变应性因素对不同年龄段儿童慢性鼻-鼻窦炎的影响  

作　　者：黄晓芳[1] 柴鸣雷[1] 夏晓青[1] 张鹰[1] 伍慧丽[1] 

机构地区：[1]杭州市中医院,310001

出　　处：《浙江临床医学》2020年第12期1769-1770,1773,共3页Zhejiang Clinical Medical Journal

基　　金：杭州市卫生科技计划项目(2018A69)。

摘　　要：目的探讨变应性因素在儿童慢性鼻-鼻窦炎(CRS)发病过程中的作用。方法选取2018年8月至2019年7月的CRS患儿为观察对象,设立健康对照组,并将各组分别按年龄分为<7岁组和≥7岁组,检测血IgE及各项过敏原的特异性IgE,对于CRS患儿的鼻内镜检查进行Lund-Kennedy评分,鼻窦CT进行Lund-Mackey评分,通过统计学比较分析组间及组内各项指标。结果CRS组中IgE阳性53例,占52.5%;其中尘螨特异性IgE阳性50例,占49.5%,均明显高于健康对照组,差异有统计学意义(P<0.05);其中<7岁患儿中,IgE阳性占42.3%,尘螨特异性IgE阳性率37.7%,≥7岁患儿中,IgE阳性占75%,尘螨特异性IgE阳性率75%;IgE阳性与IgE阴性患儿的鼻黏膜评分和鼻窦CT评分差异无统计学意义(P>0.05),二者近期的治疗有效率差异无统计学意义(P>0.05);IgE阳性与儿童CRS发病的相关系数r=0.3(P<0.05),危险度比值比(OR)=3.915;其中,≥7岁儿童中r=0.438(P<0.05),OR=6.6;<7岁儿童中r=0.266(P<0.05),OR=3.383;尘螨特异性IgE阳性在CRS发病中的危险度OR=4.037,其中,≥7岁组OR值9,<7岁组OR值2.676。结论变应性因素与儿童CRS发病密切相关,为儿童CRS发病的危险因素,在学龄儿童中尤为显著。Objective To explore the role of allergic factors in the pathogenesis of chronic rhinosinusitis(CRS)in children.Methods Children with CRS from August 2018 to July 2019 were selected as the research objects,and a healthy control group was set up.Each group was divided into 2 groups according to age,namely<7 years old group and≥7 years old group.The total blood IgE level and specific IgE of each allergen were detected.Lund-Kennedy score was performed on nasal endoscopy and Lund-Mackey score was performed on sinus CT.Statistical comparison was conducted to analyze the indicators between and within groups.Results In the CRS group,53 cases(52.5%)had IgE elevation.Among them,50 cases were positive for dust mites in blood allergen test,accounted for 49.5%,which were significantly higher than those in healthy control,with statistically significant difference(P<0.05).Among children<7 years old,IgE elevation accounted for 42.3%,dust mite positive rate of 37.7%,≥7 years old children,IgE elevation accounted for 75%,dust mite positive rate of 75%.There was no statistically significant difference in nasal mucosa score and sinus CT score between IgE positive and IgE negative children(P>0.05),and there was no statistically significant diference in the recent treatment response rate between the two(P>0.05).The correlation coefficient between IgE elevation and CRS in children was r=0.3(P<0.05),and the risk OR=3.915.Among them,r=0.438(P<0.05),OR=6.6 in children≥7 years old.Among children<7 years old,r=0.266(P<0.05),OR=3.383.The risk of dust mite positive in CRS was OR=4.037,with the OR value of9 in≥7 years old group and 2.676 in<7 years old group.Conclusion Allergic factors are closely related to the incidence of CRS in children,and they are the risk factors for the incidence of CRS in children,especially in school-age children.

关 键 词：儿童 慢性鼻-鼻窦炎 变应性因素 过敏原 

分 类 号：R76[医药卫生—耳鼻咽喉科]