纯化葎草花粉变应原免疫治疗的研究

目的　观察纯化草花粉变应原特异性免疫治疗 (SIT)的疗效。方法　采取凝胶过滤方法部分提纯草花粉变应原。将 86例季节性草花粉过敏性哮喘患者随机分为纯化草花粉变应原SIT观察组 (A组 )及粗制变应原SIT对照组 (B组 ) ,采取双盲法 ,为时半年。观察临床疗效、副反应 ,以及SIT前后的T淋巴细胞亚群、皮肤试验 (IT)风团直径、嗜碱性粒细胞脱颗粒试验 (HBDT)指数及特异性IgE (sIgE)指数均值。 结果　A组总有效率 90 .7%(39/ 4 3) ,B组 79.1% (34/ 4 3,P <0 .0 5 )。A组SIT后仅 1例出现轻度副反应。两组SIT后CD4细胞及CD4/CD8显著降低 ,CD8细胞显著升高 ,且A组变化更明显。两组SIT后ID风团直径、HBDT指数及sIgE指数均值都较SIT前明显下降 (P均 <0 .0 1) ;A组SIT后上述指标下降程度较B组更明显 (P均 <0 .0 1)。结论　纯化草花粉变应原SIT的疗效优于粗制变应原 ,副作用小。提示纯化草花粉变应原SIT后对变态反应抑制性强于粗制变应原。

The effect of immunotherapy with purified humulus pollen allergens for asthma patient

Objective To study the effect of specific immunotherapy (SIT) with purified humulus pollen allergens for asthma patients. Methods The humulus pollen allergens were purified partially by gelatin filtration. A double-blinded study was carried out. Eight-six patients with seasonal humulus pollen allergic asthma were divided randomly into two groups: observation group (group A) and control group (group B), which were administered SIT with purified or crude humulus pollen allergens, respectively, before the allergic season for half a year. The clinical effect and side effects were observed. The laboratory observation norms included T lymphocyte subpopulation, the wheals’diameter of IT, the average index of HBDT and the specific IgE before and after SIT . Results The general effect of SIT with purified allergens in group A was 90.7% (39/43), and that with crude allergens in group B was 79.1% (34/43) (P<0.05). Only one patient in group A suffered mild side effect after SIT. The patients’ CD 4and CD 4/CD 8decreased significantly and CD 8increased significantly after SIT, especially in group A. A significant decrease in diameter of skin wheal, average index of HBDT and sIgE (P< 0.01) were observed after SIT with both types of allergens but to a significantly greater extent for purified humulus pollen allergen (P< 0.01). Conclusion The effects of purified humulus pollen allergens in SIT were higher than that of crude allergens, and the side effect of the former was milder than that of the latter. The results suggest that SIT with purified allergen is more effective than crude allergen in controlling allergic disease.