过敏原特异性免疫疗法对特异性哮喘FEV1、气道反应性的影响

摘要

Objective To investigate the effect of allergen-specific immunotherapy on FEV1 and airway responsiveness in patients with idiopathic asthma.Methods 90 patients with idiopathic asthma from January 2013 to August 2015 in Deqing City People's Hospital were selected and randomly divided into control group and study group with 45 cases in each group.Control group were treated with anti-infection, relieving cough and eliminating phlegm, relieving spasm and relieving asthma, the study group was treated with allergen specific immunotherapy based on the control group, and a total of 3 months for a course of treatment.Blood samples were used to measure inflammatory mediators , airway sensitivity index, pulmonary function and airway responsiveness, at the same time, the clinical efficacy and complications were compared.Results Compared with before treatment, the levels of FVC, PEF, FEV1 and FEV1/FVC in the two groups increased, levels of AI, AO, T and WA decreased, levels of serum IL-4 decreased, levels of IL-10, IFN-γincreased, levels of serum IgE, SIgE, TIgE and EOS decreased, the difference was statistically significant (P<0.05), compared with the control group, the levels of FVC, PEF, FEV1 and FEV1/FVC in the study group were higher, the levels of AI, AO, T and WA were lower, serum IL-4 levels were lower after treatment, levesls of IL-10, IFN-γwere higher, levels of serum IgE, SIgE, TIgE and EOS were lower, the difference was statistically significant (P<0.05), and the effective rate in the control group (71.11%) was lower than the study group (88.89%), the difference was statistically significant(P <0.05).Conclusion Allergen-specific immunotherapy was effective for cough variant asthma, it can improve pulmonary function, inflammation and airway sensitivity.%目的 探讨过敏原特异性免疫疗法对特异性哮喘FEV1、气道反应性的影响.方法 选取浙江省德清市人民医院于2013年1月~2015年8月收治的咳嗽变异性哮喘患者90例,按随机数字表法分为对照组和研究组,每组各45例.对照组予以抗感染、止咳化痰、解痉平喘治疗;研究组在对照组基础上予以过敏原特异性免疫疗法治疗,共治疗3个月为一疗程,采血测定炎症介质、气道敏感性指标,测定肺功能以及气道反应性,同时对比临床疗效及并发症.结果 与治疗前比较,2组治疗后最大肺活量(forced vital capacity,FVC)、峰值呼气流速(peak expiratory flow rate,PEF)、第一秒用力呼气量(forced expiratory volume in first second,FEV1)以及第一秒用力呼气量/最大肺活量(FEV1/FVC)含量升高,治疗后气道腔面积(area of airway,AI)、气道总横截面积(total airway cross-sectional area,AO)、气道壁厚度(airway wall thickness,T)以及气道壁面积(area of airway wall,WA)水平降低,治疗后血清IL-4含量降低,IL-10、IFN-γ含量升高,治疗后血清免疫球蛋白E(IgE)、特异性免疫球蛋白E(SIgE)、总免疫球蛋白E(TIgE)以及嗜酸性粒细胞(eosinophilic granulocyte,EOS)含量降低,差异有统计学意义(P<0.05);与对照组比较,研究组治疗后FVC、PEF、FEV1以及FEV1/FVC含量较高,治疗后AI、AO、T以及WA水平较低,治疗后血清IL-4含量较低,IL-10、IFN-γ含量较高,治疗后血清IgE、SIgE、TIgE以及EOS含量较低,差异有统计学意义(P<0.05);对照组有效率71.11%低于研究组有效率88.89%,差异有统计学意义(P<0.05).结论 过敏原特异性免疫疗法对咳嗽变异性哮喘疗效显著,提高肺功能,改善炎症以及气道敏感指标.