【摘要】 目的　探讨抗原特异性免疫治疗 (SIT)对过敏性鼻炎的疗效及作用机制。方法　将豚草致敏的季节性过敏性鼻炎患者 132例随机分为治疗组(SIT组 ,n =6 8)、对照组 (症状性治疗组 ,ST组 ,n =6 4 ) ,另选 4 0例健康人为健康组。用豚草变应原进行季节前 6个月的抗原特异性免疫治疗 ,疗程为 3年。分别测定各组细胞因子IL 4、IL 5、IFN γ的含量 ,血清sIgE、TIgE、ECP、IgG水平和外周血嗜酸性粒细胞 (Eos)计数。比较SIT组和ST组治疗前、后上述各指标及肺功能、鼻炎症状评分和皮肤试验指数的变化。结果　与ST组比较 ,SIT组血清TIgE、ECP水平 ,血Eos计数 ,细胞因子IL 4、IL 5水平均明显下降 (P <0 0 1) ,而IgG和IFN γ含量明显上升 (P <0 0 1)。两组sIgE水平差异无统计学意义 (P >0 0 5 )。SIT组临床控制 30 88% ,显效 4 1 18% ,好转 2 0 5 9% ,无效 7 35 % ;其中出现轻度不良反应的占 16 18%。ST组治疗前、后上述各种参数无明显改变 ,其中 2 5 % (16 / 6 4 )的过敏性鼻炎患者在第 3年发生哮喘。结论　SIT能明显改善过敏性鼻炎的临床症状和相关实验室指标 ,是治疗过敏性鼻炎的有效方法之一。更多还原

【Abstract】 Objective To evaluate the effectiveness of allergen specific immunotherapy (SIT) in the treatment of allergic rhinitis. Methods A total of 132 patients with seasonal ragweed allergic rhinitis were enrolled in this study. The patients were randomly divided into two groups. SIT group, in which 68 patients were treated with ragweed SIT for six months before July for 3 years. ST (symptomatic therapy) group, in which 64 patients were treated with ST during seasonal symptomatic period. The healthy control group included 40 subjects. The levels of serum total IgE (tIgE), specific IgE (sIgE), ECP, IgG and IL-4, IL-5, IFN-γ were measured, and eosinophil numbers were counted. The symptom score, lung-function test and skin prick test were performed before and after the treatment. Results The elevated levels of tIgE, ECP, IL-4, IL-5 in the sera and eosinophil counts in peripheral blood of the patients were significantly reduced, whereas the levels of IgG and IFN-γ were increased following SIT. The levels of serum sIgE were not changed in both SIT and ST groups. 30.88% of the patients were clinically cured, the effective rate was 41.18%, the improvement rate was 20.59% after SIT, and only in 7.39% of patients there was no clinical improvement. In 16.18% of patients there were mild side effects to SIT. In the ST group, there was on change in all the laboratory results and clinical symptoms, and 25% of the patients developed asthma. Conclusion SIT was able to improve the symptoms and laboratory results of the patients with allergic rhinitis. The results indicated that SIT may be an effective and safe therapy for patients with allergic rhinitis.更多还原