患有较大的局部反应的患者应该接受毒素免疫疗法吗? 一场支持反对的辩论
M Beatrice Bilò1, David B K Golden2, M Chiara Braschi3
1Allergy Unit, Department of Internal Medicine, University Hospital AOU delle Marche, Ancona, Italy; Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
概括
昆虫刺伤引起的大型局部反应 (LLR) 可以损害生活质量. 虽然指南不建议对LLRs进行毒素免疫疗法 (VIT),但本次审查讨论了其潜在的益处与风险.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 毒理学 毒理学 毒理学
背景情况:
- 昆虫刺伤经常导致大型局部反应 (LLR),这是IgE介导的免疫反应.
- 慢性肺炎可能导致显著的患者发病率和降低生活质量.
- 存在潜在的系统反应的风险,包括过敏反应,以未来的刺痛存在.
研究的目的:
- 审查目前的证据和关于使用毒素免疫疗法 (VIT) 对患有LLRs的患者的辩论.
- 在LLRs的背景下评估VIT的风险和好处.
- 为管理昆虫的LLRs提供临床决策信息.
主要方法:
- 文献综述和对现有关于昆虫刺反应和毒液免疫疗法的研究进行批判性分析.
- 检查有关LLR后过敏反应发生率的数据.
- 讨论VIT对LLRs的优缺点,考虑安全性,有效性和患者因素.
主要成果:
- 目前的指导方针不建议VIT用于LLRs,因为人们认为过敏反应的风险很低.
- 支持VIT的论点包括潜在的过敏反应风险被低估,新兴的有力刺物种,以及LLRs对生活质量的显著损害.
- 反对VIT的论点包括LLRs的一般良性性质,罕见的刺痛事件,VIT成本,与LLR患者的刺痛相比,VIT的系统反应率更高.
结论:
- 使用VIT用于LLR的决定是复杂的,应该涉及患者和医疗保健提供者之间的共享决策.
- 考虑个体患者的价值观,偏好和风险因素至关重要.
- 可能需要进一步的研究来澄清特定的LLR患者群体中过敏反应的确切风险.
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