Thay đổi một số chỉ tiêu miễn dịch ở bệnh nhân viêm mũi dị ứng do dị nguyên lông vũ được điều trị miễn dịch đặc hiệu đường dưới lưỡi

THAY odl MO T Sd CHJ TIEU MII N DjCH OT BENH NHAN VIEM MUI Dj UfNG

DO Di NGUYEN LON G VU OU0C DIEU TRI MIEN DICH DAC HIEU DUUNG DUIDTI LUUl

TOMTAT:

Nghiin ciru can thigp theo ddi dgc, tw ddi chimg cho

40 bgnh nhin dwgc chin doan xae djnh la viim mui dj

img do dj nguyen Idng vu tgi Hal Phdng. Kit qua sau 6

thing diiu tq cic eh! tieu mien djch deu eai thign rd rgt

so vdi trwdc diiu tri ed y nghTa thdng ke: Test kieh thich

mui sau diiu tn cd 7,5 % (-) va 70 % (+) so vdi trwdc

dieu tri dwang tinh 100%, tmng dd chu yiu la (++) vi

(+++): 87,5 %; Phan ung tieu bgch ciu: tnrdc diiu tri

100% dwang tinh, sau diiu tri 35 % am tinh; Phan ung

phan huy Mastoeyte: tnrdc dieu trj 92,5 % dwang tinh,

sau diiu trj 37,5 % im tinh. IgE toin phin trwdc diiu tri

523,59 ± 369,83, sau diiu tri 315,24 ± 230,47 Ul/ml; IgG

toin phin tnrde dieu tri 1000,33 ± 111,62, sau dieu trj

1862,95 ± 276,69 mg%,.

Twkhda : viem mui dj img, dj nguyen Idng vu

SUMMARY

CHANGES IN SOMES IMMUNOLOGICAL INDICATORS

IN PATIENTS WITH ALLERGIC RHINITIS DUE TO FEATHER

ALLERGEN TREATED BY USING SPECIFIC SUBLINGUAL

IMMUNOTHERAPY

Auto controlled follow-up study included 40 patients

with allergic rtiinitis due to feather allergen at Haiphong

City. After 6 months of treated by specific sublingual

immunotherapy (SLIT) with feather allergen 300IR/ml all

immunological parpmeters significantly had been

impmved (p<0.05) such as: Before the treatment, 100%,

of nasal pmvoeation test (NPT) was positive, but after

the tmatment the number mduees and 7.5% with NPT

have negative:, especially number of patients with NPT

(++) .and (+++) deemase from 87.5%, to 22.5%.

Destmying leucocyte test befom tmatment: 100%, wem

positive and after 35%, negative (p<0.05); Decomposition

mastoeyte test befom tmatment: 92.5% wem positive

and 37.5%, negative (p<0.01). Momover, the tmatment

makes change." In semm immunoglobulin, such as

reduction of total IgE level (before the tmament, IgE

level was 523.59 Ul/ml, after the treatment that was

315.24 Ul/ml), incmase in total IgG synthesis (before the

treament IgG levels were 1,000.33 mg%, and after the

treatment that was 1.862.95 mg% (p < 0.05).

* Keywonjs: Allergic .rhinitis; Feather allergen;

sublingual immunothempy. ^

DATVANOfe

Dilu tri vigm mui dj ung (VMDLf) theo ca ehl bgnh

sinh, hay cdn gpi lg MDDH, lg mpt phuang phap dilu tn

duy nhit iam thay ddi su tiln triln qua trinh tu nhien

bgnh ly dj ung, ed higu qua lgu dai ddi vdi VMDLf. Dj

nguyen dupe dua vao ea th i ngudi bgnh dj ung vdi lilu

nho tang di n cho tdi khi dgt tdi lilu iam giam hogc mit

din cac trigu ehung dj ung d nhii'ng li n tilp xiic sau vdi

dj nguygn gay bgnh. Trgn th i gidi MDDH da dupe ung

dyng rpng rai trong dilu tn eac bgnh dj ung vg higu qua

da dupe Chung minh. Dilu trj MDDH cd 2 dudng phd

bien d l dua dj nguygn vgo ca th i lg dudng tiem trong

N G 6 THANH BINH - Trudng Dai hgc Y Thii Binh

VU MINH THUC - Benh vien Tai Mui Hgng Trung uong

da (SIT) vg dudng nhd dudi luai (SLIT). Trong dd, SLIT

t h i hign dupe su uu vigt han bdi tinh an togn va mue

dp thugn tign eho bgnh nhan.

