上海地区变应性鼻炎患者变应原特征分析  

Analysis of allergen characteristics of allergic rhinitis patients in Shanghai,China

作　　者：邓月[1] 张健[2] 程寅 张森森[3] 梁才全 杨子轩 陶绮蕾[1] 刘环海[1] 彭浒[1] 范静平[1] DENG Yue;ZHANG Jian;CHENG Yin;ZHANG Sen-sen;LIANG Cai-quan;YANG Zi-xuan;TAO Qi-lei;LIU Huan-hai;PENG Hu;FAN Jing-ping(Department of Otolaryngology/Head and Neck Surgery,Changzheng Hospital,Naval Medical University(Second Military Medical University),Shanghai 200003,China;Department of Otolaryngology/Head and Neck Surgery,Qidong Hospital of Traditional Chinese Medicine,Qidong 226200,Jiangsu,China;Department of Laboratory Medicine,Changzheng Hospital,Naval Medical University(Second Military Medical University),Shanghai 200003,China;Department of Otolaryngology/Head and Neck Surgery,No.940 Hospital of Logistic Support Forces of PLA,Lanzhou 730050,Gansu,China)

机构地区：[1]海军军医大学(第二军医大学)长征医院耳鼻咽喉头颈外科,上海200003 [2]江苏省启东市中医院耳鼻咽喉头颈外科,启东226200 [3]海军军医大学(第二军医大学)长征医院实验诊断科,上海200003 [4]解放军联勤保障部队940医院耳鼻咽喉头颈外科,兰州730050

出　　处：《第二军医大学学报》2020年第10期1062-1067,共6页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(81870702);海军军医大学(第二军医大学)校级军事课题(2017JS18).

摘　　要：目的回顾性分析上海地区变应性鼻炎(AR)患者的变应原特征与发病季节。方法选择2015年1月1日至2017年12月31日就诊于海军军医大学(第二军医大学)长征医院耳鼻咽喉头颈外科AR专病门诊的AR疑似患者1570例。抽取患者血清1 mL,采用变应原特异性IgE抗体检测试剂盒(免疫印迹法)检测22种变应原特异性IgE及总IgE水平。将AR患者按年龄分为5~16岁、17~39岁、40~64岁和≥65岁组,比较各组变应原阳性率。记录每月检出≥1种变应原阳性AR患者的例数,分析变应原阳性季节分布。结果1570例AR疑似患者中单纯血清总IgE升高者143例(9.1%),≥1种变应原阳性AR患者共1182例(75.3%),其中单一变应原阳性的AR患者491例(41.5%),≥2种变应原阳性者691例(58.5%)。22种变应原中,尘螨(包括屋尘螨和粉尘螨)是最常见的变应原(715例,60.5%),其次为青霉素(239例,20.2%)、梧桐类(167例,14.1%)。1182例AR患者中17~39岁人群占比最高(61.0%,721例)。5~16岁组尘螨阳性率高于17~39岁、40~64岁和≥65岁组,差异均有统计学意义(P均<0.05)。4、5、6、8、9、10和11月为AR的发病高峰,≥1种变应原阳性AR患者例数分别为(175±21)、(156±16)、(259±31)、(172±15)、(176±14)、(164±4)和(204±32)例,高于2015年1月1日至2017年12月31日36个月的平均值[(97±42)例],差异均有统计学意义(P均<0.05);尘螨阳性检出时间主要集中在5、6、7、8、9和11月,尘螨阳性AR患者例数分别为(64±11)、(113±21)、(68±18)、(76±15)、(70±11)和(89±21)例,高于36个月的平均值[(52±32)例],差异均有统计学意义(P均<0.05)。结论上海地区AR患者最常见、最主要的变应原是尘螨,17~39岁人群占比高,4-6月、8-11月是AR患者就诊高峰。Objective To retrospectively analyze the allergen characteristics and the onset season of allergic rhinitis(AR)patients in Shanghai,China.Methods From Jan.1,2015 to Dec.31,2017,1570 suspected AR patients were selected from the Department of Otolaryngology/Head and Neck Surgery,Changzheng Hospital,Naval Medical University(Second Military Medical University).One milliliter of serum was extracted from each patient and the specific immunoglobulin E(IgE)levels of 22 kinds of allergens and total IgE levels were detected using allergen specific IgE antibody detection kit(immunoblotting method).The AR patients were divided into 5-16,17-39,40-64 and≥65 years old groups,and the positive rates of allergens were compared.The number of AR patients with one or more positive allergens was recorded every month,and the seasonal distribution of positive allergen was analyzed.Results Of the 1570 suspected AR patients,143(9.1%)had elevated serum total IgE,and 1182(75.3%)had one or more positive allergens,including 491(41.5%)with single positive allergen and 691(58.5%)with two or more positive allergens.Among the 22 kinds of allergens,dust mites(including Dermatophagoides pteronyssinus and Dermatophagoides farinae)were the most common allergens(715 cases,60.5%),followed by penicillin(239 cases,20.2%)and Chinese parasol(167 cases,14.1%).Among the 1182 AR patients,17-39 years old was the highest proportion(61.0%,721 cases).The positive rate of dust mites in the 5-16 years old group was significantly higher than those in the 17-39,40-64 and≥65 years old groups(all P<0.05).The prevalence peaks of AR were in Apr.,May,Jun.,Aug.,Sep.,Oct.and Nov.;and the numbers of AR patients with one or more positive allergens were 175±21,156±16,259±31,172±15,176±14,164±4 and 204±32,respectively,which were significantly higher than the average value(97±42)of 36 months from Jan.1,2015 to Dec.31,2017(all P<0.05).The positive detection time of dust mites was mainly in May,Jun.,Jul.,Aug.,Sep.and Nov.;and the numbers of dust mite positive AR patien

关 键 词：变应性鼻炎 变应原 流行病学 免疫球蛋白E 年龄分布 季节 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]