重庆地区变应性鼻炎和哮喘患儿的吸入性变应原的异同分析  

Characteristics of inhaled allergen spectrum between allergic rhinitis and asthma of children in Chongqing

作　　者：罗南 王玲[1] 袁小平[1] 刘玉琳[1] 丁凤霞[1] 田代印[1] 张明香[1] 牛超[1] LUO Nan;WANG Ling;YUAN Xiaoping;LIU Yulin;DING Fengxia;TIAN Daiyin;ZHANG Mingxiang;NIU Chao(Department of Respiratory Diseases,National Clinical Research Center for Child Health and Disorders,Key Laboratory of Child Development and Disorder of Ministry of Education,Children’s Hospital of Chongqing Medical University,Chongqing,400010,China)

机构地区：[1]重庆医科大学附属儿童医院呼吸科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,重庆400010

出　　处：《陆军军医大学学报》2023年第24期2547-2555,共9页Journal of Army Medical University

基　　金：国家自然科学基金面上项目(81600022);重庆市科卫联合医学科研项目(2020FYYX132,2023MSXM047);重庆医科大学未来医学青年创新团队支持计划(W0063)。

摘　　要：目的了解重庆地区变应性鼻炎(allergic rhinitis,AR)和哮喘患儿吸入性变应原分布的特点。方法采用横断面研究设计方案,收集重庆地区2021年1月至2022年9月在我科行吸入性变应原皮肤点刺试验(skin prick test,SPT)的AR和哮喘患儿9240例,根据临床诊断分为AR组(n=2217)和哮喘组(n=7023)。采用χ^(2)检验比较两组患儿吸入性变应原阳性检出率及两组患儿分别在不同性别、年龄段及季节吸入性变应原阳性检出率的差异。结果AR和哮喘患儿吸入性变应原SPT阳性检出率分别为71.6%和57.9%,两组比较差异有统计学意义(χ^(2)=132.66,P<0.001)。AR组和哮喘组常见吸入性变应原均为粉尘螨(65.4%、50.3%)、户尘螨(65.0%、50.4%)、蟑螂(10.2%、7.9%)、猫毛(8.3%、6.0%)、玉米花粉(6.5%、6.1%),均以双重(57.1%/54.7%)和三重(22.2%/20.8%)致敏为主。AR组中男孩吸入性变应原阳性检出率高于女孩(χ^(2)=7.01,P=0.008),哮喘组中仅有蟑螂阳性检出率存在性别差异(χ^(2)=21.67,P<0.001)。AR组中夏季的粉尘螨、户尘螨的阳性检出率最高,春季的鸭毛阳性检出率最高;哮喘组中粉尘螨、户尘螨阳性检出率夏季最高,玉米和白桦花粉、狗毛阳性检出率春季最高。AR和哮喘患儿吸入性变应原阳性检出率随年龄增大逐渐升高,且1~10岁AR组吸入性变应原阳性检出率高于同年龄段哮喘组。结论重庆地区AR和哮喘儿童吸入性变应原主要来自室内;与哮喘比较,AR以常年性吸入性变应原为主;AR和哮喘的吸入性变应原分布趋势具有相似性。ObjectiveTo investigate the distribution characteristics of inhaled allergens in children with allergic rhinitis(AR)and asthma in Chongqing.MethodsA cross-sectional study was conducted on 9420 children with AR and asthma who underwent inhaled allergen skin prick test(SPT)in our department from January 2021 to September 2022 in Chongqing.According to the clinical diagnosis,these children were divided into the AR group(n=2217)and the asthma group(n=7023).Chi-square test was used to compare the detection rate of inhaled allergen SPT in 2 groups of children and the difference in the detection rate of inhaled allergen SPT between the 2 groups in terms of gender,age group and season,respectively.ResultsThe detection rate of inhaled allergen SPT was 71.6%in the AR group and 57.9%in the asthma group(Chi-square=132.664,P<0.001).The primary inhalant allergens in the 2 groups were dust mites(65.4%,50.3%),house dust mites(65.0%,50.4%),cockroach(10.2%,7.9%),cat hair(8.3%,6.0%),and corn pollen(6.5%,6.1%),and children accepted test mainly had dual(57.1%/54.7%)and triple(22.2%/20.8%)inhaled allergens.In the AR group,the detection rate of inhaled allergens was higher in boys than that in girls(Chi-square=7.011,P=0.008),and the gender difference only appeared in the asthma group for the detection rate of cockroach(Chi-square=21.671,P<0.001).In the AR group,the highest detection rates for dust mites and house dust mites happened in summer,while the highest detection rates for duck hair happened in spring;In the asthma group,the summer witnessed the highest detection rates for dust mites and house dust mites and the spring experienced the highest detection rates for corn,birch pollen and dog hair.The detection rate of inhaled allergens in children with AR and asthma was increased with age,and the detection rate of inhaled allergens in the AR group aged 1~10 years was higher than that in the asthma group of the same age group.ConclusionThe inhaled allergens of children with AR and asthma in Chongqing are mainly from indoor sources.AR

关 键 词：儿童哮喘 儿童变应性鼻炎 皮肤点刺试验 吸入性变应原 

分 类 号：R392.8[医药卫生—免疫学] R725.622.5[医药卫生—基础医学] R765.21