包头市某三甲医院变应性疾病就医患者过敏原现状及影响因素研究
|
摘要
研究背景：近50年来,由于工业化的加剧、环境的污染、饮食结构的改变以及心理压力增大等诸多因素,使得变态反应性疾病的发病率呈逐年上升趋势。目前全球共有2.5亿人罹患变态反应性疾病,占世界总人口的22%。变态反应性疾病涉及多个临床科室,包括皮肤科、耳鼻喉科、呼吸科等,临床上以湿疹、特异性皮炎、过敏性鼻炎、过敏性哮喘等疾病最常见。因其症状复杂,种类繁多,难以根治,成为长期以来医学界的一大难题。
变态反应性疾病发生与多种内外因素相关,除患者有一定的遗传基础外,还受到多种致敏因素的影响,其中过敏原在变应性疾病的发生、发展中起着关键性的作用。国外调查报告显示：54%-69%的变态反应性疾病是由于吸入性过敏原引起的。约33%的变态反应由食物诱发。因此是预防和治疗变态反应性疾病的重要举措之一。目前包头地区未开展此领域的研究。本研究皆在了解包头地区某些变应性疾病的主要过敏原及过敏原在不同性别、不同年龄、不同时间、不同地区、不同职业、不同疾病患者中可能存在的差异,从而更好地为临床提供诊疗依据。
研究目的：探讨包头市某医院常见变应性疾病的主要过敏原及过敏原在不同性别、不同年龄、不同季节、不同地区、不同职业、不同疾病患者中可能存在的差异,为临床诊疗提供依据,从而提出预防和治疗过敏性疾病的有效措施。
研究方法：应用德国Regumed公司生产的百康生物共振系统(BICOM-2000)治疗仪对2008年2月1日-2009年1月31日到包头医学院第一附属医院皮肤科就诊的变态反应性疾病患者(共计1902人)进行过敏原检测,询问一般情况并进行登记,将检测资料整理后建立数据文件。用Epidata3.0软件建立数据库输入数据,SPSS11.5软件包进行相关统计学分析。
主要结果：(1)1902例患者过敏原检测结果：过敏率排在前十位的分别为屋尘螨(52.9%),羊肉(41.9%),粉尘螨(39.3%),牛奶(34.9%)甲醛(32.0%),鱼类混合物(32.0%),蒿(31.2%),动物皮毛(31.0%),真菌混合物(29.7%),牛肉(28.5%),毛霉菌混合物(27.5%)。其中吸入组以屋尘螨、粉尘螨、蒿、动物皮毛为主；食物及添加剂类以羊肉、牛奶、鱼类混合物、苯甲酸为主,化学、接触性物质类以甲醛、细菌、农药为主。(2)不同性别的患者中香料、农药、苯胺、杨属、辣椒、乙醇、真菌混合物等过敏原的阳性检出率存在差异。(3)不同年龄的患者中毛霉菌混合物、羊肉、二甲基亚硝胺、牛奶、鱼类混合物、鸡蛋、细菌、香料、甲醛的过敏原阳性检出率存在差异。(4)不同地区的患者中黄曲霉菌、毛霉菌混合物、动物皮毛、甲醛、细菌、苯并芘、杨属、玉米花粉、鱼类混合物、辣椒、苯甲酸等过敏原阳性检出率存在差异。(5)6种职业的患者中屋尘螨、粉尘螨、黄曲霉素、毛霉菌混合物等49种过敏原阳性检出率存在差异。其中工人、学生、干部阳性率较高,农民、儿童阳性率较低。(6)四个季节中除真菌混合物、二甲基亚硝胺之外,其他52种过敏原阳性率均有差异。(7)不同变应性疾病患者的过敏原阳性率比较：54种主要过敏原在8种变态反应性疾病中均有差异。
结论与建议：变应性疾病就医患者过敏原种类较多、阳性检出率高,其中屋尘螨、粉尘螨、羊肉、牛奶、甲醛、蒿、杨属是主要过敏原。建议在医院和社区采取健康教育活动等形式,使患者了解过敏原在变应性疾病的发病中的重要性,避免相关过敏原的接触,减少疾病的发生。还要改善居住环境,保持室内干燥、通风,经常晒洗衣服、被褥,经常清洗空调、洗衣机,减少一切接触变应原的可能。同时建议政府部门采取有效措施对包头市主要绿化植物的蒿草、杨树进行环境干预,减少和消除过敏原。
BACKGROUND
During the past 50 years,due to the factors of the aggravating industrialization,environmental pollution,dietary changes and the increasing psychological pressure,allergic diseases are increasing year by year.Presently there are 250 million people suffering from allergic diseases, accounting for 22% of the total world population.Allergic diseases involved multiple clinical departments such as dermatology, ENT,respiratory,etc.It had become a diffcult problem.
Allergic diseases relate to multi-factors, including a variety of internal and external factors.Allergens play a very important role in allergic diseases. Foreign survey reports show that 54%-69% of the allergic diseases are caused by inhalation of allergen and about 33% are food-induced allergic reaction. The study in order to understand the primary allergens and discrepancies between different genders ages,seasons,nationalities, regions, occupations and diseases of allergens in Baotou,and to provide the basis for clinical diagnosis and treatment better.
OBJECTIVBES
To explore the primary allergens and discrepancies of allergens between genders, ages, seasons, nationalities, regions, occupations and diseases in Baotou,and to provide the basis for clinical diagnosis and treatment better and to propose effective measures for allergic diseases prevention and treatments.
METHODOLGY
We chose the patients who got allergic diseases and went to in the First affiliated hospital of Baoto Medical College on May 1,2008 to May 1,2009.The patients were examined and recorded by the BICOM 2000. The data was analzed by SPSS11.5.
