Observation Of The Immunological Parameters And Acoustic Rhinometry In Allergic Rhinitis Patients During The Dose-accumulating Stage Of Specific Immunotherapy

Objective:1.To evaluate the curative effect of subcutaneous specific immunotherapy(SCIT)in patients with allergic rhinitis.2.To observe the changes of saliva sIgG4,serum immunological parameters(sIgG4,eosinophils,total IgE,sIgE)and acoustic rhinometry during the dose-accumulating stage of subcutaneous specific immunotherapy(SCIT)in patients with allergic rhinitis(AR).3.To analysis of the correlation between saliva sIgG4 and serum sIgG4.Methods:1.Forty-two cases were randomly selected form the mite-sensitive AR patients who received SCIT treatment at the Affiliated Hospital of Ningbo University from August 2015 to June 2016.The VAS score,blood eosinophil(absolute value,percentage),the concentration of total IgE,sIgE,sIgG4,saliva sIgG4 concentration and total nasal cavity as well as the nasal minimum cross-sectional area were recorded and compared before and after the treatment in the dose accumulation stage.Follow-up and record their adverse effects.2.Calculate the efficacy of patients after treatment through the efficacy evaluation formula,and compare the changes of VAS score,serum indexes and changes of saliva s Ig G4 concentration and nasal test(total volume of nasal cavity,minimum cross-sectional area)before and after treatment.3.Analysis the correlation between serum sIgG4 and saliva sIgG4 before and after treatment.Results:1.41 cases of AR patients completed the treatment of dose-accumulating stage in 42 cases.Compared with before treatment,VAS score of the main symptoms(nasal congestion,nasal itching,runny nose,sneezing and accompanied symptoms(itching),were significantly different(p <0.05).The total effective rate was 78.05%(32/41).Among41 patients,the markedly effective rate was 21.95(9/41);the effective rate was 56.10%(23/41);the ineffective rate was 21.95%(9/41).2.Compared with before treatment,Serum sIgG4 concentration,saliva sIgG4 concentration,total nasal cavity and minimal cross-sectional area were significantly different(p <0.05).3.There were no significant differences in the absolute value and percentage of eosinophils,the concentration of total IgE and sIgE after the treatment(P> 0.05)compared with before treatment.4.Serum sIgG4 was positively correlated with saliva sIgG4 before treatment(R = 0.734,P <0.05).The correlation between serum sIgG4 and saliva sIgG4 was not significant(R = 0.304,P> 0.05)after the treatment.Conclusion:1.SCIT can control and improve the symptoms of allergic rhinitis effectively,nasal congestion,nasal itching,runny nose,sneezing and the accompanied symptoms itching.2.SCIT can increase the serum and saliva sIgG4 concentration of the AR patients,which may be used as an important immunological index to evaluate the clinical curative effect of immunotherapy.3.Compared with before treatment,the total volume of the nasal cavity and the minimum cross-sectional area are significantly increased,indicating that immunotherapy in the early can significantly improve nasal ventilation function.4.The relationship between serum sIgG4 and saliva sIgG4 needs deep study through expanding the sample size,prolonging the follow-up time and so on.