儿童慢性鼻-鼻窦炎与变应性鼻炎血清特异性免疫球蛋白E变应原的分布特征  

Distribution characteristics of serum specific immunoglobulin E of allergen in children with chronic rhinosinusitis and allergic rhinitis

作　　者：李双勇 张蕾[2] 朱大庆 曾敏波 黄文 何六六 LI Shuang-yong;ZHANG Lei;ZHU Da-qing;ZENG Min-bo;HUANG Wen;HE Liu-liu(The Second Affiliated Hospital of Gannan Medical University;The First Affiliated Hospital of Gannan Medical University;Ganzhou Fifth People's Hospital,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第二附属医院 [2]赣南医学院第一附属医院 [3]赣州市第五人民医院,江西赣州341000

出　　处：《赣南医学院学报》2023年第10期1061-1065,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省教育厅科学技术研究项目(GJJ161005);赣州市卫生和计划生育委员会科研计划项目(2016-2-45)。

摘　　要：目的:探讨血清特异性免疫球蛋白E(Specific immunoglobulin E,SIgE)变应原在儿童慢性鼻-鼻窦炎患者和儿童变应性鼻炎患者的分布特征。方法:收集2015年7月至2018年7月赣南医学院第二附属医院诊治的儿童慢性鼻-鼻窦炎(Chronic rhinosinusitis,CRS)68例(CRS组)、儿童变应性鼻炎(Allergic rhinitis,AR)63例(AR组),采用德国AlleryScreen过敏原检测系统对患者进行血清SIgE检测,观察两组血清变应原SIgE阳性率及血清SIgE阳性变应原分布情况、两组血清SIgE阳性变应原前3种的分级及构成比、两组血清SIgE阳性变应原户尘螨的分级情况以及两组血清特异性IgE阳性变应原种(类)数分布情况。结果:⑴CRS组、AR组血清变应原SIgE阳性率分别为57.35%(39/68)、100%(63/63),差异有统计学意义(χ^(2)=34.506,P<0.001)。⑵CRS组变应原分布前3种为户尘螨[61.54%(24/39)]、腰果[23.08%(9/39)]及蟹、虾和点青/分枝/烟曲/黑曲/交链霉(MX3)[均为20.51%(8/39)];AR组变应原分布前3种为户尘螨[93.65%(59/63)]、蟑螂[28.57%(18/63)]和屋尘[20.63%(13/63)]。⑶SIgE阳性变应原前3种分级中,CRS组72.22%(26/36)<3级,AR组70.45%(62/88)≥3级。⑷CRS组、AR组中户尘螨分级≥3级的比例分别为37.50%(9/24)和86.44%(51/59),差异有统计学意义(χ^(2)=20.399,P<0.001)。⑸CRS组、AR组存在2种及以下的变应原阳性率分别为58.97%(23/39)和58.73%(37/63),差异无统计学意义(χ^(2)=0.766,P=0.858)。结论:⑴儿童CRS与AR患者变应原均以户尘螨为主,但变应原的分布和分级有差别,儿童CRS患者以户尘螨、腰果、蟹、虾和MX3多见,且变应原分级大部分<3级,儿童AR患者以户尘螨、蟑螂和屋尘多见,且变应原分级大部分≥3级。⑵部分CRS患者符合尘螨特异性免疫治疗的致敏变应原数量及分级要求。Objective:To explore the distribution characteristics of allergen serum specific immunoglobulin E(SIgE)of allergen in children with chronic rhinosinusitis and children with allergic rhinitis.Methods:A total of 68 cases of children with chronic rhinosinusitis and 63 cases of children with allergic rhinitis were included.They were treated in The Second Affiliated Hospital of Gannan Medical University from July 2015 to July 2018,and their medical history,and detected their serum SIgE by German AlleryScreen allergen detection system.The distribution of positive rate of serum allergen SIgE,the grading and composition of the top three positive rate of serum allergen SIgE,classification of Dermatophagoides pteronyssinus(D.Pteronyssinus)distributiobs of species(classes)between the two groups were observed.Results:⑴The positive rate of serum allergen SIgE in children with CRS,AR and healthy children was 57.35%(39/68),100%(63/63)respectively.There was significant difference between the two groups(χ^(2)=34.506,P<0.001).⑵The top three allergen distributions in children with CRS were D.Pteronyssinus 61.54%(24/39),cashew nut 23.08%(9/39),crab 20.51%(8/39),shrimp 20.51%(8/39)and penicillium notatum/cladosporium/aspergillus fumigatus/aspergillus niger/streptomyces alternatus(MX3)20.51%(8/39).The top three allergen distributions in children with AR were D.Pteronyssinus 93.65%(59/63),cockroach 28.57%(18/63)and house dust 20.63%(13/63).Seropositive allergen in one child from the healthy children group was MX3.⑶Among the first three kinds of SIgE positive allergens of D.Pteronyssinus,cockroach and crab,72.22%(26/36)of children with CRS had a grade lower than 3,and 70.45%(62/88)of children with AR had a grade of 3 or above.⑷There were 37.50%(9/24)children with CRS and 86.44%(51/59)children with AR had D.Pteronyssinusof grade 3 or above.The difference was statistically significant(χ^(2)=20.399,P<0.001).⑸58.97%(23/39)of children with CRS and 58.73%(37/63)of children with AR had two or less allergens positive.There was no si

关 键 词：慢性鼻-鼻窦炎 变应性鼻炎 儿童 特异性免疫球蛋白E 变应原 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]