北京市某儿童医院2010—2020年儿童主要变应原致敏模式特征及变化分析  

Characteristics and changes of sensitization patterns of major allergens in children from 2010 to 2020 in a hospital of pediatric in Beijing

作　　者：宋欣[1] 刘传合[1] 王伟[2] 黄贵民 赵京[1] 沙莉[1] Song Xin;Liu Chuanhe;Wang Wei;Huang Guimin;Zhao Jing;Sha Li(Department of Allergy,Capital Institute of Pediatrics Affiliated Children′s Hospital,Beijing 100020,China;Department of Biochemistry and Immunology,Capital Institute of Pediatrics,Beijing 100020,China;Child Health Big Data Research Center,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院变态反应科,北京100020 [2]首都儿科研究所生化免疫研究室,北京100020 [3]首都儿科研究所儿童健康大数据研究中心,北京100020

出　　处：《中华预防医学杂志》2022年第6期763-773,共11页Chinese Journal of Preventive Medicine

基　　金：北京市医院管理局科研培育计划(PX2021051)。

摘　　要：目的探讨2010—2020年期间北京市某儿童医院儿童主要变应原的致敏特征及变迁情况,为儿童过敏性疾病的诊断、治疗及预防提供依据。方法回顾性研究,以2010年1月至2020年12月在首都儿科研究所附属儿童医院怀疑过敏性疾病就诊并进行血清免疫球蛋白E(总IgE和特异性IgE)检测的患儿作为研究对象,共纳入45746例居住在北京地区的儿童,年龄范围0~17岁,中位数(四分位间距)为3.8(2.5,5.3)岁。男童28918例(63.2%),女童16828例(36.8%)。婴幼儿组(<3岁)14984例(32.8%)、学龄前组(3~6岁)22049例(48.2%)、学龄期组(6岁及以上)8713例(19.0%)。应用ImmunoCAP变应原系统(荧光酶联免疫法)检测并采用χ^(2)检验进行统计分析11年期间变应原的致敏特征及变化趋势。结果单价食物变应原sIgE阳性检出率前3位依次为鸡蛋白42.6%(2788/6577例次)、牛奶38.4%(2606/6782例次)和小麦31.8%(1417/4449例次);单价吸入变应原依次为豚草42.6%(440/1034例次)、艾蒿38.4%(1045/3191例次)、链格孢31.3%(3358/10725例次)。鸡蛋白47.0%(1904/4048例次)、牛奶41.9%(1769/4226例次)、小麦33.9%(973/2870例次)在婴幼儿组阳性检出率最高,差异有统计学意义(χ^(2)=91.495、73.907、16.966,P均<0.05),坚果混合fx1(22.5%,121/537例次)、花生(24.9%,111/446例次)、大豆(20.0%,74/370例次)和虾(7.48%,44/588例次)在学龄组阳性率最高,差异有统计学意义(χ^(2)=14.436、10.751、11.569、13.703,P均<0.05)。婴幼儿组最常见的吸入变应原为链格孢霉(14.8%,422/2859例次),学龄前期以豚草(34.5%,143/415例次)和链格孢霉(33.5%,1762/5254例次)为主,学龄期豚草(56.4%,282/500例次)和艾蒿(48.2%,573/1189例次)检出率最高。2010—2020年期间鸡蛋白、牛奶、小麦、芝麻、花生的阳性检出率整体存在差异,呈现出先下降后上升的趋势(χ^(2)=10.293、χ^(2)=12.066、χ^(2)=7.402、χ^(2)=32.458、χ^(2)=31.747,P均<0.05);大豆阳性检出率呈现下降趋势(2010年21.4%Objective To analyze the sensitization characteristics and change of major allergens in children from 2010 to 2020 in Beijing,so as to provide basis for diagnosis,treatment and prevention of allergic diseases in children.Methods A retrospective study was conducted to analyze the children who were suspected of allergic diseases and tested for serum immunoglobulin E(total IgE and specific IgE)in the children′s Hospital Affiliated to the Capital Institute of Pediatrics from January 2010 to December 2020.A total of 45746 children aged 0-17 years in Beijing were enrolled with a median(interquartile range)of 3.8(2.5,5.3)years.There were 28918 boys(63.2%)and 16828 girls(36.8%)and 14984 cases(32.8%)in the infant group(<3 years old),22049 cases(48.2%)in the preschool group(3-6 years old),and 8713 cases(19.0%)in the school-age group(6 years old and above).Immunocap allergen detection system(fluorescence enzyme-linked immunosorbent assay)was used to detect and the characteristics and change trend of allergens during 11 years were statistically analyzed by Chi square test.Results The top three positive rates of single food allergens sIgE were egg white 42.6%(2788/6577 tests),milk 38.4%(2606/6782 tests)and wheat 31.8%(1417/4449 tests),and the sequence of single inhaled allergens were Ragweed 42.6%(440/1034 tests),Artemisia 38.4%(1045/3191 tests)and Alternaria alternata 31.3%(3358/10725 tests).The positive detection rates of egg white 47.0%(1904/4048 tests),milk 41.9%(1769/4226 tests)and wheat 33.9%(973/2870 tests)in the infant group were the highest,and there have statistically significant(χ^(2)=91.495,73.907,16.966,P<0.05).The positive rates of fx1(22.5%,121/537 tests),peanut(24.9%,111/446 tests),soybean(20.0%,74/370 tests)and shrimp(7.48%,44/588 tests)were the highest in the school-age group(χ²=14.436,10.751,11.569,13.703,P<0.05).The most common inhaled allergens were Alternaria alternata(14.8%,422/2859 tests)in the infant group,Ambrosia(34.5%,143/415 tests)and Alternaria alternata(33.5%,1762/5254 tests)in the preschoo

关 键 词：变应原 儿童 免疫球蛋白E 

分 类 号：R725.9[医药卫生—儿科]