居室尘埃内毒素水平对广东城市和农村地区青少年气道反应性及特应性的影响  

The influence of house dust endotoxin on airway responsiveness and allergen sensitization in adolescence in urban and rural areas of Guangdong province

作　　者：潘利英[1] 冯木林[1] 赖旭新 鲜墨[1] 黄夏飞[1] 陈燕[3] 李靖[1] 

机构地区：[1]广州医学院第一附属医院呼吸疾病国家重点实验室,510120 [2]丹麦ALK-Abell6公司亚太地区研发部 [3]广东药学院临床医学院

出　　处：《中华微生物学和免疫学杂志》2012年第5期440-448,共9页Chinese Journal of Microbiology and Immunology

摘　　要：目的探讨居室尘埃内毒素水平对广东城市和农村地区青少年气道反应性及特应性的影响。方法根据初筛问卷结果选取13-14岁有喘息症状的青少年为病例组，广州188例（男109例，女79例），从化地区129例（男70例，女59例），同时选取同一年龄组的健康青少年作为正常对照组，广州231例（男125例，女106例），从化地区307例（男145例，女162例），进行哮喘与变应性鼻炎等相关疾病的详细问卷调查、变应原皮肤点刺试验、肺通气功能及组胺支气管激发试验以及外周血嗜酸性粒细胞计数；随机收集参与上述研究的青少年卧室床铺尘埃共156份（广州76份，从化80份），检测尘埃的内毒素水平，并将尘埃的内毒素水平与气道反应性（PD20-FEVl）和变应原皮肤点刺风团直径进行相关分析。结果广州青少年喘息症状、哮喘、鼻炎症状以及变应性鼻炎的报告率显著高于从化地区（P〈0．0001），其报告率分别为广州28．6％、27．7％、66．O％、46．4％，从化地区5．0％、2．5％、31．O％、6．2％；支气管激发试验阳性率，屋尘螨、粉尘螨、猫毛与狗毛变应原皮肤点刺试验阳性率广州均高于从化（P〈0．0001）；蟑螂变应原皮肤点刺试验阳性率从化高于广州（P〈0．0001）。从化的青少年床铺中尘埃内毒素含量、浓度及密度的几何平均数（GM）均显著高于广州（P〈0．0001；从化：6452EU，10．95EU／mg，1794EU／m2；广州：1591EU，6．45EU／mg，508．80EU／m2）。PD20-FEVl与内毒素总含量呈明显正相关（r=0．174，P〈0．05）；屋尘螨及粉尘螨的SPT风团直径与内毒素总含量及分布密度均呈明显负相关（P〈0．01）。结论广州青少年喘息症状、哮喘、鼻炎症状以及变应性鼻炎的报告率显著高于从化地区。蟑螂是农村地区青少年仅次于螨的主要变应原。床铺中的内毒素水平与PD20－FEVl呈明显Objective To study the association between house dust endotoxin levels and the airway responsiveness as well as allergen sensitization in adolescence in the urban and rural areas of Guangdong province. Methods Middle school students, aged 13-14, 188 （male 109, female 79） from Guangzhou, 129（male 70, female 59） from Conghua with positive responses, and 231 （male 125, female 106） and 307 （ male 145, female 162） of their respective reference students are selected from questionnaire prescreening. A detailed questionnaire, the lung function test, histamine bronchial provocation test, skin prick test and peripheral blood eosinophil count are undertaken. Seventy-six students from Guangzhou and 80 from Conghua were selected randomly for mattress dust sample collection to detect the levels of endotoxin. Results The prevalence of wheeze symptom, diagnosed asthma, nasal symptoms and allergic rbinitis of Guangzhou was significantly higher than that of Conghua （P〈0.0001）, with 28.6%, 27.7%, 66.0%, 46.4% for Guangzhou respectively, and 5.0%, 2.5%, 31.0%, 6.2% for Conghua respectively. The positive rates of bronchial provocation test and skin sensitization against Derrnatophagoides pteronyssinus （ Der. p）, D. farinae （Der. f） , cat and dog allergen in the students of Guangzhou were significantly higher than that of Conghua （ P〈0.0001 ）. The positive rate of cockroach of Conghua was significantly higher than that of Guangzhou（ P〈 0. 0001 ）. The levels of endotoxin （amount, concentration and load） of samples from Conghua were significantly higher than that from Guangzhou （Conghua： 6452 EU, 10.95 EU/mg, 1794 EU/m2 ; Guangzhou： 1591 EU, 6.45 EU/mg, 508.80 EU/m2, respectively）. PD20-FEV1 was correlated positively with endotoxin amount（ r=0. 174, P〈0.05 ）. The diameters of the skin wheal size for Der. p and Der. f were correla- ted inversely with endotoxin amount and load （ P〈0. 001 ）. Conclusion The prevalence of wheeze symptom, diagnosed asthma, nasal symptoms and al

关 键 词：哮喘 鼻炎 特应性 环境 内毒素 

分 类 号：R56[医药卫生—呼吸系统]