher pre-treatment levels of T-IgE, sIgE/T-IgE, medication score, and symptom and medication score should alert clinicians to the risk of local adverse reactions, while asthma patients should be monitored for the potential occurrence of systemic adverse reactions. |
| keywords:Cat dander Allergic rhinitis Allergic asthma Allergen-specific immunotherapy Safety |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
