舌下免疫治疗变应性鼻炎患者的脱落特点分析

Analysis of characteristics of drop-out from sublingual immunotherapy in patients with allergic rhinitis

摘要:

目的 研究耳鼻咽喉科门诊行舌下免疫治疗（SLIT）变应性鼻炎（AR）患者的脱落率、脱落特点及脱落原因。方法 通过电话随访2018年5—8月东部战区总医院耳鼻咽喉科门诊行SLIT的AR患者343例，男214例，女129例，年龄3~55岁。根据年龄分为5组：学龄前组（3~6岁），学龄组（7~12岁），青春期组（13~20岁），青年期组（21~40岁），中年期组（41~60岁）。分析患者的脱落率。结果 ①343例患者具有完整随访资料的患者299例，其中男194例，女105例。学龄前组27例，学龄组91例，青春期组104例，青年期组66例，中年期组11例。年龄4~52岁；②随访的299例患者中，用药6个月后脱落率为51.17%；1年后脱落率为59.20%；2年后脱落率为74.25%。停药例数最多的月份位于用药的第3、4个月。男女之间的脱落率比较无差异。不同年龄组间的脱落率比较无差异；③7例患者因不良反应停止用药，占脱落患者3.15%；④排名前四的脱落原因依次为：疗程太长、对治疗效果的感知、不方便继续获取药物、经济原因。结论 AR患者SLIT脱落率较高，年龄、性别因素对脱落率的影响无明显差异；脱落最多的月份位于用药的第3、4月份。加强患者教育、加强随访、延长首次处方时长有助于减少脱落。

Abstract:

Objective To analyze the drop-out rate, characteristics of drop-outs and the causes leading to premature discontinuation of sublingual immunotherapy (SLIT) in allergic rhinitis (AR).Methods Clinical data of 343 AR patients who received SLIT in our department from May 2018 to Aug 2018 were collected by telephone follow-up and analyzed retrospectively. All the patients were divided into 5 groups based on the age (3~6 years old, preschool group; 7~12 years old, school group; 13~20 years old, puberty group; 21~40 years old, adolescent group; 41~60 years old, middle-age group).Results ①Of the 343 patients, 299 (194 males and 105 females) had complete follow-up data and aged from 4 to 52.The case numbers of preschool, school, puberty,adolescent and middle-age groups were 27, 91, 104, 66 and 11, respectively;②The drop-out rate was 51.17% at the first 6 months, 59.20% at the first year and 74.25% at the second year. Most patients terminated SLIT at the third and the fourth month of treatment. There was no difference of the drop-out rate between the male and the female groups, and the differences of the drop-out rate among different age groups were all statistically insignificant; ③Seven patients (3.15% of the drop-out cases) terminated the therapy because of adverse reactions; ④The top 4-ranked causes of drop-out were the long course of treatment, perceived efficacy of treatment, inconvenience of getting the prescription, and cost of drugs.Conclusions The drop-out rate of SLIT for AR is quite high, and the most drop-outs happen at the third and fourth month of the therapy. Neither age nor gender has an significant effect on the drop-out rate. Enhancing education of patients, strengthening follow-up and extending the duration of the first prescription may help to reduce the drop-out rate of SLIT.