湖南地区变应性鼻炎皮肤点刺试验结果分析  

Optimizing the prevention and treatment of allergic rhinitisin Hunan based on skin prick test results

作　　者：孟来 袁璇 谢邵兵 王风君[1] 谢淑敏[1] 张俊毅[1] 章华[1] 蒋卫红[1] 谢志海[1] MENG Lai;YUAN Xuan;XIE Shaobing;WANG Fengjun;XIE Shumin;ZHANG Junyi;ZHANG Hua;JIANG Weihong;XIE Zhihai(Department of Otolaryngology Head and Neck Surgery,Hunan Province Key Laboratory of Otolaryngology Critical Diseases,National Clinical Research Center for Geriatric Disorders,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院、耳鼻咽喉头颈外科、耳鼻咽喉科重大疾病研究湖南省重点实验室、国家老年疾病临床医学研究中心,湖南长沙410008

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第1期65-70,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：国家自然科学基金(82171118);湖南省自然科学基金(2022JJ30327)。

摘　　要：目的 分析湖南地区拟诊变应性鼻炎(AR)患者皮肤点刺试验(SPT)结果,探讨近年来该地区常见吸入性变应原的演变及其在不同人群中的分布特征,针对性指导本地区AR防治工作。方法 回顾性分析2017年1月—2019年12月就诊的6 276例拟诊AR患者门诊资料,以及常见11种吸入性变应原的SPT结果,依据不同年度、性别和年龄进行分层描述特征。结果 共有5 178例AR患者对至少一种吸入性变应原SPT呈阳性反应。变应原阳性率由高到低的前3种依次为粉尘螨(96.81%)、屋尘螨(96.33%)和蟑螂(57.92%)。97.89%的阳性患者存在至少2种阳性变应原的共同致敏现象。变应原SPT总体阳性率在不同年度组和性别组之间差异均无统计学意义(P>0.05),而在不同年龄组之间差异显著(P<0.05),且随年龄增加呈逐渐下降趋势。进一步分析不同个体SPT阳性率在不同年度、性别和年龄之间的差异。研究期间,杂草SPT阳性率呈逐年下降趋势,而霉菌1 SPT阳性率呈逐年上升(P<0.05)。此外,男性患者的杂草和葎草的SPT阳性率显著高于女性患者(P<0.05),而动物毛发SPT阳性率显著低于女性患者(P<0.05)。11种变应原中有8种不同变应原SPT阳性率在不同年龄组间具有显著差异,且主要高发于≤20岁年龄段的患者(P<0.05)。结论 湖南地区6 276例疑诊AR患者SPT阳性率排在前3位的变应原是粉尘螨、屋尘螨和蟑螂。不同阳性变应原在不同年度、性别和年龄中分布特征不同。应根据本地区AR患者常见吸入性变应原的特点开展有效的防治工作。Objective To investigate the recent evolution of common inhaled allergens and their distribution characteristics in different populations,and provide targeted guidance for allergic rhinitis(AR)prevention and treatment in Hunan province via analyzing the skin prick test(SPT)results of suspected AR patients.Methods A retrospective analysis was conducted on the outpatient data and the SPT results for 11 common inhaled allergens from 6276 suspected AR patients presented to Xiangya Hospital between January 2017 and December 2019.Characteristics were described in a stratified manner based on different years,gender,and age.Results A total of 5,178 AR patients showed positive SPT responses to at least one inhaled allergen.The sequence of the top three allergens from the highest to the lowest in positive rate was dust mites(96.81%),house dust mites(96.33%),and cockroaches(57.92%).Of the positive patients,co-sensitization to at least two allergens existed in 97.89%.The differences of overall allergen SPT positive rate were statistically insignificant among different year groups and different gender groups(P>0.05).The overall allergen SPT positive rates were significantly different among different age groups(P<0.05),showing a gradual decrease with increasing age.Further analysis revealed a decreasing trend for weed and an increasing trend for mould 1 over the three years of observation(P<0.05).In addition,the positive rates for weed and humulus in male patients were significantly higher than those in female patients(P<0.05),while the positive rate for animal hair in male patients was significantly lower than that in female patients(P<0.05).Among the 11 allergens,the positive rates of 8 allergens showed significant differences among different age groups,with the highest prevalence mainly in patients with age≤20 years(P<0.05).Conclusions The top three SPT-positive allergens for the 6276 suspected AR cases in Hunan province are dust mites,house dust mites,and cockroaches.The distribution characteristics of different positive

关 键 词：变应性鼻炎 吸入性变应原 皮肤点刺试验 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]