摘要
目的探讨特异性免疫治疗对变应性鼻炎(AR)患者的远期疗效及外周血T调节细胞的影响。方法选取2011年5月至2012年8月于绵阳市第三人民医院耳鼻咽喉科确诊为AR患者96例,按照随机数字表法分为观察组(51例)和对照组(45例);另选择同期在医院体检的健康人群50例作为健康组。观察组采用特异性免疫治疗,每周就诊1次,注射时间间隔30 min,每次注射一针,起始剂量20 U,剂量累计逐渐增加,15周后达到维持剂量;对照组采用常规药物治疗。分别于治疗前、治疗后15周及3年后进行疗效、生活质量评价,并观察外周血T调节细胞变化。结果两组患者治疗前、治疗15周后、治疗3年后症状改善程度评分均呈下降趋势[观察组:(8.9±1.2)分、(4.8±0.9)分、(2.5±1.2)分;对照组:(9.0±1.8)分、(4.5±0.8)分、(2.9±1.4)分],治疗15周以前对照组下降速度更快,治疗15周至治疗3年间观察组下降速度更快,差异有统计学意义(P<0.05)。治疗15周后两组总有效率比较差异无统计学意义(P>0.05)、3年后观察组总有效率高于对照组[98.0%(50/51)比86.7%(39/45)],差异有统计学意义(P<0.05)。治疗前CD4+CD25+T细胞比例观察组为(6.24±1.65)%,对照组为(6.28±1.46)%,治疗3年后观察组为(7.66±2.46)%,对照组为(6.32±1.56)%,治疗前两组患者在外周血CD4+CD25+T细胞比例显著低于健康组[(8.44±2.15)%],差异有统计学意义(P<0.05),治疗3年后,观察组患者CD4+CD25+T细胞比例较治疗前显著提高,观察组和对照组患者CD4+CD25+T细胞比例显著低于健康组,差异有统计学意义(P<0.05),对照组与治疗前比较差异无统计学意义(P>0.05)。外周血CD4+CD25hiT细胞比例与健康组及治疗前后比较差异均无统计学意义(P>0.05)。结论 AR患者特异性免疫治疗后,症状显著改善,疗效确切,生活质量明显提高,与CD4+CD25+T调节细胞功能改善有关。
Objective To explore the effects of specific immunotherapy on peripheral blood T regulatory cells in patients with allergic rhinitis( AR) and the long-term efficacy. Methods Total of 96 patients with AR treated in Mianyang Third Hospital from May 2011 to Aug. 2012 were included in the study,and divided into observation group( 51 cases) and control group( 45 cases) according to random number table method; another 50 healthy people for health examination during the same period were included as healthy group. The observation group was treated with specific immunotherapy( 1 time / week,30 min / time,initial dose of 20 U and gradually increased,reaching the maintenance dose after 15 weeks); the control group was treated with conventional therapy. The curative effect,life quality of the two groups were compared before treatment,15 weeks and 3 years after treatment. Results The symptoms score of the two groups decreased from before treatment,after 15 weeks and 3 years of treatment[observation group:( 8. 9 ± 1. 2) scores,( 4. 8 ± 0. 9) scores,( 2. 5 ± 1. 2) scores; control group:( 9. 0 ± 1. 8) scores,( 4. 5 ± 0. 8) scores,( 2. 9 ± 1. 4) scores],before 15 weeks of treatment the control group dropped more quickly while between the 15 weeks and 3 years the observation group dropped more quickly with statistically significant difference( P < 0. 05). After 15 weeks of treatment the total efficacy of the two groups was no statistically significant( P > 0. 05),after 3 years observation group was higher than the control group[98. 0%( 50 /51) vs 86. 7%( 39 /45) ],the differences was statistically significant( P < 0. 05). Before treatment,the proportion of CD4+CD25+T cells in peripheral blood of the observation group was( 6. 24 ± 1. 65) %,of the control group( 6. 28 ±1. 46) %,significantly lower than the healthy group' s( 8. 44 ± 2. 15) %( P < 0. 05),which became( 7. 66 ±2. 46) % and( 6. 32 ± 1. 56) % after 3 years of treatment respectively,but still significantly lower than the healthy group( P < 0. 05); the 3 years tr
出处
《医学综述》
2016年第10期2021-2023,2029,共4页
Medical Recapitulate
关键词
变应性鼻炎
特异性免疫治疗
远期疗效
T调节细胞
Allergic rhinitis
Specific immunotherapy
Long term effect
Regulatory T cells
