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目的:探讨奥马珠单抗对过敏性鼻炎合并中度持续性支气管哮喘的临床疗效。方法:回顾性分析于郑州大学第一附属医院接受治疗的167例过敏性鼻炎合并中度持续支气管哮喘患者的临床资料。167例患者中，82例给予中剂量ICS/LABA类药物(布地奈德福莫特罗吸入粉雾剂或沙美特罗替卡松吸入气雾剂)联合奥马珠单抗治疗者为观察组，85例给予高剂量布地奈德福莫特罗吸入粉雾剂或沙美特罗替卡松吸入气雾剂治疗者为对照组。评估两组各时间点相关检测指标[血免疫球蛋白E(IgE)、外周血嗜酸性粒细胞(EOS)，呼出气一氧化氮(FeNO)、哮喘控制测试评分(ACT)]、肺功能指标[第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%pred)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)]及鼻部症状缓解情况。结果:对照组治疗3个月IgE、FeNO水平低于治疗前，ACT、FEV1、FEV1/FVC水平高于治疗前( P<0.05)，对照组治疗后12个月IgE、FeNO水平低于治疗前，ACT、FEV1、FEV1%pred、FEV1/FVC水平高于治疗前( P<0.05)；对照组治疗12个月FeNO水平低于治疗3个月，FEV1、FEV1%pred、FEV1/FVC水平高于治疗3个月，鼻部症状缓解情况优于治疗3个月( P<0.05)。观察组治疗3、12个月IgE及FeNO水平低于治疗前，ACT、FEV1、FEV1%pred、FEV1/FVC水平高于治疗前( P<0.05)；观察组治疗12个月IgE、FeNO水平低于治疗后3个月，ACT、FEV1、FEV1%pred、FEV1/FVC水平高于治疗后3个月，鼻部症状缓解优于治疗后3个月( P<0.05)。治疗3个月，观察组FeNO水平低于对照组，ACT、FEV1、FEV1/FVC水平高于对照组( P<0.05)；治疗12个月，观察组IgE、FeNO水平低于对照组，ACT、FEV1、FEV1%pred、FEV1/FVC水平高于对照组，鼻部症状缓解优于对照组( P<0.05)。 结论:高剂量ICS/LABA类药物单独使用，以及中剂量ICS/LABA类药物联合奥马珠单抗于治疗3、12个月，患者呼吸功能及鼻部症状均有所缓解，但联合用药随着治疗时间的延长鼻部症状缓解、肺功能改善更明显。

Objective:To investigate the therapeutic efficacy of omalizumab on allergic rhinitis complicated by moderate persistent bronchial asthma.Methods:The clinical data of 167 patients with allergic rhinitis complicated by moderate persistent bronchial asthma who were treated in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Among the 167 patients, 82 cases treated with medium-dose ICS/LABA drugs (budesonide formoterol inhalation powder aerosol or salmeterol ticasone inhalation aerosol) combined with omalizumab were selected as the observation group, and 85 cases treated with high-dose budesonide formoterol inhalation powder aerosol or salmeterol ticasone inhalation aerosol were selected as the control group. The relevant test indicators such as blood immunoglobulin E (IgE), peripheral blood eosinophils (EOS), exhaled nitric oxide (FeNO) and asthma control test (ACT) score, pulmonary function indicators including forced expiratory volume in 1 second (FEV1), forced expiratory volume in 1 second percent predicted (FEV1% pred), forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC), and remission of nasal symptoms of the two groups were compared.Results:In the control group, the 3-month postoperative levels of IgE and FeNO were lower than those before treatment, while the 3-month postoperative levels of ACT, FEV1 and FEV1/FVC were higher than those before treatment ( P<0.05); in the control group, the 12-month postoperative levels of IgE and FeNO were lower than those before treatment, moreover, the 12-month postoperative levels of ACT, FEV1, FEV1%pred and FEV1/FVC were higher than those before treatment ( P<0.05). In the control group, the levels of FeNO after 12 months of treatment was lower, while the levels of FEV1, FEV1%pred and FEV1/FVC after 12 months of treatment were higher, and the remission of nasal symptoms was better compared with these indexes after 3 months of treatment ( P<0.05). In the observation group, the levels of IgE and FeNO after 3 and 12 months of treatment decreased compared with those indexes before treatment, moreover the levels of ACT, FEV1, FEV1%pred and FEV1/FVC increased compared with these indexes before treatment ( P<0.05). In the observation group, the levels of IgE and FeNO after 12 months of treatment decreased, while the levels of ACT, FEV1, FEV1%pred and FEV1/FVC increased compared with these indexes after 3 months of treatment, and the remission of nasal symptoms was better than that after 3 months of treatment ( P<0.05). After 3 months of treatment, the level of FeNO in the observation group was lower than that in the control group, and the levels of ACT, FEV1 and FEV1/FVC in the observation group were higher than those in the control group ( P<0.05). After 12 months of treatment, the levels of IgE and FeNO in the observation group were lower than those in the control group, the levels of ACT, FEV1, FEV1%pred and FEV1/FVC in the observation group were higher than those in the control group, and the remission of nasal symptom in the observation group was better than that in the control group ( P<0.05). Conclusions:Both high-dose ICS/LABA drugs alone and medium-dose ICS/LABA drugs combined with omalizumab can alleviate respiratory function and nasal symptoms after 3 and 12 months of treatment; however, the combined drug protocol can improve nasal symptoms and lung function more significantly with the extension of treatment time.