RESULTS
(1) The top ten allergens were:house dust mite (52.9%), mutton (41.9%), dust mite (39.3%), animal fur (38.9%), milk (34.9%), formaldehyde (32.0%), fish mixture (32.0%), Artemisia (31.2%), fungal mixture (29.7%), beef (28.5%), Mucor mixture (27.5%).(2) The positive rate of allergens,such as spices, pesticides, aniline, Populus, pepper, alcohol, fungus mixture etc, had statistically significant genders.(3) The positive rate of allergens, such as fungus mixture, lamb, dimethylnitrosamine, milk, fish mixture, eggs, bacteria, perfume, formaldehyde,had statistically significant with different ages. (4) The positive rate of allergens,such as aspergillus flavus, mucor mixture, animal fur, formaldehyde, bacteria, benzopyrene, Populus, corn pollen, fish mixture, pepper, benzoic acid, had statistically significant with different regions.(5) The positive rate of 49 kinds of allergens, such as house dust mite.dust mite,Aspergillus flavus,mucor and so on, had statistically significant with different professions. (6) Except for fungal compounds and domethylnitrosamine,the positive rate of the other 52 kinds of allergens all had statistically significant in four seasons.(7) The comparison of the positive rate of different kinds of allergic patients showed that 54 kinds of major allergens had statistically significant in 8 kinds of allergic diseases.
CONCLUSION
The main allergens were house dust mites, dust mites, mutton, milk, formaldehyde, Artemisia and poplars.The kinds of allergens were more and the positive rate was higher of the allergic patients in Baotou. Hospitals and communities should take health education activities and make patients understand the inportance of the allergens to avoid contacting interrelated allergens in order to reduce the diseases. Living conditions should be improved and governments should take effctive in tervention measures to reduce and dliminate allergens.
变态反应性疾病发生与多种内外因素相关,除患者有一定的遗传基础外,还受到多种致敏因素的影响,其中过敏原在变应性疾病的发生、发展中起着关键性的作用。国外调查报告显示：54%-69%的变态反应性疾病是由于吸入性过敏原引起的。约33%的变态反应由食物诱发。因此是预防和治疗变态反应性疾病的重要举措之一。目前包头地区未开展此领域的研究。本研究皆在了解包头地区某些变应性疾病的主要过敏原及过敏原在不同性别、不同年龄、不同时间、不同地区、不同职业、不同疾病患者中可能存在的差异,从而更好地为临床提供诊疗依据。
研究目的：探讨包头市某医院常见变应性疾病的主要过敏原及过敏原在不同性别、不同年龄、不同季节、不同地区、不同职业、不同疾病患者中可能存在的差异,为临床诊疗提供依据,从而提出预防和治疗过敏性疾病的有效措施。
研究方法：应用德国Regumed公司生产的百康生物共振系统(BICOM-2000)治疗仪对2008年2月1日-2009年1月31日到包头医学院第一附属医院皮肤科就诊的变态反应性疾病患者(共计1902人)进行过敏原检测,询问一般情况并进行登记,将检测资料整理后建立数据文件。用Epidata3.0软件建立数据库输入数据,SPSS11.5软件包进行相关统计学分析。
主要结果：(1)1902例患者过敏原检测结果：过敏率排在前十位的分别为屋尘螨(52.9%),羊肉(41.9%),粉尘螨(39.3%),牛奶(34.9%)甲醛(32.0%),鱼类混合物(32.0%),蒿(31.2%),动物皮毛(31.0%),真菌混合物(29.7%),牛肉(28.5%),毛霉菌混合物(27.5%)。其中吸入组以屋尘螨、粉尘螨、蒿、动物皮毛为主；食物及添加剂类以羊肉、牛奶、鱼类混合物、苯甲酸为主,化学、接触性物质类以甲醛、细菌、农药为主。(2)不同性别的患者中香料、农药、苯胺、杨属、辣椒、乙醇、真菌混合物等过敏原的阳性检出率存在差异。(3)不同年龄的患者中毛霉菌混合物、羊肉、二甲基亚硝胺、牛奶、鱼类混合物、鸡蛋、细菌、香料、甲醛的过敏原阳性检出率存在差异。(4)不同地区的患者中黄曲霉菌、毛霉菌混合物、动物皮毛、甲醛、细菌、苯并芘、杨属、玉米花粉、鱼类混合物、辣椒、苯甲酸等过敏原阳性检出率存在差异。(5)6种职业的患者中屋尘螨、粉尘螨、黄曲霉素、毛霉菌混合物等49种过敏原阳性检出率存在差异。其中工人、学生、干部阳性率较高,农民、儿童阳性率较低。(6)四个季节中除真菌混合物、二甲基亚硝胺之外,其他52种过敏原阳性率均有差异。(7)不同变应性疾病患者的过敏原阳性率比较：54种主要过敏原在8种变态反应性疾病中均有差异。
结论与建议：变应性疾病就医患者过敏原种类较多、阳性检出率高,其中屋尘螨、粉尘螨、羊肉、牛奶、甲醛、蒿、杨属是主要过敏原。建议在医院和社区采取健康教育活动等形式,使患者了解过敏原在变应性疾病的发病中的重要性,避免相关过敏原的接触,减少疾病的发生。还要改善居住环境,保持室内干燥、通风,经常晒洗衣服、被褥,经常清洗空调、洗衣机,减少一切接触变应原的可能。同时建议政府部门采取有效措施对包头市主要绿化植物的蒿草、杨树进行环境干预,减少和消除过敏原。
BACKGROUND
During the past 50 years,due to the factors of the aggravating industrialization,environmental pollution,dietary changes and the increasing psychological pressure,allergic diseases are increasing year by year.Presently there are 250 million people suffering from allergic diseases, accounting for 22% of the total world population.Allergic diseases involved multiple clinical departments such as dermatology, ENT,respiratory,etc.It had become a diffcult problem.
Allergic diseases relate to multi-factors, including a variety of internal and external factors.Allergens play a very important role in allergic diseases. Foreign survey reports show that 54%-69% of the allergic diseases are caused by inhalation of allergen and about 33% are food-induced allergic reaction. The study in order to understand the primary allergens and discrepancies between different genders ages,seasons,nationalities, regions, occupations and diseases of allergens in Baotou,and to provide the basis for clinical diagnosis and treatment better.
OBJECTIVBES
To explore the primary allergens and discrepancies of allergens between genders, ages, seasons, nationalities, regions, occupations and diseases in Baotou,and to provide the basis for clinical diagnosis and treatment better and to propose effective measures for allergic diseases prevention and treatments.
