复旦大学附属儿科医院2413例过敏性鼻炎患儿过敏原筛查结果分析
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摘要
目的了解过敏性鼻炎(allergic rhinitis,AR)患儿的过敏原,为儿童AR的预防和治疗提供依据。方法采用免疫印迹法对2013年1月至2018年7月就诊于复旦大学附属儿科医院耳鼻咽喉头颈外科的2413例AR患儿进行过敏原检测并进行分析。结果吸入性过敏原前4位分别为户尘螨(49.52%)、混合霉菌(23.62%)、狗毛(17.99%)、屋尘(15.54%)。食入性过敏原前4位分别为牛奶(46.54%)、鸡蛋(22.92%)、腰果(19.10%)、螃蟹(9.45%)。部分AR患儿(46.33%)同时存在吸入性及食入性过敏。男女患儿过敏原阳性率比较差异有统计学意义(P<0.05)。随着年龄增长,儿童的吸入性过敏原阳性率逐渐增加,食入性过敏原阳性率逐渐降低。结论儿童吸入性过敏原以尘螨及混合霉菌为主,食入性过敏原以牛奶及鸡蛋为主,过敏原检测有助于了解患儿的过敏状态。
Objective To analyse the allergens in children with allergic rhinitis and provide evidence for the prevention and treatment of allergic rhinitis in children. Methods Allergens were detected in 2413 children with allergic rhinitis by immunoblotting from January 2013 to July 2018 in Department of Otolaryngology Head and Neck Surgery,Children's Hospital of Fudan University. Results The first four inhaled allergens were house dust mites,mixed mold,dog hair and house dust,each accounting for 49.52%,23.62%,17.99%,and 15.54%. The first four food-borne allergens were milk,eggs,cashews,and crabs,each accounting for 46.54%,22.92%,19.10%,and 9.45%. Most patients with allergic rhinitis(46.33%)have both inhaled and ingestive allergies.There was a statistically significant difference in the positive rate of allergens between male and female children(P<0.05). With age increasing,the positive rate of inhaled allergens in children gradually increased,and the positive rate of ingestive allergens gradually decreased. Conclusion The inhaled allergens in Shanghai are mainly dust mites and mixed molds. The food-borne allergens are mainly milk and eggs. The detection of allergens can help to understand the allergic state of children.
Objective To analyse the allergens in children with allergic rhinitis and provide evidence for the prevention and treatment of allergic rhinitis in children. Methods Allergens were detected in 2413 children with allergic rhinitis by immunoblotting from January 2013 to July 2018 in Department of Otolaryngology Head and Neck Surgery,Children's Hospital of Fudan University. Results The first four inhaled allergens were house dust mites,mixed mold,dog hair and house dust,each accounting for 49.52%,23.62%,17.99%,and 15.54%. The first four food-borne allergens were milk,eggs,cashews,and crabs,each accounting for 46.54%,22.92%,19.10%,and 9.45%. Most patients with allergic rhinitis(46.33%)have both inhaled and ingestive allergies.There was a statistically significant difference in the positive rate of allergens between male and female children(P<0.05). With age increasing,the positive rate of inhaled allergens in children gradually increased,and the positive rate of ingestive allergens gradually decreased. Conclusion The inhaled allergens in Shanghai are mainly dust mites and mixed molds. The food-borne allergens are mainly milk and eggs. The detection of allergens can help to understand the allergic state of children.
引文
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[11]马燕,方平,刘业海,等.安徽省合肥地区过敏性鼻炎、哮喘的过敏原分布及临床意义[J].安徽医科大学学报,2013,48(10),1249-1251.
[12]Bischoff SC.Food allergies[J].Curr Treat Options Gastroenterol,2007,10(1):34-43.
[13]郑欣欣,林榆,杨婷婷.福州地区642例儿童过敏性鼻炎过敏原检测结果分析[J].福建医药杂志,2017,39(5):123-125.
