广州市成人变应性鼻炎环境危险因素分析
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摘要
目的观察广州市变应性鼻炎(AR)患者的居住环境和饮食习惯中可能的危险因素,为AR的防治提供建议和指导。方法选取2014年11月—2018年7月于广东省第二中医院采用过敏原检测并确诊为AR的1 096例患者作为研究对象,进行问卷调查收集资料,并将同期健康体检人群作对照,分析成人AR的环境危险因素。结果天冷、风大、潮湿、气压低、春季和秋季是AR发病的危险因素(P<0.05)。屋尘螨、粉尘螨是占比最高的过敏原,占40.51%,说明环境对AR具有决定性作用。屋尘螨、粉尘螨、点青霉分枝孢霉、烟曲霉、交链孢菌、潮湿时加重、风大时加重、天冷时加重及气压低时加重均有较高的AR患病风险(P <0.05)。结论居住环境在AR的发生中起重要作用,应加强对家庭居住环境的清洁卫生,尽量降低空气中尘螨密度,并注意合理饮食结构,以降低过敏性疾病的发生率。
Objective To explore the possible risk factors of environmental and living habits of patients with allergic rhinitis(AR) in Guangzhou City, and to provide suggestions and guidance for the prevention and treatment of AR. Methods Through the detection of allergen test, 1096 patients aged 18 ～ 65 years with allergic rhinitis were selected as subjects. Questionnaires were collected and compared with the health check-up crowd to analysis the environmental risk factors of adult allergic rhinitis in the same period. Results Univariate analysis showed that allergic rhinitis may be related to temperature changes, wind speed, dry humidity, air pressure and seasonal changes(P < 0.05). House dust mites and dust mites were the most common allergens, accounting for 40.51%, indicating that environmental factors have a decisive role in allergic rhinitis. House dust mites, dust mites, Penicillium diffusum,Aspergillus fumigatus, Alternaria, increased in humidity, increased in strong wind, increased in cold weather and increased in low air pressure all were high risks of AR(P < 0.05). Conclusions The living environment plays an important role in the occurrence of allergic rhinitis. It is necessary to strengthen the sanitation of home living environment, reduce the density of dust mites in the air as much as possible, and pay attention to the rational diet structure in order to reduce the incidence of allergic diseases.
Objective To explore the possible risk factors of environmental and living habits of patients with allergic rhinitis(AR) in Guangzhou City, and to provide suggestions and guidance for the prevention and treatment of AR. Methods Through the detection of allergen test, 1096 patients aged 18 ～ 65 years with allergic rhinitis were selected as subjects. Questionnaires were collected and compared with the health check-up crowd to analysis the environmental risk factors of adult allergic rhinitis in the same period. Results Univariate analysis showed that allergic rhinitis may be related to temperature changes, wind speed, dry humidity, air pressure and seasonal changes(P < 0.05). House dust mites and dust mites were the most common allergens, accounting for 40.51%, indicating that environmental factors have a decisive role in allergic rhinitis. House dust mites, dust mites, Penicillium diffusum,Aspergillus fumigatus, Alternaria, increased in humidity, increased in strong wind, increased in cold weather and increased in low air pressure all were high risks of AR(P < 0.05). Conclusions The living environment plays an important role in the occurrence of allergic rhinitis. It is necessary to strengthen the sanitation of home living environment, reduce the density of dust mites in the air as much as possible, and pay attention to the rational diet structure in order to reduce the incidence of allergic diseases.
引文
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[17]JUNG C G,LEE J H,BAN G Y,et al.Prevalence and clinical characteristics of local allergic rhinitis to house dust mites[J].Yonsei Med J,2017,58(5):1047-1050.
[18]LIM F L,HASHIM Z,THAN L T,et al.Asthma,airway symptoms and rhinitis in office workers in Malaysia:associations with house dust mite(HDM)allergy,cat allergy and levels of house dust mite allergens in office dust[J].PLoS One,2015,10(4):DOI:10.1371/journal.pone.0124905.
[19]THACHER J D,GRUZIEVA O,PERSHAGEN G,et al.Mold and dampness exposure and allergic outcomes from birth to adolescence:data from the BAMSE cohort[J].Allergy,2017,72(6):967-974.
