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目的:评估规范化舌下特异性免疫治疗(SLIT)不同年龄组儿童过敏性哮喘伴鼻炎的临床疗效。方法:回顾性分析250例3~13岁过敏性哮喘伴鼻炎患儿的临床资料,按年龄分为低龄组(3~6岁,128例)和高龄组(7~13岁,122例),进行2年SLIT治疗,评估两组患儿治疗前后的哮喘日间、夜间症状、药物评分、VAS评分和肺功能FEV1、PEF%水平以及鼻炎的症状、用药评分。结果:与治疗前相比,2组患儿在SLIT治疗半年、1年、2年时哮喘DASS、NASS、TAMS、VAS评分和肺功能FEV1、PEF%以及鼻炎的TNSS、TRMS均有显著变化,差异均有统计学意义(均P<0.05);同时,治疗在1、2年后,疗效持续得到巩固,TAMS、VAS、TNSS和TRMS进一步降低(均P<0.05);治疗后的各个时间点,仅在SLIT治疗半年时TAMS、VAS评分方面,低龄组要明显低于高龄组(Z=4.58、2.45,均P<0.05),其余组间差异无统计学意义(均P>0.05)。结论:采用标准化粉尘螨滴剂对尘螨致敏的哮喘伴鼻炎患儿进行2年SLIT能获得显著疗效,低龄组与高龄组疗效一致。
Objective: To evaluate the clinical efficacy of normalized sublingual immunotherapy (SLIT) in children of different age groups with allergic asthma and rhinitis. Methods: The clinical data of 250 cases of allergic asthma with rhinitis from 3 to 13 years old were retrospectively analyzed. They were divided into three groups according to age: young group (3-6 years old, 128 cases) and senior group (aged 7-13 years, 122 cases) The 2-year SLIT treatment was performed. The asthma daytime and nighttime symptoms, drug scores, VAS scores, pulmonary function FEV1, PEF% levels and the symptoms and medication scores of asthma in both groups before and after treatment were evaluated. Results: Compared with those before treatment, the two groups had significant changes in DASS, NASS, TAMS, VAS score, pulmonary function FEV1, PEF% and TNSS and TRMS in rhinitis at six months, one year and two years after treatment with SLIT, (All P <0.05). At the same time, the therapeutic effects continued to be consolidated after 1 and 2 years of treatment, and the levels of TAMS, VAS, TNSS and TRMS were further decreased (all P <0.05); at various time points after treatment (P <0.05). There was no significant difference between the other groups (P> 0.05). Only in the half year of SLIT treatment, the scores of TAMS and VAS in young group were significantly lower than those in senior group (Z = 4.58,2.45, all P <0.05). CONCLUSIONS: Two-year SLIT treatment of dust mite-sensitized asthmatic children with rhinitis achieved a significant effect using standardized dust mite drops, with similar efficacy in the younger and older age groups.