蒿属花粉症的发病特点及季节前干预治疗的疗效分析  

Onset feature and efficacy of early interventional treatment of Artemisia pollinosis

作　　者：欧阳昱晖[1,2] 范尔钟[3] 李颖[3] 张罗[1,2] 

机构地区：[1]100730,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鼻病研究北京市重点实验室 [3]北京市耳鼻咽喉科研究所鼻病研究北京市重点实验室,100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2014年第4期272-276,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金杰出青年基金（81025007）;北京市自然科学基金（7131006）;首都卫生发展科研专项重点攻关项目（2011-1017-06）;北京市重点实验室2012年阶梯计划项目（Z121107009212032）;卫生部2012年度公益性行业科研专项（201202005）

摘　　要：目的 探讨蒿属过敏的花粉症患者的发病特点及其治疗方式.方法 根据北京同仁医院2007-2011年14 426例皮肤点刺试验结果和北京市同期花粉监测数据,分析蒿属花粉症患者的发病特点及其与花粉浓度的相关性.蒿属花粉敏感的花粉症患者分两组,一组在花粉季节前予以2周白三烯受体拮抗剂（孟鲁斯特纳）干预治疗,在花粉期予以4周鼻喷激素（糠酸莫米松）治疗（EIT组,n =21）,另一组在花粉期予4周鼻喷激素（糠酸莫米松）治疗（POT组,n=16）,分析比较两组患者症状评分.以SPSS16.0软件进行数据分析.结果 蒿属花粉症占变应性鼻炎患者的30.8％（4442/14 426）,蒿属花粉皮肤点刺阳性结果主要为强阳性（3 793/4442,85.4％）;患者发病年龄高峰是19～30岁,发病时间集中在8-9月,与蒿属花粉飞散的高峰期一致;EIT组打喷嚏、流涕和鼻痒等过敏症状与未干预治疗的POT组相比有显著改善（t值分别为3.28、3.92、3.09,P值均＜0.01）,但两组鼻塞和咳嗽症状差异无统计学意义（t值分别为0.85、1.52,P值均＞0.05）.结论 蒿属花粉是北京地区最主要的花粉致敏原,花粉季节前干预治疗可以有效改善患者的过敏症状.Objective To analyze the clinical feature and treatment methods of Artemisia pollinosis.Methods Skin prick test results of 14 426 cases from Beijing Tongren hospital and pollen concentration of Beijing observatory from 2007 to 2011 were analyzed to identify the clinical feature of Artemisia pollinosis patients and its correlation with the pollen concentration.Patients were given leukotriene receptor antagonists （Montelukast） for 2 weeks,followed by 4 weeks of mometasone furoate nasal spray （EIT group：n =21）,or only 4 weeks of mometasone furoate nasal spray （POT group：n =16）.The nasal symptom score was compared between 2 groups.SPSS 16.0 software was used to analyze the data.Results Artemisia pollinosis accounted for 30.8％ （4 442/14 426） of all SPT positive allergic rhinitis patients,and most Artemisia SPT positive results were strong positive （3 793/4 442,85.4％） ; onset age peak of Artemisia pollinosis patients was at the age of 19 to 30,onset time concentrated in August to September,was consistent with the peak period of Artemisia pollen concentration; EIT treatment using leukotriene receptor antagonists two weeks before pollen season significantly improved sneeze,sniveling and rhinocnesmus symptoms （t value was 3.28,3.92,3.09,respectively,all P ＜ 0.01） compared with post-onset treatment（POT）.But nasal obstruction and cough symptoms had no significant difference between two groups （t value was 0.85,1.52,respectively,all P ＞ 0.05）.Conclusion Artemisia pollen is the main pollen allergen in Beijing,EIT treatment was effective to pollinosis.

关 键 词：鼻炎 变应性 季节性 蒿属 治疗结果 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]