[2]PASSALI D,CING CI,STAFFA P,et al.The international study of the allergic rhinitis survey:outcomes from 4 geographical regions[J].Asia Pac Allergy,2018,8(1):DOI:10.5415/apallergy.2018.8.e7
[3]MASIERI S,CAVALIERE C,INCORVAIA C,et al.New scientific synergies to manage patients with severe Rhinitis:allergy diagnosis and treatment for ENT specialists[J].Journal of Biological Regulators and Homeostatic Agents,2018,32(Suppl 1):1.
[4]MAY J R,Dolen W K.Management of allergic rhinitis:a review for the community pharmacist[J].Clin Ther,2017,39(12):2410-2419.
[5]NISHIJIMA H,SUZUKI S,KONDO K,et al.Environmental factors associated with allergic rhinitis symptoms in Japanese university students:a cross-sectional study[J].Auris Nasus Larynx,2018,45(5):1006-1013.
[6]TIAN J,LIU Y L,JIANG Y.Correlation between the incidence of allergic rhinitis and the environmental air quality in zibo area[J].Acta Academiae Medicinae Sinicae,2018,40(1):26-29.
[7]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.
[8]NAVARRO-LOCSIN C G,LIM-JURADO M.Aeroallergen sensitization and associated comorbid diseases of an adult Filipino population with allergic rhinitis[J].Asia Pacific Allergy,2018,8(3):e25.
[9]BOUSQUET J,ANTO J M,ANNESI-MAESANO I,et al.POLLAR:impact of air POLLution on asthma and rhinitis;a european institute of innovation and technology health(EITHealth)project[J].Clin Transl Allergy,2018,8:36.
[10]TENG B,ZHANG X L,YI C H,et al.The association between ambient air pollution and allergic rhinitis:further epidemiological evidence from changchun,northeastern China[J].Int J Environ Res Public Health,2017,14(3):226.
[11]MEHANNA N,MOHAMED N,WORDOFA M,et al.Allergyrelated disorders(ARDs)among Ethiopian primary school-aged children:Prevalence and associated risk factors[J].PLoS One,2018,13(9):245-249.
[12]AKSOY C,ELSüRER?,ARTA?H,et al.Evaluation of olfactory function in children with seasonal allergic rhinitis and its correlation with acoustic rhinometry[J].International Journal of Pediatric Otorhinolaryngology,2018,113:188-191.
[13]PATELLA V,FLORIO G,MAGLIACANE D,et al.Urban air pollution and climate change:“The Decalogue:Allergy Safe Tree”for allergic and respiratory diseases care[J].Clinical and Molecular Allergy:CMA,2018:DOI:10.1186/s12948-018-0098-3.
[14]POMéS A,CHAPMAN M D,WüNSCHMANN S.Indoor allergens and allergic respiratory disease[J].Curr Allergy Asthma Rep,2016,16(6):43.
[15]LYNCH S V,WOOD R A,H.BOUSHEY H,et al.Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children[J].J Allergy Clin Immunol,2014,134(3):593-601.
[16]WANG J,ENGVALL K,SMEDJE G,et al.Rhinitis,Asthma and respiratory infections among adults in relation to the home environment in multi-family buildings in Sweden[J].PLoS One,2014,9(8):DOI:10.1371/journal.pone.0105125.
[17]JUNG C G,LEE J H,BAN G Y,et al.Prevalence and clinical characteristics of local allergic rhinitis to house dust mites[J].Yonsei Med J,2017,58(5):1047-1050.
[18]LIM F L,HASHIM Z,THAN L T,et al.Asthma,airway symptoms and rhinitis in office workers in Malaysia:associations with house dust mite(HDM)allergy,cat allergy and levels of house dust mite allergens in office dust[J].PLoS One,2015,10(4):DOI:10.1371/journal.pone.0124905.
[19]THACHER J D,GRUZIEVA O,PERSHAGEN G,et al.Mold and dampness exposure and allergic outcomes from birth to adolescence:data from the BAMSE cohort[J].Allergy,2017,72(6):967-974.