METHODOLGY
We chose the patients who got allergic diseases and went to in the First affiliated hospital of Baoto Medical College on May 1,2008 to May 1,2009.The patients were examined and recorded by the BICOM 2000. The data was analzed by SPSS11.5.
RESULTS
(1) The top ten allergens were:house dust mite (52.9%), mutton (41.9%), dust mite (39.3%), animal fur (38.9%), milk (34.9%), formaldehyde (32.0%), fish mixture (32.0%), Artemisia (31.2%), fungal mixture (29.7%), beef (28.5%), Mucor mixture (27.5%).(2) The positive rate of allergens,such as spices, pesticides, aniline, Populus, pepper, alcohol, fungus mixture etc, had statistically significant genders.(3) The positive rate of allergens, such as fungus mixture, lamb, dimethylnitrosamine, milk, fish mixture, eggs, bacteria, perfume, formaldehyde,had statistically significant with different ages. (4) The positive rate of allergens,such as aspergillus flavus, mucor mixture, animal fur, formaldehyde, bacteria, benzopyrene, Populus, corn pollen, fish mixture, pepper, benzoic acid, had statistically significant with different regions.(5) The positive rate of 49 kinds of allergens, such as house dust mite.dust mite,Aspergillus flavus,mucor and so on, had statistically significant with different professions. (6) Except for fungal compounds and domethylnitrosamine,the positive rate of the other 52 kinds of allergens all had statistically significant in four seasons.(7) The comparison of the positive rate of different kinds of allergic patients showed that 54 kinds of major allergens had statistically significant in 8 kinds of allergic diseases.
CONCLUSION
The main allergens were house dust mites, dust mites, mutton, milk, formaldehyde, Artemisia and poplars.The kinds of allergens were more and the positive rate was higher of the allergic patients in Baotou. Hospitals and communities should take health education activities and make patients understand the inportance of the allergens to avoid contacting interrelated allergens in order to reduce the diseases. Living conditions should be improved and governments should take effctive in tervention measures to reduce and dliminate allergens.
引文
1.龚菲力.医学免疫学.第一版.北京：科学出版社,2003,191.
2.聂凌鸿.食物过敏原研究进展[J].生命的化学,2002,22：474-477.
3. Yazdanbakhsh M, Kremsner PG,Van et al.Science,2002,296(5567):490-494.
4.毕爱华,龚非力.医学免疫学[M].北京：人民军医出版社,1995：191.
5. Paganelli R,Ansotegui J,Sastre J,et al.Specific IgE antibodies in the diagnosis of atopic disease. Clinical evaluation of a new in vitro test system, VniCAP,in six European allergy clinics[J].Allergy,1998,53(8):763-768.
6.于 陆,韩乃揆.支气管哮喘的体内、体外检测和免疫治疗的相关分析[J].中华微生物学和免疫学杂志,2001,21(4)：87.
7.江向东,黄艳华.量子物理学[M].上海：上海科技教育出版社,2001：81.
8. Kruszew ski J Diagnosis of allergic diseases[J].Pol Merkuriusz Lek, 2003(84):541-544.
9. Suhum acher P. Allergien gegen Tiere sindheilber [M].Stuttgart Sonntag Verlag Stuttgart,2001:117-118.
10.李润祥,龚业青,肖常青等.变态反应性皮肤病常见变应原检测结果分析[J].中国麻风皮肤病杂志.2008,24(5)：362-363.
11.巴德年.当代免疫学技术与应用.北京：北京医科大学,中国协和医科大学联合出版社,1998.122-123.
12.张晓波,陆爱珍,王立波,等.儿童变态反应性疾病相关因素研究[J].临床儿科杂志,2007,25(9)：755-758.
13. Arbanovski D,Nedeljkovic M Bicom-bioresonance therapy[J].Med Pregl,2000,537(7-8):437-439.
14. Calabria CW, Dice JP,Hagan LL. Prevalence of positive skin test responses to 53 allergens in patients with rhinitis symptoms, Allergy Asthma Proc 2007 Jul-Aug;28(4):442-448.
15. Koro O,Furutani K,Hide M,Hide M,et al.Chemical mediators in atopicdermatitis:involvement of leukotriene B4 released by a type I allergic reaction in the pathogenesis of atopic dermatitis,J Allergy Clin Immunol 1999;103:663-70.
16. Wistokat-Wulfing A,Schmidt P,Darsow U,et al. Atopy patch test reactions are associated with T lymphocyte-mediated allergenspecific immune responses in atopic dermatitis, Clin Exp Allergy 1999;29:513-521.
17. Kwon BC,Sohn MH,Kim KW,et al. House Dust Mite Induces Expression of Intercellular Adhesion Molecule-1 in Eol-1 Human Eosinophilic Leukemic Cells, J Korean Med Sci 2007 Oct;22(5):815-819.
18.李林峰.接触性皮炎与皮肤变态反应[M].北京：北京大学医学出版社,2003;1：54.
19. Bussmann C,Maintz L,Hart J,et al.Clinical improvement and immunological changes in atopic dermatitis patients undergoing subcutaneous immunotherapy with a house dust mite allergoid:a pilot study,Clin Exp Allergy 2007 Sep;37(9):1277-1285.
20.丁梅,史梅.常州地区600例变态反应性疾病过敏原检测分析[J].临床和实验医学杂志.2008,7(12)：37-38.
21.吴清香,开月梅,张杨.过敏性鼻炎变应原皮肤点刺试验结果分析[J].护理学杂志,2006,21(4)：12.
22.魏淑湘,王晓云,高峰,等.243例湿疹过敏原检测结果分析[J].中国麻风皮肤病杂志.2007,23(1)：79.
23.赵京,马煜,陈育智,等.北京地区儿童呼吸道过敏性疾病与皮肤过敏原试验的调查[J].中华医学杂志.2003,83(21)：1879-1881.
24.范剑,楼滨,张杰等.浙江地区变态反应性疾病季节变化的初步分析[J].江西医学检验,2005,23(4)：341-342.
25.钱迪,洪苏玲,杨玉成,等.我国西部部分地区变应性鼻炎流行病学抽样调查[J].第三军医大学学报.2008,30(6)：539-542.
