Methods: All of 70 dust mite allergic asthma and rhinitis children with mild to moderate severity were enrolled (male 52, female 18, 4 to 14 years old) February to November in 2011. 57 patients took add-on therapy of sublingual dust mite specific immunotherapy (SLIT) while the other 13 patients with subcutaneous immunotherapy (SCIT). The patients were visited at the baseline period and followed up every three months to assess asthma control test (ACT), visual analog scale (VAS) of asthma and rhinitis symptom and spirometry for pulmonary function test. All the subjects were required to continuously record daily symptom and medication score (SMS) by diary card and to monitor morning and night peak expiratory flow value (PEFR) each day. The controller medication were adjusted to step up or down according to the control level. At the baseline period and after treatment for 6 months and 12 months, serum sIgE and sIgG4 to dermatophagoides pteronyssinus and dermatophagoides farinae, total IgE were determinated by enzyme-linked immunoassay with immunCAP system.
Results: (1)The analysis of clinical efficacy of dust mite specific immunotherapy in allergic asthma and rhinitis children. 54 patients completed treatment for 12 months. The average daily SMS was used as the evaluation index, the clinical response to SIT (effective cases) at 3, 6, 9 and 12 months after SIT were 72.2%, 75.9%, 81.5% and 87.0%, respectively. The ACT/C-ACT assessment, average daily SMS, VAS score, FEV1%pred, MMEF%pred, FEV1%pred, MMEF%pred were all improved than before treatment. (2)The analysis of the impact factors in the clinical efficacy of dust mite specific immunotherapy. The SMS at the baseline period, the asthma history and PEF%pred at the baseline period could affect the clinical efficacy of dust mite specific immunotherapy.
Conclusions: 87.0% of the patients showed effective response to SIT for one year. The patients with higher baseline SMS, shorter asthma history and lower PEF%pred responsed more effectively to SIT.