深圳地区2560例变态反应性皮肤病患者皮肤点刺试验结果临床分析
|
摘要
目的了解深圳地区常见变态反应性皮肤病变应原的特点及分布情况。方法对北京大学深圳医院2015年1月至2018年1月皮肤科门诊2 560例变态反应性皮肤病患者皮肤点刺试验结果进行回顾性分析,将所有患者按变应原种类、年龄段、疾病种类进行分组,并对各组结果进行分析。结果 2 560例变态反应性皮肤病患者吸入组阳性率最高的变应原是粉尘螨(32.66%),致敏级数多为3、4级,食入组阳性率最高的变应原是小虾(5.12%),致敏级数多为1、2级。0～6岁组变应原总阳性率为73.68%,7～17岁组变应原总阳性率为64.95%,18～77岁组变应原总阳性率为42.41%,不同年龄组间变应原总阳性率比较差异有统计学意义(P<0.05)。男性患者中变应原总阳性率为36.94%,与女性患者的34.76%比较,差异无统计学意义(P>0.05)。湿疹、特应性皮炎、慢性自发性荨麻疹和其他变态反应性皮肤病患者的皮肤变应原总阳性率分别为41.06%、88.41%、46.22%和40.65%,不同皮肤病间皮肤变应原总阳性率比较差异有统计学意义(P<0.05)。结论深圳地区变态反应性皮肤病主要的变应原有粉尘螨、小虾。青少年及幼儿皮肤点刺阳性率高,随年龄增长食入性变应原的阳性率呈下降趋势。外源性变应原致敏是特应性皮炎发病的重要因素。
Objective To investigate the distribution characteristics of common allergens in patients with allergic dermatitis in Shenzhen. Methods The skin prick test results of 2 560 patients with allergic skin diseases in the Outpatient Department of Dermatology of Peking University Shenzhen Hospital from January 2015 to January 2018 were retrospectively analyzed. The 2 560 patients were divided into groups according to allergen type, age group and disease type, and the results of each group were analyzed. Results The total positive rate of skin prick test in 2 560 patients with allergic dermatitis was 35.66%. The main allergen in the inhalation group was dust mites(32.66%), and the sensitization levels were mostly grade 3 and 4. The main allergen in the ingestion group was shrimp(5.12%), and the sensitization levels were mostly grade 1 and 2. The total positive rate of allergens was 73.68% in the 0 to 6 year old group,64.95% in the 7 to 17 year old group, and 42.41% in the 18 to 77 year old group, showing statistically significant difference among age groups(P<0.05). No significant difference was observed in the total positive rate between different genders(P>0.05): males(36.94%) versus females(34.76%). The total positive rates of allergens in patients with eczema,atopic dermatitis, chronic spontaneous urticaria and other allergic skin diseases were 41.06%, 88.41%, 46.22%, 40.65%,showing statistically significant differences(P<0.05). Conclusion The major allergens in Shenzhen are the dust mites and shrimps. Adolescents and infant have high skin prick test positive rates, and the positive rate of ingested allergens declines with age. Exogenous allergens are an important factor in the pathogenesis of atopic dermatitis.
Objective To investigate the distribution characteristics of common allergens in patients with allergic dermatitis in Shenzhen. Methods The skin prick test results of 2 560 patients with allergic skin diseases in the Outpatient Department of Dermatology of Peking University Shenzhen Hospital from January 2015 to January 2018 were retrospectively analyzed. The 2 560 patients were divided into groups according to allergen type, age group and disease type, and the results of each group were analyzed. Results The total positive rate of skin prick test in 2 560 patients with allergic dermatitis was 35.66%. The main allergen in the inhalation group was dust mites(32.66%), and the sensitization levels were mostly grade 3 and 4. The main allergen in the ingestion group was shrimp(5.12%), and the sensitization levels were mostly grade 1 and 2. The total positive rate of allergens was 73.68% in the 0 to 6 year old group,64.95% in the 7 to 17 year old group, and 42.41% in the 18 to 77 year old group, showing statistically significant difference among age groups(P<0.05). No significant difference was observed in the total positive rate between different genders(P>0.05): males(36.94%) versus females(34.76%). The total positive rates of allergens in patients with eczema,atopic dermatitis, chronic spontaneous urticaria and other allergic skin diseases were 41.06%, 88.41%, 46.22%, 40.65%,showing statistically significant differences(P<0.05). Conclusion The major allergens in Shenzhen are the dust mites and shrimps. Adolescents and infant have high skin prick test positive rates, and the positive rate of ingested allergens declines with age. Exogenous allergens are an important factor in the pathogenesis of atopic dermatitis.
引文
[1]李邻峰.湿疹皮炎与皮肤过敏反应的诊断与治疗[M].北京:北京大学医学出版社, 2010:2-7.
[2]宋黎,叶俊儒,陆茂,等.成都地区荨麻疹、湿疹、特应性皮炎等点刺试验结果分析[J].临床皮肤科杂志, 2016, 45(5):375-377.