26.周玲,余霞萍.1012例变态反应性疾病的测敏及脱敏治疗分析[J].中国误 诊学杂志.2001,1(2)：295-296.
27. Paganelli R,Ansotegui J, Sastre J,et al.Specific IgE antibodies in the diagnosis of atopic disease. Clinical evaluation of a new in vitro test system, VniCAP,in six European allergy clinics[J].Allergy,1998,53(8):763-768.
28.蒋源.310例荨麻疹患者过敏原检测结果[J].岭南皮肤性病科杂志.2004,11(4)：357-358.
29.杨玲,许以平,邹寒冰,等.2475例过敏患者过敏原分析[J].标记免疫分析与临床.2007,14(3)：141-143.
30.王晓云,韩雪峰,阎建华,等.潍坊地区荨麻疹、湿疹患者的过敏原检测结果与分析[J].潍坊医学院学报.2007,29(1)：82-83.
1.龚菲力.医学免疫学.第一版.北京：科学出版社,2003,191.
2. Yazdanbakhsh M, Kremsner PG,Van et al.Science,2002,296(5567):490-494.
3.巴德年.当代免疫学技术与应用.北京：北京医科大学,中国协和医科大学联合出版社,1998.122-123.
4. Nowak D,Volmer T,Wettengel R.Bronchial asthma-a cost of illness anaglysis(abstract).Pneumologie,1996,50:364.
5. National Asthma Campaign. Asthma Agenda(National Asthma Camppaign,London:1998)
6. Smith DH,Malone DC,Lawson KA et al. A national estimate of the economic costs of asthma.Am J Respir Crit Care Med,1997,156:787.
7. Chandra RK.Breast feeding,hydrolysate formulas and delayed introduction of selected foods in the prevention of food hypersensitivity and allergic disease[J].Nutrition Research,2002(2):125-135.
8.张建中.慢性湿疹的内在因素和预防[J].中国全科医学,2004,7(12)：854-855.
9.杨捷,曾仁山,方锐华等.2333例变应性皮肤病患者血清过敏原检测分析[J].国际医药卫生导报.2006,12(6)：84-85.
10. Matsuoka S,Nakaqawa R,Nakayama H, et al. Prevalence of specific allerrgic diseases in school children as related to parental atopy.Pediatr Int.1999;41(1):46-51.
11.张晓波,陆爱珍,王立波,等.儿童变态反应性疾病相关因素研究[J].临床儿科杂志,2007,25(9)：755-758.
12.李雅莉,张洁,孙秀珍.支气管哮喘发病因素的回顾性分析[J].陕西医学杂志,2001,30(30)：189-190.
13.张迎俊.山东地区过敏患者过敏原检测结果调查分析[J].中国全科医
学.2008,6(8)：841-842.
14. Paganelli R,Ansotegui J,Sastre J,et al.Specific IgE antibodies in the diagnosis of atopic disease.Clinical evaluation of a new in vitro test system, VniCAP,in six European allergy clinics[J].Allergy,1998,53(8):763-768.
15. Montealegre F, Meyer B,Chardon D.Comparative prevalence of sensitization to common animal,plant and mould allergens in subjects with asthma,or atopic dermatitis and/or allergic rhinitis living in a tropical environment. Clin Exp Allergy 2004;34(1):51-8.
16. Kidon MI,Chiang WC,Liew WK et al. Secsitization to dust mites in children with allergic rhinitis in Singapore:does it matter if you scratch while you sneeze? Clin Exp Allergy.2005;35(4):434-40.
17.赵京,马煜,陈有智,等.北京地区儿童呼吸道过敏性疾病与皮肤过敏原试验的调查.中华医学杂志.2003；83(2)：1879-81.
18.江萍,肖持坚,钟维健,等.564例支气管哮喘致病因素调查[J].华夏医学,2000,13(3)：279-280.
19.范剑,楼滨,张杰等.浙江地区变态反应性疾病季节变化的初步分析[J].江西医学检验,2005,23(4)：341-342.
20.吴清香,开月梅,张杨.过敏性鼻炎变应原皮肤点刺试验结果分析[J].护理学杂志,2006,21(4)：12.
21.杜永成,哮喘的现代诊断与治疗(M).北京：中国医药科技出版社,2002.5.
22.孙艺渊.变应性鼻炎的病因学研究.上海医科大学学报.2006,2,17-18.
23. Dearman R J,Kimber I.Food allergy:What are the issues?Toxicologyletters,2001,120(1-3)：165-170.
24.顾恒,颜艳,陈蓖,等.我国特应性皮炎流行病学调查[J].中华皮肤科杂志,2000,33(6)：379-383.
25. Motta AC, Mrliere M, Peltre G,et al.Traffic related air pollutants induce the release of allergen-containing cytoplasmic granules from gress pollen.Int Arch Allergy Immunol,2006,139:294-298.
26. Kagan Rs.Food allergy:an overview [J].Environ Health Perspect, 2003,111(2):223-225.
27. Niggemann B, Sieaff B, Beyer K, et al.Outcome of double-blind, placebor controlled food challenge tests in 107 children with atopic dermatitis.Clin Exp Allergy,1999,29(1):91-96.
28. Cantani A.The growing genetic links and the early onset of atopic diseases in children stress the unique role of the atopic march:a meta-analysis.J Investing Allergol Clin Immunol,1999:9(5):314-20.
29. Tarip SM,Mattews SM,Hakim EA,et al.Egg allergy in infancy predicts respiratory allergic disease by 4 years of age.Pediatr Allergy Immunol, 2000;11(3):162-7.
30.胡燕,黎海芪.0-24儿童食物过敏的流行病学研究[J].中华儿科杂志,2000；38(7)：431-434.
31. Ogura Y,Ogura H,IusiN.The incidence of food allergy in atopic dematitis[J].Arerugj,2001,50(7):621-628.
32. Nambu M, Shintaku N, ohta S. Rice allergy [J].Pediatrics,2006,117(6): 2331-2332.
33. Kumar R,Srivastave P,Kumari D,et al.Rice(Oryzasativa) allergy in rhinitis and asthm a patients a clinico-immunological study[J].Immunobiology,2007, 212(2):141-147.
