变应性鼻炎患者10030例吸入性变应原谱分析  

Prevalence of sensitization to aeroallergens in 10 030 patients with allergic rhinitis

作　　者：杨酉[1] 赵岩[1] 王成硕[1] 王向东[1] 张罗[2] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730 [2]北京市耳鼻咽喉科研究所教育部耳鼻咽喉头颈科学重点实验室首都医科大学

出　　处：《中华耳鼻咽喉头颈外科杂志》2011年第11期914-920,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：基金项目：国家杰出青年科学基金（81025007）;国家自然科学基金（30872846、30973282）;北京市自然科学基金（7102030）;北京市教委科技计划重点项目（KZ200910025008）

摘　　要：目的调查不同年龄和性别的10030例变应性鼻炎（allergic rhinitis，AR）患者的吸人性变应原谱分布情况。方法采用21组共43种标准化变应原对54813例慢性鼻炎患者进行皮肤点刺试验，诊断AR10030例，男性和女性均按年龄（以周岁记）分为4组，分别是：3～17岁、18-39岁、40—59岁以及≥60岁组（共8组），分析各组患者变应原分布状况。结果①不同年龄组患者对不同变应原反应呈阳性的例数分析显示，男性占前4位的变应原依次为粉尘螨、屋尘螨、艾蒿、德国小蠊，女性依次为粉尘螨、屋尘螨、艾蒿和藜。②患者阳性变应原个数的分布显示，不同年龄男性和女性患者，双重变应原阳性均位列首位，其次是三重变应原阳性或单一变应原阳性。③单一阳性变应原分析显示，男性3—17岁患者前d位是粉尘螨、屋尘螨、交链孢霉菌、艾蒿，其余年龄组男性患者阳性变应原前4位均是粉尘螨、屋尘螨、艾蒿和德国小蠊；女性3～17岁患者阳性变应原前d位是粉尘螨、屋尘螨、艾蒿和交链孢霉菌，18～39岁组是粉尘螨、屋尘螨、艾蒿和蒲公英，40～59岁组是粉尘螨、屋尘螨、艾蒿和混合树1，〉／60岁患者前4位变应原是粉尘螨、屋尘螨、混合动物毛和艾蒿。④不同年龄和性别患者双重阳性变应原占首位的均是粉尘螨＋屋尘螨。在3～17岁的患者中，对交链孢霉菌的双重阳性患者例数排在粉尘螨＋屋尘螨之后，高于其他变应原组合。18岁以上的患者，交链孢霉菌双重阳性患者比例下降，而花粉类变应原、德国小蠊、粉尘螨或屋尘螨的双重阳性率上升。⑤不同性别患者三重阳性变应原居首位的是粉尘螨＋屋尘螨＋德国小蠊，其次是粉尘螨＋屋尘螨＋混合动物毛和粉尘螨＋屋尘螨＋艾蒿，其余组合少见。结论尘螨、夏秋花粉及杂草花粉、交链孢霉菌和德国小蠊是导致我国北Objective To investigate the main inhaled allergens in patients with allergic rhinitis. Methods Forty-three standardization allergens were used to perform skin prick test in 54 813 patients with chronic rhinitis. According to different gender and age groups, 10 030 patients with allergic rhinitis were divided into eight groups. The distributions of different allergens in the eight groups were analyzed. Results ①The most common four allergens in male patients with allergic rhinitis were Dermatophagoidesfarina （Der f）, Dermatophagoides pteronyssinus （ Der p ）, Mugwort and Blaterlia Germanica. Der f, Der p, Mugwort and Chenopodium album were the most common in female patients. ②In all groups, patients with dual positive allergens were the most common, followed by triple positive allergens and single positive allergen. ③ In single positive allergen group, the top four allergen in male 3 -17 year group were Derf, Der p, Alternaria tenuis and Mugwort. In other male groups, the most common positive allergen were Der f, Der p, Mugwort and Blaterlia Germanica. Meanwhile, the top four positive allergens in female 3 - 17 year group were Derf, Der p, Mugwort and Alternaria tenuis, in 18 - 39 year group were Der f, Der P, Mugwort and Dandelion, in 40 -59 year group were Derf, Der p Mugwort and mixed tree 1, in ≥60 year group were Derf, Der P, mixed animal hair and Mugwort. ④ In dual positive allergens group, the most common allergen combination was Derf ＋ Der p, followed by Alternaria tenuis in patient of 3 - 17 year group. ⑤ In triple positive allergens group, the most common allergen combination was Derf ＋ Der p ＋ Blaterlia Germanica, followed by Derf ＋ Der p ＋ mixed animal hair. Conclusions Dust mites, flowers pollen, herbs, Alternaria tenuis and Blaterlia Germanica were the most common allergens in patients with allergic rhinitis. However, the frequencies of the allergens were different in different age groups.

关 键 词：鼻炎 变应性 常年性 鼻炎 变应性 季节性 变应原 皮肤试验 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]