目的：对接受舌下特异性免疫治疗粉尘螨致敏患者进行随访，探讨变应性疾病患者免疫治疗依从性影响因素。方法回顾性分析2008年至2013年就诊于山西医科大学第一临床医学院耳鼻咽喉科161例患者的临床资料，采用Phidia ImmunoCAP全自动体外过敏原检测系统及浙江我武生物科技股份有限公司提供的粉尘螨皮肤点刺诊断试剂盒对调查病例行血清粉尘螨及皮肤粉尘螨变应原点刺检测，采用浙江我武生物科技股份有限公司提供粉尘螨滴剂对上述检测粉尘螨变应原阳性患者行舌下特异性免疫治疗，并对调查病例进行电话随访。结果（1）161例变应性疾病患者行血清粉尘螨检测、皮肤粉尘螨变应原点刺检测，结果均显示阳性；（2）舌下特异性免疫治疗前后的症状（P＜0.001）、体征（P＜0.005）差异有统计学意义；（3）电话随访161例变应性疾病患者失访6例，随访脱落率为3.73％；在治疗疗程、治疗规范、定期复查、环境控制、不良反应方面，患者综合评价评分较高组（A组）与评分较低组（B组）比较差异有统计学意义（P＜0.05）；疾病认知、预后期望两项， A组与B组差异无统计学意义（P＞0.05）。对舌下免疫治疗依从性影响因素与自行停止舌下特异性免疫治疗关联行多元Logistic回归分析，在95％可信区间内，关系强度依次为：家庭经济状况（OR＝4.12， P＜0.05）、治疗效果不明显（OR ＝3.32， P ＜0.05）、症状缓解（OR ＝3.10， P＜0.01）、个人因素（OR＝2.31， P＜0.01）、文化程度（OR＝1.58， P＜0.01）、不良反应（OR＝1.23， P＜0.05）。结论影响161例患者行舌下特异性免疫治疗疗程因素中，家庭经济状况与终止舌下特异性免疫治疗关联最强；家庭经济状况、治疗效果不明显、症状缓解、个人因素、文化程度、不良反应是患者终止治疗及依从性的常见因素。%Objective To analyze sublingual immunotherapy in house dust mite sensitized patients and to investigate the influencing factors of sublingual immunotherapy's compliance in allergic disease patients. Methods Serum house dust mite sIgE detection and skin prick test were performed among patients involved in this study by using Phidia ImmunoCAP system and house dust mite SPT Kit produced by Zhejiang Wolwo Bio-Pharmaceutical Co., Ltd.respectively.House dust mite sublingual immunotherapy was prescribed for the patients with positive SPT results by using the dust mite drops produced by Zhejiang Wolwo Bio-Pharmaceutical Co., Ltd..Followed up of the patients was based on telephone call.Results Serum sIgE and skin prick test of house dust mite were all positive among 161 allergic disease patients. The differences of symptoms ( P <0.001 ) and signs ( P <0.005 ) before and after sublingual immunotherapy were significant statistically.Withdraw rate was 3.73% ( 6/161 ) during follow-up by telephone call.The patients were divided into group A ( higher score) and group B ( lower score) based on the combine scores.The differences of duration and standardization of treatment, regular follow-up, environmental control, adverse reactions between group A and group B were significant statistically ( P<0.05) .But the differences of disease cognition and prognosis expectation between group A and B were mot significant statistically ( P>0.05 ) .The correlation between influencing factors of compliance and cessation sublingual immunotherapy was analyzed by using logistic multiple regression analysis.Intensity of correlation in proper order were familial financial conditions ( OR=4.12, P<0.05 ) , poor treatment effect (OR=3.32, P<0.05), relief of symptoms (OR=3.10, P<0.01), personal reasons (OR=2.31, P<0.01), educational attainments (OR=1.58, P<0.01) and adverse reactions (OR=1.23, P<0.05 ) within 95% confidence interval.Conclusion The familial financial condition was the strongest influencing factors for the cessation of sublingual immunotherapy among 161 patients.The familial financial conditions, poor treatment effect, relief of symptoms personal reasons, educational attainments and adverse reactions were common influencing factors of compliance and common reasons for cessation sublingual immunotherapy.
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