Mgt khgc dj nguyen Idng vu (DNLV) da dupe dieu

ehl vg chuin hda tgi Vipt Nam. Han nii'a ty Ig mle

VMDU' do DNLV tgi Vigt Nam lg tuang ddi cao, dgc bigt

la d nhirng ngudi lgm vigc tgi nai ehl biln Idng vu vg

chgn nudi gia elm (26,15-32,5%).

Ndi tdi bgnh dj ung la ndi din vai trd trung gian eua

IgE vg mpt sd macker mien dieh khac. Xet nghigm cae

chit nay d cac bpnh nhan dupe dilu tn theo phuang

phap mien djch dgc higu trudc, trong vg sau rit ed gig

tri- Dua tren nhirng su thay ddi ciia cac xet nghigm mien

djch kit hpp vdi su thay ddi eac trigu ehung lgm sgng

ed th i dgnh gia chinh xgc dupe higu qua cua MDDH ddi

vdi VMCLf. Vi vgy, nghien cuu sy thay ddi cgc chi tieu

mien djch d bgnh nhan VMDLC do DNLV dilu tn bing

MDDH dudng dudi luai lg hit sue ein thiet va hiru ich.

Vi vgy chiing toi nghien cuu d l tgi nay vdi myc tieu:

Danh gia sw bien ddi mgt sd chi tieu mien djch &

bgnh nhan bgnh nhan VMDW do DNLV sau 6 thing

dieu trj mien djch dgc higu dwdng dwdi Iwdi.

D 6 I TU'P'NG VA PHLCQNG PHA P NGHIEN CIJU

1. odi tu'p'ng nghien ciru

Gdm 40 bgnh nhan dupe chin doan xic djnh la

VMDLT do DNLV dupe dieu trj bing MDDH dudng dudi

luai.

* Dja dilm thue hign: tgi khoa Mien djch-Dj ung iam

sang, Dgi hpc Y Hai Phdng.

* Thdi gian tu 01/2009-12/2009.

2. Phuang phap nghien ciru

2.1. Thilt k l nghien ciru: Nghien cuu can thigp

theo doi dpc, tu ddi ehung.

2.2. Phuang phap nghien eu'u.

2.2.1. Phwang phip dieu trj MDDH

- Tiln hanh tgi khoa Mien djch-Dj ung iam sang, Dgi

hpc Y Hai Phdng.

- Dj nguyen Idng vij do Bgnh vign Tai mOi hong

Trung uong san xuit, ndng dp 10 IR/ml, 100 R/ml vg

300 R/ml.

* Ky thugt tiln hgnh: Theo quy trinh dieu tn ciia

Bousquet:

Thi bit di u nhanh (dilu trj bit diu , tgng lieu): thudc

sir dung vgo budi sgng liic doi. Lilu su dung cd dupe

bing each bdp vao bp phgn bam, thudc bam true tilp

vao dudi ludi vg d l ygn trong vdng 2 phiit trudc khi

nudt. Thudc dupe sir dung theo kieu tgng lieu hang

nggy eho di n khi dgt dupe lilu duy tri. Thdi gian thudng

keo dgi 1 thgng.

Thi duy tri: Lilu duy tri dupe sir dyng la 4 lilu (ndng

dp 300 IR/ ml) /ngay. Ndng dp 300 IR/ ml Ja dupe

ehung td trong cae thu nghipm lam sang cd ddi chung lg

ndng dp thich hpp nhit d l nhanl, chdng dgt dupe lieu

tieh luy higu qua.

Y HOC THl/C HANH (741) - SO 11/2010 93