Objective: To investigate the incidence and risk factors of systemic allergic reactions induced by subcutaneous immunotherapy (SCIT) in patients undergoing SCIT injections in Peking Union Medical College Hospital (PUMCH). Methods: This is a single center retrospective cohort study. Using the outpatient information system of PUMCH, the demographic information and injection-related reaction data of patients undergoing SCIT injection in Allergy Department of PUMCH from December 2018 to December 2022 were retrospectively analyzed to count the incidence and risk factors of systemic allergic reactions caused by SCIT. Mann-Whitney nonparametric test or chi-square test was used for single-factor analysis, and multiple logistic regression was used for multiple-factor analysis. Results: A total of 2 897 patients received 18 070 SCIT injections in Allergy Department during the four years, and 40 systemic allergic reactions occurred, with the overall incidence rate of 0.22%. The incidence of systemic allergic reaction was 0.37% when using imported dust mite preparation and 0.15% when using domestic multi-component allergen preparation. The risk factors significantly related with SCIT-induced systemic allergic reactions in patients using imported dust mite preparation were age less than 18 years old (OR=3.186,95%CI: 1.255-8.085), highest injection concentration (OR value could not be calculated because all patients with systemic reactions were injected with highest concentration), and large local reaction in previous injection (OR=22.264,95%CI: 8.205-60.411). The risk factors for SCIT-induced systemic allergic reactions in patients using domestic allergen preparation were 5 or more types of allergens (OR=3.455,95%CI: 1.147-10.402), highest injection concentration (OR=3.794,95%CI: 1.226-11.740) and large local reaction in previous injection (OR=63.577,95%CI: 22.248-181.683). However, SCIT injection in pollen allergic patients during the pollen season did not show a correlation with systemic allergic reaction. Conclusion: The incidence of SCIT-induced systemic allergic reactions was low in the Chinese patient population of this study. Patients with one or more risk factors, such as multiple allergen injection, highest injection concentration, large local reaction in previous injection, should be given high attention and vigilance against systemic allergic reactions.
目的： 探讨在北京协和医院进行变应原皮下注射免疫治疗（subcutaneous immunotherapy，SCIT）注射的患者群体中SCIT所致全身过敏反应的发生率及其危险因素。 方法： 这是一项单中心回顾性队列研究，使用北京协和医院门诊信息系统，回顾性分析从2018年12月至2022年12月在北京协和医院变态反应科进行SCIT注射操作的患者人口学信息及注射相关反应数据，统计SCIT所致全身过敏反应的发生率及危险因素。单因素分析使用Mann-Whitney非参数检验或卡方检验，多因素分析使用多元logistic回归方法。 结果： 四年期间共有2 897例患者在变态反应科接受了18 070次SCIT注射，发生全身过敏反应40次，总体发生率为0.22%。使用进口尘螨制剂注射时全身过敏反应发生率为0.37%，使用国产多成分变应原制剂注射时全身过敏反应发生率为0.15%。在使用进口尘螨制剂的患者中，年龄小于18岁（OR=3.186，95%CI：1.255~8.085），最高浓度注射（因发生全身过敏反应的患者均注射的是最高浓度，故无法计算OR值），既往注射有大局部反应（OR=22.264，95%CI：8.205~60.411）是与发生SCIT所致全身过敏反应显著相关的危险因素。在使用国产变应原制剂的患者中，注射变应原种类≥5种（OR=3.455，95%CI：1.147~10.402），最高浓度注射（OR=3.794，95%CI：1.226~11.740），既往注射有大局部反应（OR=63.577，95%CI：22.248~181.683）是全身过敏反应的危险因素。而花粉过敏患者在花粉季中进行SCIT注射这一因素，并未显现出与全身过敏反应的相关性。 结论： 在本研究的中国患者群体中，SCIT所致全身过敏反应的发生率低。对于具有使用多种变应原注射、最高浓度注射、既往注射有大局部反应等一种或多种危险因素的患者，应当予以高度重视，警惕其发生全身过敏反应。.