34. Hendra T.Passing the food allergen test.Cereal Foods World,2003,48(1):20.
35.周文明,张学军.特应性皮炎的环境因素.国外医学皮肤性病学分册,2003,29(2)：92-93.
36.张春香,王建英,王亚平.青岛地区882例变应性皮肤病患者血清过敏原及IgE检测分析[J].中国中西医结合皮肤性病学杂志.2004,3(4)：223-224.
37.晓梅,沈彦红.理发员使用化学药品诱发变态反应性疾病的流行病学调查[J].中国初级卫生保健.2005,19(2)：77-78.
38.陈丽芳,李林峰.微生物与特应性皮炎[J].国外医学.皮肤性病学分
册,2001,27,(5)：265-267.
39.林麟,陈晓,陈敏,等.湿疹皮炎中葡萄球菌及常用抗生素耐药性状况与硝酸益康唑/曲安奈德霜治疗的观察.临床皮肤科杂志,2002,31(12)：764-766.
40. Sakurane M,Shiotani A,Furukawa F.Therapentic effects of antibacterial treatment for in tractable skin diseases in Helicobacter phlori-positive Japanese patients.J Dermatol,2002,29(1):23-7.
41. Donnel AT.Grammer LC.An overview of allergens [J].Allergy A sthma Proe,2004,25(4):S2-S5.
42. Miyake Y,Ohya Y,Tanaka K,et al.Home environment and suspected atopic eczema in Japanese infants The osaka matemal and child health study[J].Pediatr Allergy Immunol,2007,18(5):425-432.
43.叶世泰,乔秉善.中国气传致敏真菌调查.第一版.北京：科技出版社.1995：1-50.
44.杨津丽.三种过敏性疾病分析[J].江西医学院学报,1997,37(1)：73.
45.郝飞.特应性皮炎的发病机制及治疗进展[J].中华皮肤科杂志,2002,35(1)：73-75.
46. Liu A.Hand Murphy J.R.Hygiene hypiene hypathesis:fact or fiction?J Allergy Clin Immunol.2003,3:471-478.
47. Marks GB.Environmental factors and gene-environment interactions in the aetiology of asthma[J].Clini Exp Physiol,2006,33(3):285-289.
48.范永琛.小儿哮喘与喘息性支气管炎的区别.中华儿科杂志,2006,44(1)：68-70.
49. Ceappens J.Westem Lifestyle,Local defenses and the rising incidence of allergic rhinitis. Acta Otorhinolaryngol Belg,2000,54:391-395.
50.魏为利,邱忠民,吕寒静.性别对哮喘发病年龄的影响[J].第四军医大学学报,2006,27(5)：472-474.
51.安杨,高丽,刘俊昌.乌鲁木齐市成年人变应性鼻炎流行病学调查.中国中西医结合耳鼻喉科杂志.2005;13(4)：231-2.
52. Shamssain MH,Shamsian N.Prevalence and severity of asthma,rhinitis,and atopic eczema in 13-to 14-year-old schoolchildren from the northeast fo England. Ann Allergy Asthma Immunol.2001;(4):428-32.
53. Ishizaki T,Koizumi K,Ikemori R,et al.Studies of prevalence of Japanese cedar pollinosis among the residents in a densely cultivated area.Aun Allergy,1987,58:265-270.
54. Slvica Stevanovic,Dragana Nikic.Exposure to air pollution and development of allergic rhinitis and asthma. Medicine and Biology.2006;13(2):114-8.
55. Kumar R,Srivastave P,Kumari D,et al.Rice(Oryzasativa) allergy in rhinitis and asthm a patients a clinico-immunological study[J].Immunobiology,2007, 212(2):141-147.
56. Huurre TM,Aro HM,Jaakola JJ.Incidence and prevalence of asthma and allergic rhinitis:a cohort study of Finish adolescents.J Asthma.2004;41(3):311-7.
57.江斐.室内污染造成儿童哮喘高发[J].沿海环境.2003,4(2)：29.
58. Brasche S,Bischof W.Daily time spent indoors in Fgerman homes-baseline data for the assessment of indoor exposure of German occupants.Intermational Journal of Hygiene and Environmental Health,2005,208(4):247-253.
59. Leech JA,Nelson WC,Burnett RT, et al.It is about time:A comparison of Canadian and American time-activity patterns. Journal of Exposure Analysis and Environmental Epidemiology,2002,12(6):427-432.
60. Behrendt H,Kramer V,Schafer T,et al.Allergotoxicology A research concept to study the role of environmental pollutants in allergy [J].ACI. Internationa,2001,13:122-128.
61.林颖,陈灿达.变态反应性疾病发病相关因素的研究进展[J].中国中西医结合皮肤病学杂志,2005,4(1)：60-63.
62.吴国勤,金岚,李明等.咪唑斯丁治疗慢性特发性荨麻疹临床研究[J].临床皮肤科杂志.2001,30(3)：181.
63.贾爱华,李玉平,李艳玲,等.皮肤划痕症患者生活事件和特质应对方式研究[J].中华皮肤科杂志,2008,41(2)：124-125.
64.程靖,彭贵阳,张奇峰.等.变应性鼻炎与食物因素的相关性研究初探[J].临床耳鼻咽喉科杂志,2002,16：393-394,396.
65. Wood P,Asner MI,Bjorksten B,et al.Diet and asthma,allergic Rhino conjunctivitis and atopic eczema symptom prevalence:an ecological analysis of the International Study "Asthma and Allergies in childhood(ISAAC) data[J]".Eur Respir J,2001,17:436-443.
66. Shaheen S O,Sterna J A,Mthompson R L,et al.Dietary antioxideants and asthma in aduls:population-based case-control study [J].Am J Respir Crit Care Med,2001,164:1823-1828.
67. Huamg SL,Pan WH.Dietary fats and asthma in teenagers:analyses of the first Nutrition and Health Survey in Taiwan(NAHSIT)[J].Clin Exp Allergy,2001,31:1875-1880.
68.杨季国,叶万敏,陈玉燕,等.儿童哮喘与饮食等相关因素的研究[J].浙江中医学院学报,2003,27(3)：30-31.
69.王亚平,尉莉.80例过敏性疾病患者的过敏原调查.China J Lepr Skin Dis.2005,21(12):995-996.
