Starting a learning experience. Well written please teacher change.
2007 7 held in Chengdu on 5 September, Abbe gifted Corporation, West China Hospital Professor Xue Dehou chaired the meeting. Capital Institute Professor Chen Yuzhi children, Guangzhou Institute of Respiratory Diseases, Professor of change
state reaction Keli Jing made a keynote speech. If the United States, West China Second Hospital of the king, and shared in the Yi Fuyuan Professor Liu Xiaofan them in specific immunotherapy experience.
Professor Chen Yuzhi to do the report was Asthma children and contact from the flu caused by allergens. And a third of parents did not pay attention to this, or that their child's asthma well controlled. At present 80% of the rhinitis and 50% to 80% asthma is allergic in nature, mostly mite allergens, pollen, insects, cat hair, dog hair and so on. In China allergic rhinitis and allergic bronchial asthma allergens outpatient multi-center clinical investigation (CARRAD) suggest the most common to mite allergens (67% to 80%), which mainly house dust mites, pets with the increase in recent years, cat hair, dog hair, as the percentage increase in allergens, allergic rhinitis, bronchial asthma allergen skin test positive rate of 80%. now that was the respiratory tract allergic disease is continuous, the best allergy treatment (OAT): Under the guarantee the validity of the premise of safety, select both the upper and lower respiratory therapy program at the same time. but in the global Asthma
2006 edition (GINA2006) in the specific immunotherapy is not in a important position. A number of studies show that early initiation of treatment of asthma can quickly relieve and improve symptoms , to reduce drug consumption, reducing airway hyperresponsiveness. One of the children pre-school
long-term (2 years) after inhaled corticosteroid withdrawal is not going to improve asthma symptoms, and the same long-term (2 years) specific immunotherapy children, stop the treatment but can be sustained after the relief of symptoms or no asthma attacks. a long
10 years of research shows that, while standardized treatment of asthma in children and the efficacy of specific immunotherapy is superior to separate standardized treatment of asthma in children. In summary, the early start desensitization therapy can reduce asthma attacks, reduce the use of hormones
, induction of immune tolerance, sustained prevention of allergy, to avoid further deterioration, and even cure asthma can do.
Professor Li Jing do report, the mechanism of immunotherapy (SIT) of the mechanism, this is the only basis for the etiology of allergic disease treatment. SIT course of treatment should pay attention to the following one, looking for allergens; 2, selecting the right patients ; 3, with the vaccine; 4, adjusting for dose; 5, deal with adverse reactions. looking for methods 1 allergen, in vivo tests; 2, in vitro experiments; 3, nasal or airway challenge test. need to find out after allergen Analysis of allergens associated with the symptoms, then consider whether on balance the line SIT treatment. generally less than 5 years old, more than 60 years of age regardless of SIT. The contraindications are severe cardiopulmonary disease, malignancy, is b blockers in patients in FEV1 (1 second forced expiratory volume) is less than 70% of the expected value is also not suitable to the SIT.
SIT uses standardized allergen sensitization must contain all the relevant proteins . efficacy was positively correlated with the injected dose, treatment, need to ensure access to maintain the phase volume of each injection, 5-20 mg, if the maintenance dose is less than 5ug desensitization can not achieve satisfactory results.
SIT the need to avoid or minimize the process reduce the possibility of exposure to allergens. such as allergies to dust mites, you can use density, surface without uneven bedding, need to be cleaned every month, 60 ℃ water for 5 minutes or more can kill dust mites.
SIT poor treatment compliance, to patients with rhinitis, non-compliance of the main reasons are: lack of understanding of treatment and on the efficacy of doubt. causes of poor efficacy compared to 1, poor environmental control, are still too many, too frequent exposure to allergens; 2 diagnostic errors; 3, the use of standardized allergen error; 4, the premature cessation of treatment; 5, can not tolerate the higher dose (generally greater than 5ug dose) of allergen. < br> If the patient is allergic to multiple allergens, SIT should pay attention when, can not accept more than three kinds of allergen desensitization therapy, the injection time for each allergen over half an hour every time, different types of changes should be the original can not be mixed injection.
SIT's are divided into local and systemic adverse reactions, systemic reactions occur may be due to 1, the period of drug dose increases; 2, the injection of the wrong allergens; 3, the misuse by intravenous the allergen into the blood circulation; 4, highly sensitive to allergens; 5, uncontrolled asthma; 6, conducted before the injection of intense physical activity; 7, the replacement of the bottle; 8, the use of b-blockers; 9, exposure to a large number of allergens. for high-risk patients, the need to avoid rapid desensitization treatment programs to reduce injection treatment. were no serious systemic reactions are required to stop treatment.
in Yifu Yuan of Professor Liu Xiaofan and West Professor Wang Meiruo the hospital has done a report, shared their experience in specific immunotherapy. emphasized the treatment of asthma patients should pay attention to enhancing education, avoid contact with allergens, the use of standardized treatment of asthma and early start desensitization therapy.
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