Long-efficacy And Influencing Factors Of Specific Subcutaneous Immunotherapy In Children With Dust Mite Allergy

[Objective] To investigate the efficacy of specific subcutaneous immunotherapy(SCIT)in the treatment of children with dust mite allergies,the factors that affect the efficacy of the treatment,and to evaluate its safety.[Methods] A retrospective analysis of children diagnosed as allergic asthma with or without allergic rhinitis in the Shanghai Children’s Hospital from2005 to 2015.Dust mite allergy was determined by skin prick test or serum allergen examination.The children received standardized dust mite-specific subcutaneous immunotherapy for 3 years,and they were followed up in the asthma specialist clinic or telephone.Baseline T0 before treatment,F1 at the end of treatment,F2 after 2 years of treatment,F3 after 5 years of treatment,F4 after 7 years of treatment,all children were evaluated for asthma symptom score ASS,rhinitis symptom score RSS,rhinitis and asthma total score TSS,drug score TMS,symptomatic drug total score SMS,asthma quality of life score PAQLQ,and nasal conjunctivitis quality of life score RQLQ.ASS,RSS,TSS,TMS,PAQLQ,and RQLQ are self-evaluations of children or their parental evaluations,and the time of the evaluation is nearly one month.The treatment period of 3 years is early,the time points of F1 and F2 are short-term,and the time points of F3 and F4 are long-term.This study evaluated the short-term,sustained,and long-term effects of SCIT on children with allergies to dust mites through self-control and comparison with conventional drug groups.The age,gender,dust mite stab test diameter,personal food allergy history,drug allergy history,inhalation allergy history,and family allergy history of children before treatment were calculated.Through Spearman correlation analysis,analyze the correlation indicators that affect the clinical efficacy of SCIT.According to the early asthma control situation,it is divided into good control,partial control,and uncontrolled.According to the improvement rate of rhinitis symptoms,it is divided into an effective group and an ineffective group.The chi-square test was used to compare the long-term efficacy of asthma with good control / partial control and uncontrolled groups,and effective group and ineffective group.Explore the relationship between the early and long-term efficacy of SCIT.Adverse event during treatment,and evaluate its safety.[Results] This study followed 267 patients and included 176 patients,including 88 in the experimental group(specific subcutaneous immunotherapy group)and 88 in the control group(conventional drug treatment group).There were differences between the scores at different time points in the SCIT treatment group.The evaluation indexes of the SCIT group and the conventional drug group are different at the same evaluation time point,which is statistically significant(P <0.05).The improvement degree of asthma symptoms and the improvement degree of rhinitis symptoms at each evaluation time point are statistically significant(P<0.05).The number of people in the SCIT group who had their symptom scores and drug scores reduced to 0 is different from the conventional drug group,and the difference is statistically significant((P<0.05).Age,gender,dust mite prick test diameter,personal food allergy history,drug allergy history,inhalation allergy history and family allergy history,total Ig E,s Ig E,s Ig E / total Ig E and other indicators have no correlation with the efficacy of SCIT treatment.There is no difference in the long-term efficacy of asthma between well-controlled/partially-controlled and uncontrolled groups.There was no difference in the long-term efficacy between the effective group and the ineffective group in improving rhinitis symptoms.The incidence of grade 1adverse reactions was 97.72%,the incidence of grade 2 adverse reactions was 1.14%,and the incidence of grade 3 adverse reactions was 1.14%.[Conclusions](1)SCIT treatment of children with dust mite allergic asthma with or without allergic rhinitis can effectively improve symptoms,reduce medication,improve quality of life,and change the long-term course of disease.(2)The improvement degree of rhinitis symptoms is more obvious in boys than girls.(3)SCIT treats children with allergic asthma and allergic rhinitis,the early treatment effect is not obvious,and the long-term effect is certain.(4)The incidence of local adverse reactions during the treatment of SCIT was 97.72%,and the incidence of systemic adverse reactions was2.28%.No serious life-threatening adverse reactions occurred.