70. Sunyer J,Anto JM,Kogevinas M,et al.Smoking and bronchial respon siveness in nonatopic and atopic young adults.Thorax,1997,52:235-238.
71. Thomson NC.Chandhuri R.Linngston E.Asthma and cigaretle smoking.Eur Respir J,2004,24:822-33.
72. Melen EM.Wickman SL.Nordvall M.et al.Influence of early and current environmental exposure factors on sensitization and outcome of asthma in preschool children Allergy.2001,56:646-652.
73. Noauthorss Listed.Health effects of exposure to enviromental tobacco smoke. Califonia enviromental Protection Agency[J].Tob control,1997,6(4):346-353.
74. Nambu M,Shintaku N,ohta S.Rice allergy [J].Pediatrics,2006,117(6): 2331-2332.
75. Min YG,Choi BY, Knon SK,et al.Multicenter study on the prevaleace of perennial allergic rhinitis and allergy-associated disorders.J korean Med Sei.2001:697-701.
2.聂凌鸿.食物过敏原研究进展[J].生命的化学,2002,22：474-477.
3. Yazdanbakhsh M, Kremsner PG,Van et al.Science,2002,296(5567):490-494.
4.毕爱华,龚非力.医学免疫学[M].北京：人民军医出版社,1995：191.
5. Paganelli R,Ansotegui J,Sastre J,et al.Specific IgE antibodies in the diagnosis of atopic disease. Clinical evaluation of a new in vitro test system, VniCAP,in six European allergy clinics[J].Allergy,1998,53(8):763-768.
6.于 陆,韩乃揆.支气管哮喘的体内、体外检测和免疫治疗的相关分析[J].中华微生物学和免疫学杂志,2001,21(4)：87.
7.江向东,黄艳华.量子物理学[M].上海：上海科技教育出版社,2001：81.
8. Kruszew ski J Diagnosis of allergic diseases[J].Pol Merkuriusz Lek, 2003(84):541-544.
9. Suhum acher P. Allergien gegen Tiere sindheilber [M].Stuttgart Sonntag Verlag Stuttgart,2001:117-118.
10.李润祥,龚业青,肖常青等.变态反应性皮肤病常见变应原检测结果分析[J].中国麻风皮肤病杂志.2008,24(5)：362-363.
11.巴德年.当代免疫学技术与应用.北京：北京医科大学,中国协和医科大学联合出版社,1998.122-123.
12.张晓波,陆爱珍,王立波,等.儿童变态反应性疾病相关因素研究[J].临床儿科杂志,2007,25(9)：755-758.
13. Arbanovski D,Nedeljkovic M Bicom-bioresonance therapy[J].Med Pregl,2000,537(7-8):437-439.
14. Calabria CW, Dice JP,Hagan LL. Prevalence of positive skin test responses to 53 allergens in patients with rhinitis symptoms, Allergy Asthma Proc 2007 Jul-Aug;28(4):442-448.
15. Koro O,Furutani K,Hide M,Hide M,et al.Chemical mediators in atopicdermatitis:involvement of leukotriene B4 released by a type I allergic reaction in the pathogenesis of atopic dermatitis,J Allergy Clin Immunol 1999;103:663-70.
16. Wistokat-Wulfing A,Schmidt P,Darsow U,et al. Atopy patch test reactions are associated with T lymphocyte-mediated allergenspecific immune responses in atopic dermatitis, Clin Exp Allergy 1999;29:513-521.
17. Kwon BC,Sohn MH,Kim KW,et al. House Dust Mite Induces Expression of Intercellular Adhesion Molecule-1 in Eol-1 Human Eosinophilic Leukemic Cells, J Korean Med Sci 2007 Oct;22(5):815-819.
18.李林峰.接触性皮炎与皮肤变态反应[M].北京：北京大学医学出版社,2003;1：54.
19. Bussmann C,Maintz L,Hart J,et al.Clinical improvement and immunological changes in atopic dermatitis patients undergoing subcutaneous immunotherapy with a house dust mite allergoid:a pilot study,Clin Exp Allergy 2007 Sep;37(9):1277-1285.
20.丁梅,史梅.常州地区600例变态反应性疾病过敏原检测分析[J].临床和实验医学杂志.2008,7(12)：37-38.
21.吴清香,开月梅,张杨.过敏性鼻炎变应原皮肤点刺试验结果分析[J].护理学杂志,2006,21(4)：12.
22.魏淑湘,王晓云,高峰,等.243例湿疹过敏原检测结果分析[J].中国麻风皮肤病杂志.2007,23(1)：79.
23.赵京,马煜,陈育智,等.北京地区儿童呼吸道过敏性疾病与皮肤过敏原试验的调查[J].中华医学杂志.2003,83(21)：1879-1881.
24.范剑,楼滨,张杰等.浙江地区变态反应性疾病季节变化的初步分析[J].江西医学检验,2005,23(4)：341-342.
25.钱迪,洪苏玲,杨玉成,等.我国西部部分地区变应性鼻炎流行病学抽样调查[J].第三军医大学学报.2008,30(6)：539-542.
26.周玲,余霞萍.1012例变态反应性疾病的测敏及脱敏治疗分析[J].中国误 诊学杂志.2001,1(2)：295-296.
27. Paganelli R,Ansotegui J, Sastre J,et al.Specific IgE antibodies in the diagnosis of atopic disease. Clinical evaluation of a new in vitro test system, VniCAP,in six European allergy clinics[J].Allergy,1998,53(8):763-768.
28.蒋源.310例荨麻疹患者过敏原检测结果[J].岭南皮肤性病科杂志.2004,11(4)：357-358.
29.杨玲,许以平,邹寒冰,等.2475例过敏患者过敏原分析[J].标记免疫分析与临床.2007,14(3)：141-143.
30.王晓云,韩雪峰,阎建华,等.潍坊地区荨麻疹、湿疹患者的过敏原检测结果与分析[J].潍坊医学院学报.2007,29(1)：82-83.
1.龚菲力.医学免疫学.第一版.北京：科学出版社,2003,191.
