目的 分析杭州地区儿童变应性鼻炎(allergic rhinitis,AR)的常见变应原分布情况,为其防治提供参考.方法 选取2020年1月至2022年12月于西湖大学医学院附属杭州市第一人民医院诊断为AR并进行体外血清过敏原特异性免疫球蛋白E(specific immunoglobulin E,sIgE)检测的 13 521 例患儿为研究对象,比较不同性别、不同年龄、不同季节AR患儿的常见变应原阳性率.结果 13 521 例患儿中,sIgE阳性率为 54.49%(7367/13 521),其中 64.82%的患儿仅对 1 种变应原过敏.在常见的 19 种变应原中,总体阳性率居前 3 位的分别是户尘螨(44.27%)、牛奶(14.62%)和混合草(4.82%).男性患儿的户尘螨、猫毛皮屑、桑树、霉菌组合、树花粉组合、苋、蟑螂、牛奶、虾、蟹、菠萝、贝、芒果的变应原阳性率显著高于女性患儿(P<0.05).不同年龄段患儿的户尘螨、混合草、猫毛皮屑、桑树、霉菌组合、蛋清、虾、蟹、菠萝、腰果、贝的变应原阳性率比较差异均有统计学意义(P<0.05).7 月和 8 月是患儿变应原阳性率最高的两个月;户尘螨、猫狗毛皮屑变应原阳性率在夏季最高,植物类变应原阳性率的高低与开花季节相一致.户尘螨的 sIgE 浓度以 3级及以上为主(77.87%),其他变应原的sIgE浓度主要集中于 1～2 级.结论 杭州地区AR患儿的变应原以尘螨和牛奶最常见,不同性别、不同年龄、不同季节间的变应原分布存在差异,变应原检测可为AR的诊断、预防和治疗提供更为精准的方案.
Objective To analyze the distribution of common allergens in children with allergic rhinitis(AR)in Hangzhou,and to provide reference for its prevention and treatment.Methods From January 2020 to December 2022,13 521 children who were diagnosed with AR and underwent in vitro serum specific immunoglobulin E(sIgE)detection in Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University were selected as the research objects.The positive rates of allergens in children with AR of different genders,ages and seasons were compared.Results Among 13 521 children,the positive rate of sIgE was 54.49%(7367/13 521),of which 64.82%were allergic to only one allergen.Among the 19 common allergens,the top three overall positive rates were household dust mite(44.27%),milk(14.62%),and mixed grass(4.82%).The positive rates of allergens of house dust mites,cat hair dander,mulberry,mold combination,tree pollen combination,amaranth,cockroach,milk,shrimp,crab,pineapple,shellfish and mango in male children were significantly higher than those in female children(P<0.05).The positive rates of allergens of house dust mite,mixed grass,cat hair dander,mulberry,mold combination,egg white,shrimp,crab,pineapple,cashew nuts and shellfish in different age groups were statistically significant(P<0.05).July and August were the two months with the highest allergen positive rate.The allergen positive rates of house dust mite,dog and cat hair dander were the highest in summer,and the allergen positive rate of plants was consistent with the flowering season.The sIgE concentration of house dust mite(77.87%)was mainly grade 3 and above.The sIgE concentration of other allergens was mainly grade 1 and 2.Conclusion Dust mites and milk are the most common allergens in children with AR in Hangzhou,and the distribution of allergens varies with gender,age and season.Allergen detection can provide a more accurate plan for the diagnosis,prevention and treatment of AR.
谢琳;马志祺;朱晓灿;刘可欣;李勇
浙江中医药大学第四临床医学院,浙江杭州 310053西湖大学医学院附属杭州市第一人民医院耳鼻咽喉科,浙江杭州 310006浙江中医药大学第四临床医学院,浙江杭州 310053||西湖大学医学院附属杭州市第一人民医院耳鼻咽喉科,浙江杭州 310006
临床医学
儿童;变应性鼻炎;变应原;特异性免疫球蛋白E
Children;Allergic rhinitis;Allergen;Specific immunoglobulin E
《中国现代医生》 2024 (010)
17-21,27 / 6
浙江省中医药科技计划项目(2023ZL569);杭州市医药卫生科技项目(A20210107)
10.3969/j.issn.1673-9701.2024.10.005
评论