[14]Almqvist C,Worm M,Leynaert B,et al.Impact of gender on asthma in childhood and adolescence:a GA2LEN review[J].Allergy,2008,63(1):47-57.
[15]袁龙,李科琼,陈益,等.重庆医科大学附属儿童医院过敏性鼻炎患儿吸入性变应原特应性阳性率变化趋势分析[J].中国实用儿科杂志,2016,31(12):937-940.
[16]刘晓颖,王静,王群,等.尘螨特异性免疫治疗哮喘合并变应性鼻炎患儿早期疗效及影响因素研究[J].中国实用儿科杂志,2016,31(3):190-194.
[17]李东丹,徐樨巍.儿童Ig E相关食物过敏消化道临床特点及随访研究[J].中国实用儿科杂志,2018,33(10):796-799.
[18]李在玲.规范食物过敏相关消化系统疾病的诊断与管理[J].中国实用儿科杂志,2017,32(10):733-735.
[2]Pawankar R.Allergic rhinitis and asthma:the link,the new ARIAclassification and global approaches to treatment[J].Curr Opin Allergic Clin Immunol,2004,4(1):1-4.
[3]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24.
[4]Bousquet J,Khaltaev N,Cruz AA,et al.Allergic rhinitis and its impact on asthma(ARIA)2008 update(in collaboration with the World Health Organization,GA(2)LEN and AllerGen)[J].Allergy,2008,63(Suppl 86):8-160.
[5]Li J,Sun B,Huang Y,et al.A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China[J].Allergy,2009,64(7):1083-1092.
[6]Arlian LG,Platts-Mills TA.The biology of dust mites and the remediation of mite allergens in allergic disease[J].J Al-Clin Immunol,2001,107(Suppl 3):406-413.
[7]梁茂茂.螨虫的危害及防治[J].吉林畜牧兽医,2012,16(10):50-51.
[8]贾家祥,陈逸君,胡梅,等.居室螨虫的危害及有效防治[J].中国洗涤用品工业,2007,16(3):58-61.
[9]陈实,王灵,廖锋,等.舌下含服粉尘螨滴剂治疗学龄前与学龄期儿童过敏性哮喘伴变应性鼻炎的疗效评估[J].中华儿科杂志,2013,51(11):831-8835.
[10]李勇,阮桂英,储洪娟,等.粉尘螨滴剂治疗儿童变应性鼻炎的疗效及安全性[J].中国临床药理学杂志,2014,30(111):991-993.
[11]马燕,方平,刘业海,等.安徽省合肥地区过敏性鼻炎、哮喘的过敏原分布及临床意义[J].安徽医科大学学报,2013,48(10),1249-1251.
[12]Bischoff SC.Food allergies[J].Curr Treat Options Gastroenterol,2007,10(1):34-43.
[13]郑欣欣,林榆,杨婷婷.福州地区642例儿童过敏性鼻炎过敏原检测结果分析[J].福建医药杂志,2017,39(5):123-125.
[14]Almqvist C,Worm M,Leynaert B,et al.Impact of gender on asthma in childhood and adolescence:a GA2LEN review[J].Allergy,2008,63(1):47-57.
[15]袁龙,李科琼,陈益,等.重庆医科大学附属儿童医院过敏性鼻炎患儿吸入性变应原特应性阳性率变化趋势分析[J].中国实用儿科杂志,2016,31(12):937-940.
[16]刘晓颖,王静,王群,等.尘螨特异性免疫治疗哮喘合并变应性鼻炎患儿早期疗效及影响因素研究[J].中国实用儿科杂志,2016,31(3):190-194.
[17]李东丹,徐樨巍.儿童Ig E相关食物过敏消化道临床特点及随访研究[J].中国实用儿科杂志,2018,33(10):796-799.
[18]李在玲.规范食物过敏相关消化系统疾病的诊断与管理[J].中国实用儿科杂志,2017,32(10):733-735.