2. Yazdanbakhsh M, Kremsner PG,Van et al.Science,2002,296(5567):490-494.
3.巴德年.当代免疫学技术与应用.北京：北京医科大学,中国协和医科大学联合出版社,1998.122-123.
4. Nowak D,Volmer T,Wettengel R.Bronchial asthma-a cost of illness anaglysis(abstract).Pneumologie,1996,50:364.
5. National Asthma Campaign. Asthma Agenda(National Asthma Camppaign,London:1998)
6. Smith DH,Malone DC,Lawson KA et al. A national estimate of the economic costs of asthma.Am J Respir Crit Care Med,1997,156:787.
7. Chandra RK.Breast feeding,hydrolysate formulas and delayed introduction of selected foods in the prevention of food hypersensitivity and allergic disease[J].Nutrition Research,2002(2):125-135.
8.张建中.慢性湿疹的内在因素和预防[J].中国全科医学,2004,7(12)：854-855.
9.杨捷,曾仁山,方锐华等.2333例变应性皮肤病患者血清过敏原检测分析[J].国际医药卫生导报.2006,12(6)：84-85.
10. Matsuoka S,Nakaqawa R,Nakayama H, et al. Prevalence of specific allerrgic diseases in school children as related to parental atopy.Pediatr Int.1999;41(1):46-51.
11.张晓波,陆爱珍,王立波,等.儿童变态反应性疾病相关因素研究[J].临床儿科杂志,2007,25(9)：755-758.
12.李雅莉,张洁,孙秀珍.支气管哮喘发病因素的回顾性分析[J].陕西医学杂志,2001,30(30)：189-190.
13.张迎俊.山东地区过敏患者过敏原检测结果调查分析[J].中国全科医
学.2008,6(8)：841-842.
14. Paganelli R,Ansotegui J,Sastre J,et al.Specific IgE antibodies in the diagnosis of atopic disease.Clinical evaluation of a new in vitro test system, VniCAP,in six European allergy clinics[J].Allergy,1998,53(8):763-768.
15. Montealegre F, Meyer B,Chardon D.Comparative prevalence of sensitization to common animal,plant and mould allergens in subjects with asthma,or atopic dermatitis and/or allergic rhinitis living in a tropical environment. Clin Exp Allergy 2004;34(1):51-8.
16. Kidon MI,Chiang WC,Liew WK et al. Secsitization to dust mites in children with allergic rhinitis in Singapore:does it matter if you scratch while you sneeze? Clin Exp Allergy.2005;35(4):434-40.
17.赵京,马煜,陈有智,等.北京地区儿童呼吸道过敏性疾病与皮肤过敏原试验的调查.中华医学杂志.2003；83(2)：1879-81.
18.江萍,肖持坚,钟维健,等.564例支气管哮喘致病因素调查[J].华夏医学,2000,13(3)：279-280.
19.范剑,楼滨,张杰等.浙江地区变态反应性疾病季节变化的初步分析[J].江西医学检验,2005,23(4)：341-342.
20.吴清香,开月梅,张杨.过敏性鼻炎变应原皮肤点刺试验结果分析[J].护理学杂志,2006,21(4)：12.
21.杜永成,哮喘的现代诊断与治疗(M).北京：中国医药科技出版社,2002.5.
22.孙艺渊.变应性鼻炎的病因学研究.上海医科大学学报.2006,2,17-18.
23. Dearman R J,Kimber I.Food allergy:What are the issues?Toxicologyletters,2001,120(1-3)：165-170.
24.顾恒,颜艳,陈蓖,等.我国特应性皮炎流行病学调查[J].中华皮肤科杂志,2000,33(6)：379-383.
25. Motta AC, Mrliere M, Peltre G,et al.Traffic related air pollutants induce the release of allergen-containing cytoplasmic granules from gress pollen.Int Arch Allergy Immunol,2006,139:294-298.
26. Kagan Rs.Food allergy:an overview [J].Environ Health Perspect, 2003,111(2):223-225.
27. Niggemann B, Sieaff B, Beyer K, et al.Outcome of double-blind, placebor controlled food challenge tests in 107 children with atopic dermatitis.Clin Exp Allergy,1999,29(1):91-96.
28. Cantani A.The growing genetic links and the early onset of atopic diseases in children stress the unique role of the atopic march:a meta-analysis.J Investing Allergol Clin Immunol,1999:9(5):314-20.
29. Tarip SM,Mattews SM,Hakim EA,et al.Egg allergy in infancy predicts respiratory allergic disease by 4 years of age.Pediatr Allergy Immunol, 2000;11(3):162-7.
30.胡燕,黎海芪.0-24儿童食物过敏的流行病学研究[J].中华儿科杂志,2000；38(7)：431-434.
31. Ogura Y,Ogura H,IusiN.The incidence of food allergy in atopic dematitis[J].Arerugj,2001,50(7):621-628.
32. Nambu M, Shintaku N, ohta S. Rice allergy [J].Pediatrics,2006,117(6): 2331-2332.
33. Kumar R,Srivastave P,Kumari D,et al.Rice(Oryzasativa) allergy in rhinitis and asthm a patients a clinico-immunological study[J].Immunobiology,2007, 212(2):141-147.
34. Hendra T.Passing the food allergen test.Cereal Foods World,2003,48(1):20.
35.周文明,张学军.特应性皮炎的环境因素.国外医学皮肤性病学分册,2003,29(2)：92-93.
36.张春香,王建英,王亚平.青岛地区882例变应性皮肤病患者血清过敏原及IgE检测分析[J].中国中西医结合皮肤性病学杂志.2004,3(4)：223-224.
37.晓梅,沈彦红.理发员使用化学药品诱发变态反应性疾病的流行病学调查[J].中国初级卫生保健.2005,19(2)：77-78.
38.陈丽芳,李林峰.微生物与特应性皮炎[J].国外医学.皮肤性病学分
册,2001,27,(5)：265-267.
39.林麟,陈晓,陈敏,等.湿疹皮炎中葡萄球菌及常用抗生素耐药性状况与硝酸益康唑/曲安奈德霜治疗的观察.临床皮肤科杂志,2002,31(12)：764-766.
