变应原皮肤点刺试验与儿童变应性鼻炎进程变化的相关性  

Skin prick test and allergic rhinitis nature course in children

作　　者：张杰[1] 张星[1] 陈敏[1] 赵靖[1] 郝津生[1] 张亚梅[1] 

机构地区：[1]首都医科大学附属北京儿童医院耳鼻咽喉科,北京100045

出　　处：《中国耳鼻咽喉头颈外科》2011年第6期311-314,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：首都医学发展科研基金(2009-3125);北京市优秀人才培养项目(2009A003008000003)联合资助

摘　　要：目的探讨3～5岁变应性鼻炎(AR)患儿变应原皮肤点刺试验(skin prick test,SPT)与AR进程转归的相关性。方法针对2006～2007年北京儿童医院就北京地区3～5岁儿童AR流行病学调查中,通过问卷和变应原SPT确诊AR患儿248例,3年后再次进行问卷调查,进行症状诊断AR,分析变应原SPT阳性等级、变应原种类、单一或多种变应原致敏与AR进程变化之间的关系。结果变应原种类分布前5位依次为交链孢霉、屋尘螨、粉尘螨、霉菌和动物毛;其中交链孢霉阳性与阴性患儿"AR持续"率分别为68.9%和52.9%,两者间有统计学差异(χ2=5.04,P=0.03);变应原阳性等级III、IV级患儿"AR持续"率分别为46.0%、67.4%,二者间有统计学差异(χ2=7.11,P<0.01);116例"AR持续"患儿变应原阳性等级差别与AR症状严重程度以及AR症状持续时间均无显著相关性;单一和多种变应原致敏患儿"AR持续"率分别为52.2%和66.9%,两者间存在显著性差异(χ2=3.95,P<0.05)。结论交链孢霉更易使AR持续存在。变应原阳性等级越高,对于AR的持续存在有明显作用,而多种变应原致敏也可使AR症状持续存在。提示早期变应原检测对于AR自然进程的进展有一定预测作用,对于AR的防治有积极作用。OBJECTIVE To investigate the relationship between the skin prick test and the natural course of children with allergic rhinitis（AR）.METHODS A total of 248 children,who diagnosed AR by questionnaire and skin prick test from 2006 to 2007 in Beijing,were followed up.The same questionnaires were re-answered after 3 years,and AR was diagnosed according to the symptoms,called ‘AR continuing’.The relationships between skin prick test positive rating,allergen type,monoallergen and multi-allergen sensitization and natural course of AR were studied.The data were statistically analyzed.RESULTS The top five allergens were rated as Alternaria tenuis,Dermatophagoides pteronyssinus,Dermatophagoides farina,moulds and animal hair.The difference of ＂AR continuing＂ rates were 68.9% and 52.9% in children with Alternaria tenuis positive and negative group（χ2=5.04,P=0.03）,46.0% and 67.4% with allergen-positive grade 3 and 4（χ2=7.11,P0.01）,52.2% and 66.9% with monoallergen and multi-allergen sensitization（χ2=3.95,P0.05）respectively.Allergen-positive grade was not related to the severity of AR.CONCLUSION Alternaria tenuis,high allergen-positive grade and multi-allergen sensitization are risk factors of ‘AR continuing’.Early detection of allergens could predict the natural course of AR.It is also useful for prevention and treatment of AR.

关 键 词：变应原 儿童 变应性鼻炎 皮肤点刺试验 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]