Abstract：
Background: Being stung by Hymenoptera species can cause life-threatening anaphylaxis. Although venom immunotherapy (VIT) seems to be the most effective treatment, its long-term efficacy, and risk factors for adverse events remain unclear. Objective: The objective was to investigate the long-term efficacy of VIT and evaluate adverse events and risk factors related to this. Method: Patients who received VIT in a tertiary-care adult allergy clinic between January 2005 and July 2022 were included. Patients\' data were compared with those of individuals who had been diagnosed with bee and/or wasp venom allergy during the same period but had not received VIT and experienced field re-stings. Results: The study included 105 patients with venom allergy, of whom 68 received VIT and 37 did not receive VIT. Twenty-three patients (34%) completed 5 years of VIT, and the overall mean ± standard deviation VIT duration was 46.9 ± 20.9 months. Re-stings occurred in 5 of 23 patients who completed 5 years of VIT, and none of them developed a systemic reaction. Eighteen patients (40%) experienced re-stings after prematurely discontinuing VIT, of whom eight (44%) developed a systemic reaction. In the control group of patients who did not receive VIT, 26 patients (70.3%) experienced re-stings, and all had systemic reactions (100%), with no change in their median Mueller scores. There was a significant difference in the median Mueller score change between the patients who received VIT and the controls who did not (p = 0.016). A total of 13 patients (19%) experienced adverse events while receiving VIT, which were systemic reactions in nine honeybee VIT. The use of β-blockers was determined as the most important risk factor (odds ratio 15.9 [95% confidence interval, 1.2-208.8]; p = 0.035). Conclusion: It was confirmed that VIT was effective in both reducing the incidence and the severity of re-sting reactions. These effects were more pronounced in the patients who completed 5 years of VIT.
摘要：
背景：被膜翅目物种叮咬会导致危及生命的过敏反应。尽管毒液免疫疗法（VIT）似乎是最有效的治疗方法，其长期功效，不良事件的危险因素仍不清楚.目的：探讨VIT的长期疗效，并评估与之相关的不良事件和危险因素。方法：纳入2005年1月至2022年7月在三级护理成人过敏诊所接受VIT的患者。将患者的数据与同期被诊断为蜜蜂和/或黄蜂毒液过敏但未接受VIT并经历过野外再刺激的个体的数据进行比较。结果：该研究包括105名毒液过敏患者，其中68人获得了VIT，37人没有获得VIT。23名患者（34%）完成了5年的VIT，总体平均值±标准差VIT持续时间为46.9±20.9个月。完成5年VIT的23例患者中有5例发生了再刺痛，他们都没有发生系统性反应。18名患者（40％）在过早停止VIT后经历了重新刺伤，其中8人(44%)出现了全身反应。在未接受VIT的对照组患者中，26例患者（70.3%）经历了再刺痛，都有全身反应（100%），他们的穆勒得分中位数没有变化。接受VIT的患者与未接受VIT的对照组之间的中位Mueller评分变化存在显着差异（p=0.016）。共有13例患者（19%）在接受VIT时出现不良事件，这是九只蜜蜂VIT的全身反应。β受体阻滞剂的使用被确定为最重要的危险因素(比值比15.9[95%置信区间，1.2-208.8]；p=0.035）。结论：证实VIT可有效降低重复反应的发生率和严重程度。这些效果在完成5年VIT的患者中更为明显。