40. Sakurane M,Shiotani A,Furukawa F.Therapentic effects of antibacterial treatment for in tractable skin diseases in Helicobacter phlori-positive Japanese patients.J Dermatol,2002,29(1):23-7.
41. Donnel AT.Grammer LC.An overview of allergens [J].Allergy A sthma Proe,2004,25(4):S2-S5.
42. Miyake Y,Ohya Y,Tanaka K,et al.Home environment and suspected atopic eczema in Japanese infants The osaka matemal and child health study[J].Pediatr Allergy Immunol,2007,18(5):425-432.
43.叶世泰,乔秉善.中国气传致敏真菌调查.第一版.北京：科技出版社.1995：1-50.
44.杨津丽.三种过敏性疾病分析[J].江西医学院学报,1997,37(1)：73.
45.郝飞.特应性皮炎的发病机制及治疗进展[J].中华皮肤科杂志,2002,35(1)：73-75.
46. Liu A.Hand Murphy J.R.Hygiene hypiene hypathesis:fact or fiction?J Allergy Clin Immunol.2003,3:471-478.
47. Marks GB.Environmental factors and gene-environment interactions in the aetiology of asthma[J].Clini Exp Physiol,2006,33(3):285-289.
48.范永琛.小儿哮喘与喘息性支气管炎的区别.中华儿科杂志,2006,44(1)：68-70.
49. Ceappens J.Westem Lifestyle,Local defenses and the rising incidence of allergic rhinitis. Acta Otorhinolaryngol Belg,2000,54:391-395.
50.魏为利,邱忠民,吕寒静.性别对哮喘发病年龄的影响[J].第四军医大学学报,2006,27(5)：472-474.
51.安杨,高丽,刘俊昌.乌鲁木齐市成年人变应性鼻炎流行病学调查.中国中西医结合耳鼻喉科杂志.2005;13(4)：231-2.
52. Shamssain MH,Shamsian N.Prevalence and severity of asthma,rhinitis,and atopic eczema in 13-to 14-year-old schoolchildren from the northeast fo England. Ann Allergy Asthma Immunol.2001;(4):428-32.
53. Ishizaki T,Koizumi K,Ikemori R,et al.Studies of prevalence of Japanese cedar pollinosis among the residents in a densely cultivated area.Aun Allergy,1987,58:265-270.
54. Slvica Stevanovic,Dragana Nikic.Exposure to air pollution and development of allergic rhinitis and asthma. Medicine and Biology.2006;13(2):114-8.
55. Kumar R,Srivastave P,Kumari D,et al.Rice(Oryzasativa) allergy in rhinitis and asthm a patients a clinico-immunological study[J].Immunobiology,2007, 212(2):141-147.
56. Huurre TM,Aro HM,Jaakola JJ.Incidence and prevalence of asthma and allergic rhinitis:a cohort study of Finish adolescents.J Asthma.2004;41(3):311-7.
57.江斐.室内污染造成儿童哮喘高发[J].沿海环境.2003,4(2)：29.
58. Brasche S,Bischof W.Daily time spent indoors in Fgerman homes-baseline data for the assessment of indoor exposure of German occupants.Intermational Journal of Hygiene and Environmental Health,2005,208(4):247-253.
59. Leech JA,Nelson WC,Burnett RT, et al.It is about time:A comparison of Canadian and American time-activity patterns. Journal of Exposure Analysis and Environmental Epidemiology,2002,12(6):427-432.
60. Behrendt H,Kramer V,Schafer T,et al.Allergotoxicology A research concept to study the role of environmental pollutants in allergy [J].ACI. Internationa,2001,13:122-128.
61.林颖,陈灿达.变态反应性疾病发病相关因素的研究进展[J].中国中西医结合皮肤病学杂志,2005,4(1)：60-63.
62.吴国勤,金岚,李明等.咪唑斯丁治疗慢性特发性荨麻疹临床研究[J].临床皮肤科杂志.2001,30(3)：181.
63.贾爱华,李玉平,李艳玲,等.皮肤划痕症患者生活事件和特质应对方式研究[J].中华皮肤科杂志,2008,41(2)：124-125.
64.程靖,彭贵阳,张奇峰.等.变应性鼻炎与食物因素的相关性研究初探[J].临床耳鼻咽喉科杂志,2002,16：393-394,396.
65. Wood P,Asner MI,Bjorksten B,et al.Diet and asthma,allergic Rhino conjunctivitis and atopic eczema symptom prevalence:an ecological analysis of the International Study "Asthma and Allergies in childhood(ISAAC) data[J]".Eur Respir J,2001,17:436-443.
66. Shaheen S O,Sterna J A,Mthompson R L,et al.Dietary antioxideants and asthma in aduls:population-based case-control study [J].Am J Respir Crit Care Med,2001,164:1823-1828.
67. Huamg SL,Pan WH.Dietary fats and asthma in teenagers:analyses of the first Nutrition and Health Survey in Taiwan(NAHSIT)[J].Clin Exp Allergy,2001,31:1875-1880.
68.杨季国,叶万敏,陈玉燕,等.儿童哮喘与饮食等相关因素的研究[J].浙江中医学院学报,2003,27(3)：30-31.
69.王亚平,尉莉.80例过敏性疾病患者的过敏原调查.China J Lepr Skin Dis.2005,21(12):995-996.
70. Sunyer J,Anto JM,Kogevinas M,et al.Smoking and bronchial respon siveness in nonatopic and atopic young adults.Thorax,1997,52:235-238.
71. Thomson NC.Chandhuri R.Linngston E.Asthma and cigaretle smoking.Eur Respir J,2004,24:822-33.
72. Melen EM.Wickman SL.Nordvall M.et al.Influence of early and current environmental exposure factors on sensitization and outcome of asthma in preschool children Allergy.2001,56:646-652.
73. Noauthorss Listed.Health effects of exposure to enviromental tobacco smoke. Califonia enviromental Protection Agency[J].Tob control,1997,6(4):346-353.
74. Nambu M,Shintaku N,ohta S.Rice allergy [J].Pediatrics,2006,117(6): 2331-2332.
75. Min YG,Choi BY, Knon SK,et al.Multicenter study on the prevaleace of perennial allergic rhinitis and allergy-associated disorders.J korean Med Sei.2001:697-701.