集群免疫治疗对轻中度哮喘患者嗜酸粒细胞阳离子蛋白的影响

摘要

目的:检测集群免疫治疗(cluster immunotherapy)前后轻中度支气管哮喘患者血清嗜酸粒细胞阳离子蛋白(ECP)的变化,探讨集群免疫治疗的机制.方法:68例轻中度过敏性哮喘患者,随机分为治疗组和对照组,每组各34例,对照组给于抗阻胺药物、布地奈德气雾剂和沙丁胺醇气雾剂治疗,治疗组在应用上述药物的同时给予剂量累加阶段为期7周的集群免疫治疗,而后每4周给予1次维持治疗.两组疗程均为1年,在治疗前后分别采用Pharmacia Unicap100系统,应用免疫荧光技术检测患者血清ECP值.结果:两组中所有患者均完成了为期1年的治疗.治疗后两组患者血清ECP值均降低,治疗组血清ECP值由治疗前的(22.14±4.20)μg/L降至(11.98±2.76)μg/L,而对照组由治疗前的(21.58±4.07)μg/L降至(16.39±3.12)μg/L,治疗前后比较,差异均有高度统计学意义(均P<0.01).治疗组治疗血清ECP值明显低于对照组,两组比较,差异有高度统计学意义(P<0.01).结论:集群免疫治疗能有效降低患者血清ECP值,这可能是集群免疫治疗的机制之一,血清ECP值可能成为特异性免疫治疗有效的监测指标.%Objective: To measure the eosinophil cationic protein (ECP) values in serum of patients with mild to moderate allergic asthma treated by cluster immunotherapy with standardized dermatophagoides pteronyssinus allergen vaccine and to explore the pathogenesis of cluster immunotherapy. Methods: 68 patients with mild to moderate allergic asthma to dermatophagoides pteronyssinus were divided randomly into 34 patients in treatment group and 34 patients in control group. Patients in control group were treated with antihistamine, budesonide aerosol, salbutamol aerosol while patients in treatment group were treated with specific immunotherapy in a 7-week cluster schedule during the incremental -dose phase with standardized aluminum-adsorbed dermatophagoides pteronyssinus allergen vaccine additionally. Thereafter, patients in treatment group received maintenance-dose injection at 4-week intervals until the end of one-year of treatment. The treat -ment course of control group was one -year too. The ECP values were measured with immunofluorescent technique by Pharmacia Ljnicap 100 system in the baseline and after 1 year treatment and compared with control group. Results: All patients in two groups were completed the one-year study. The ECP values in serum of patients in two groups reduced. The ECP values in serum of patients in treatment group reduced from (22.14±4.20)μg/L to (11.98±2.76)μg/L, while those in control group reduced from (21.58±4.07)μg/L to (16.39±3.12)μg/L (all P<0.01). The ECP values in serum of treatment group were significantly lower than that of control group (P<0.01). Conclusion: Cluster immunotherapy with standardized dermatophagoides pteronyssinus allergen vaccine for mild to moderate asthma can reduce the ECP value in serum affectedly. It may be one of the pathogenesis of cluster immunotherapy and the ECP value in serum may be a parameter of the efficacy of cluster immunotherapy.