2021—2024年深圳市某儿童医院变应性鼻炎和哮喘儿童屋尘螨组分分布特征的分析  

A clinical analysis on the distribution characteristics of dermatophagoides pteronyssinus allergen components among children with allergic rhinitis and asthma in a hospital of pediatric in Shenzhen City from 2021 to 2024

作　　者：庄仕杰 范婷婷 阮欣妤 赖熔丽 闫卫娟[2] 刘春艳 卢志威[2] 黄妙凤 杨方华[2] 鲍燕敏[2] Zhuang Shijie;Fan Tingting;Ruan Xinyu;Lai Rongli;Yan Weijuan;Liu Chunyan;Lu Zhiwei;Huang Miaofeng;Yang Fanghua;Bao Yanmin(Shenzhen Pediatrics Institute of Shantou University Medical College,Shenzhen518026,China;Respiratory Department,Shenzhen Children′s Hospital,Shenzhen518026,China)

机构地区：[1]汕头大学医学院深圳儿科临床学院,深圳518026 [2]深圳市儿童医院呼吸内科,深圳518026

出　　处：《中华预防医学杂志》2024年第12期1885-1893,共9页Chinese Journal of Preventive Medicine

基　　金：深圳市儿童医院疑难疾病精准诊治攻关项目(LCYJ2022070)。

摘　　要：目的研究深圳地区尘螨所致变应性鼻炎和哮喘儿童的屋尘螨组分分布特征,分析屋尘螨组分在儿童变应性鼻炎和哮喘诊治中的临床意义。方法本研究为横断面研究,通过收集2021—2024年就诊于深圳市儿童医院过敏门诊由尘螨诱发的变应性鼻炎和哮喘儿童的临床资料,以及采用磁珠化学发光法对患儿血清屋尘螨、粉尘螨(Der p、Der f)和屋尘螨组分(Der p 1、Der p 2、Der p 10、Der p 23)的sIgE水平进行检测,探讨屋尘螨组分与患儿临床资料的相关性。将患儿根据诊断分为变应性鼻炎(AR)组和AR合并哮喘(ARAS)组,根据年龄分为学龄前期(5岁≤年龄<7岁)、学龄期(7岁≤年龄<10岁)和青春期(10岁≤年龄≤15岁)。比较屋尘螨组分在AR组和ARAS组以及不同年龄分组中的表达差异。结果共314例尘螨所致变应性鼻炎和哮喘儿童纳入研究,其中男/女分别为222/92例,AR/ARAS分别为188/126例,年龄范围5~15岁、中位数年龄7.54岁、平均(8.02±2.24)岁,体重指数(BMI)范围13.89~31.76 kg/m^(2)、中位数15.87 kg/m^(2)、平均(16.55±3.05)kg/m^(2);AR组与ARAS组患儿在性别、年龄、BMI、血嗜酸性粒细胞、血嗜碱性粒细胞、FeNO、FVC、FEV1上的差异无统计学意义(P>0.05),在FEV1/FVC和小气道功能指标MMEF、MEF75%、MEF50%、MEF25%上的差异有统计学意义(P<0.05)。在314例患儿中,屋尘螨组分致敏率由高到低依次为Der p 1(97.1%)、Der p 2(89.8%)、Der p 23(55.1%)、Der p 10(8.6%),阳性率差异有统计学意义(χ^(2)=658.31,P<0.001)。屋尘螨组分Der p 1、Der p 2、Der p 10在学龄前期、学龄期和青春期的阳性率差异无统计学意义(P>0.05);Der p 23在学龄前期、学龄期和青春期的阳性率差异有统计学意义(χ^(2)=7.29,P=0.03)。相关性分析发现Der p、Der f、Der p 1、Der p 2之间具有高度正相关性(P<0.001);嗜酸性粒细胞与Der p、Der f、Der p 1、Der p 2、Der p 10、Der p 23具有正相关性(P<0.001);FeNO与Der p、DerObjectiveTo investigate the distribution characteristics and analyze the clinical significance of dermatophagoides pteronyssinus allergen components in children with allergic rhinitis and asthma in Shenzhen.MethodsThis study was a cross-sectional study.The clinical data of children with allergic rhinitis and asthma induced by dust mites admitted to the allergy clinic of Shenzhen Children′s Hospital from^(2)021 to 2024 were collected and the serum sIgE levels of dermatophagoides pteronyssinus,dermatophagoides farinae(Der p,Der f)and dermatophagoides pteronyssinus components(Der p 1,Der p 2,Der p 10,Der p 23)were detected by magnetic bead chemiluminescence method.The correlation between dermatophagoides pteronyssinus allergen components and clinical data of children was analyzed.According to the diagnosis,the children were divided into allergic rhinitis(AR)group and AR with asthma(ARAS)group.According to the age,the children were divided into preschool age(5 years≤age<7 years),school age(7 years≤age<10 years)and adolescence(10 years≤age≤15 years).The expression differences of dermatophagoides pteronyssinus components among AR group and ARAS group and different age groups were compared.ResultsA total of 314 children with allergic rhinitis and asthma caused by dust mites were included in the study,of whom 112 were male and 202 were female.There were 188 cases of AR and 126 cases of ARAS,aged 5-15 years,with a median age of 7.54 years and an average age of(8.02±2.24)years.BMI was 13.89-31.76 kg/m^(2),the median BMI was 15.87 kg/m^(2)and average BMI was(16.55±3.05)kg/m^(2).There was not statistically significant difference in gender,age,BMI,blood eosinophils,blood basophils,FeNO,FVC and FEV1 between the AR group and the ARAS group(P>0.05).There was significant difference in FEV1/FVC and small airway function indexes MMEF,MEF75%,MEF50%and MEF25%between the AR group and the ARAS group(P<0.05).In the 314 children,the dermatophagoides pteronyssinus allergen components sensitization rates were in the order of De

关 键 词：变应性鼻炎 哮喘 屋尘螨 粉尘螨 屋尘螨组分 

分 类 号：R765.21[医药卫生—耳鼻咽喉科] R725.6[医药卫生—临床医学]