[3]孙立英,郭胤仕,王菁兰,等.上海地区过敏患者皮肤点刺试验临床分析[J].现代免疫学, 2011, 31(1):66-70.
[4]周培媚,路永红,陈涛,等. 496例慢性荨麻疹患者变应原皮肤点刺试验结果分析[J].华西医学, 2016, 31(12):2030-2032.
[5]张建中,顾恒,宋志强,等.中国特应性皮炎诊疗指南(2014版)[J].全科医学临床与教育, 2014, 12(6):603-606, 615.
[6]中华医学会皮肤性病学分会免疫学组.中国荨麻疹诊疗指南(2014版)[J].中华皮肤科杂志, 2014, 47(7):514-516.
[7] LARENAS-LINNEMANN D, LUNA-PECH JA, MOSGES R. Debates in allergy medicine:allergy skin testing cannot be replaced by molecular diagnosis in the near future[J]. World Allergy Organ,2017, 10(1):32.
[8] BERNSTEIN IL, LI JT, BERNSTEIN DI, et al. Allergy diagnostic testing:an updated practice parameter[J]. Ann Allergy Asthma Immunol, 2008, 100(3 Suppl 3):S1-148.
[9] LICCARDI G, D'AMATO G, CANONICA GW, et al. Systemic reactions from skin testing:literature review[J]. Investig Allergol Clin Immunol, 2006, 16(2):75-78.
[10]宋志强,郝飞.变应原检测的再认识[J].临床皮肤科杂志, 2006, 45(5):333-335.
[11]杨艳,张文君,李薇,等.广州地区1335例变态反应性皮肤病患者变应原分析[J].皮肤性病诊疗学杂志, 2010, 17(5):361-362, 365.
[12]黄祖锋,刘荷英,刘腊凤,等. 437例慢性荨麻疹患者皮肤点刺试验结果分析[J].广东医学, 2017, 38(z1):186-188.
[13] SYED A, KOHLI A, NADEAU KC. Food allergy diagnosis and therapy:where are we now?[J]. Immunotherapy, 2013, 5(9):931-944.
[14] KAPLAN AP, GREAVES M. Pathogenesis of chronic urticarial[J].Clin Exp Allergy, 2009, 39(6):777-778.
[15]郑艺,赵梓纲,赵华,等.北京地区过敏性疾病皮肤点刺试验分析[J].解放军医学院学报, 2015, 36(1):56-58.
[2]宋黎,叶俊儒,陆茂,等.成都地区荨麻疹、湿疹、特应性皮炎等点刺试验结果分析[J].临床皮肤科杂志, 2016, 45(5):375-377.
[3]孙立英,郭胤仕,王菁兰,等.上海地区过敏患者皮肤点刺试验临床分析[J].现代免疫学, 2011, 31(1):66-70.
[4]周培媚,路永红,陈涛,等. 496例慢性荨麻疹患者变应原皮肤点刺试验结果分析[J].华西医学, 2016, 31(12):2030-2032.
[5]张建中,顾恒,宋志强,等.中国特应性皮炎诊疗指南(2014版)[J].全科医学临床与教育, 2014, 12(6):603-606, 615.
[6]中华医学会皮肤性病学分会免疫学组.中国荨麻疹诊疗指南(2014版)[J].中华皮肤科杂志, 2014, 47(7):514-516.
[7] LARENAS-LINNEMANN D, LUNA-PECH JA, MOSGES R. Debates in allergy medicine:allergy skin testing cannot be replaced by molecular diagnosis in the near future[J]. World Allergy Organ,2017, 10(1):32.
[8] BERNSTEIN IL, LI JT, BERNSTEIN DI, et al. Allergy diagnostic testing:an updated practice parameter[J]. Ann Allergy Asthma Immunol, 2008, 100(3 Suppl 3):S1-148.
[9] LICCARDI G, D'AMATO G, CANONICA GW, et al. Systemic reactions from skin testing:literature review[J]. Investig Allergol Clin Immunol, 2006, 16(2):75-78.
[10]宋志强,郝飞.变应原检测的再认识[J].临床皮肤科杂志, 2006, 45(5):333-335.
[11]杨艳,张文君,李薇,等.广州地区1335例变态反应性皮肤病患者变应原分析[J].皮肤性病诊疗学杂志, 2010, 17(5):361-362, 365.
[12]黄祖锋,刘荷英,刘腊凤,等. 437例慢性荨麻疹患者皮肤点刺试验结果分析[J].广东医学, 2017, 38(z1):186-188.
[13] SYED A, KOHLI A, NADEAU KC. Food allergy diagnosis and therapy:where are we now?[J]. Immunotherapy, 2013, 5(9):931-944.
[14] KAPLAN AP, GREAVES M. Pathogenesis of chronic urticarial[J].Clin Exp Allergy, 2009, 39(6):777-778.
[15]郑艺,赵梓纲,赵华,等.北京地区过敏性疾病皮肤点刺试验分析[J].解放军医学院学报, 2015, 36(1):56-58.