An Investigation of Allergens of Allergic Rhinitis and An Efficacy Analysis of 78 Cases Accepted Specific Immunotherapy in Dalian
|School||Dalian Medical University|
|Keywords||allergic rhinitis skin prick test specific immunotherapy allergen vaccines dust mite|
Objective: To investigate the positive rate of skin prick test (SPT) and allergens distributions in patients with allergic rhinitis in Dalian, as to prove a reliable basis for the prevention and treatment of allergic rhinitis. And to evaluate the efficacy and safety of the standardized dust mites vaccine for the treatment of allergic rhinitis by making a clinical analysis of standardized specific immunotherapy on our hospital allergic rhinitis patients.Methods: Retrospective analysis of the patients who accepted outpatient treatments in the department of Otolaryngology Head and Neck Surgery of the First Affiliated Hospital of Dalian Medical University during 2008.3-2011.3.1035 cases who suspected allergic rhinitis took the SPT with 13 groups of standardized allergen (Alutard ? SQ). We selected patients in accordance with perennial allergic rhinitis diagnostic criteria of Lanzhou(2004), used self-control methods to compare the clinical efficacy which was evaluated by the symptom , sign and VAS scores after 1 year and 2 years’immunotherapy with the pretreatment scores of 78 patients with allergic rhinitis caused by dust mite and we take Wilcoxon singned-rank test and other tests for statistical analysis.Results: 802 in 1035 cases with allergic rhinitis were positive to one allergen group at least (77.5%). The positive rates of dust mites, house dust mites and tropical mites were 63.7%, 61.2% and 39.6%, followed by Artemisia (24.2%), dog dander (22.9%), American cockroach (14.7%), German cockroach ( 10.9%), ragweed (9.7%), cat hair (7.8%), molds I group (7.3%), pollen I group (3.6%), pollenⅡgroup (3.1%) and moldsⅡgroup (2.1%). SPT-positive rates of males and females were 77.8% (375/482) and 77.2% (427/553), difference between men and women was not significant (p> 0.05).SPT-positive rates of children, youth and elderly group were 91.6%, 76.7% and 62.6%. The total positive rate of SPT decreased with age, difference between any two groups was significant ( P<0.05). Patients with allergic rhinitis in Dalian combined with asthma account for 10.2%. Symptom-sign scores between men and women before treatment of 78 patients who accepted specific immunotherapy were not significant(P> 0.05), the symptom-sign and VAS scores of patients completed one year immunotherapy compared with which before treatment were significantly reduced, the differences were statistically significant (P <0.05 ); Symptom-sign scores of the patients who completed 2 years’treatment compared with which of pretreatment and 1 year’s treatment were significantly reduced, the differences were significant (P <0.05). 12 cases was with asthma. After treatment, nasal symptoms and asthma symptoms were relieved, there was no significant difference compared with pure AR in efficacy(P>0.05). 40 cases appeared mild local reactions in treatment, 1 systemic adverse reactions, and no fatal systemic adverse reactions..Conclusions: SPT-positive rate of patients with allergic rhinitis in Dalian was higher and decreased with age. The positive rate of skin prick test between men and women was no significant difference. Dust mite is the most important inhaled allergens in Dalian, which provide a basis for epidemiological and clinical data for prevention and treatment of allergic rhinitis in the region. Incidence of asthma of allergic rhinitis patients with asthma in Dalian was significantly higher than that of the general population. Standardized allergen treatment is the effective and safe treatment for allergic rhinitis caused by dust .For improving the efficacy, we proposed to complete the enough course of treatment.