目的 了解广州地区呼吸道变态反应性疾病儿童常见变应原,为预防和治疗儿童变应性疾病提供科学依据.方法 选择2006年2月至2007年3月在广州医学院第一附属医院儿科门诊符合支气管哮喘(简称哮喘)和(或)变应性鼻炎(简称鼻炎)的广州地区5岁以上患儿183例,其中男132例,年龄(8.2-4-0.2)岁;女51例,年龄(7.8士0.4)岁;哮喘并鼻炎者105例,哮喘患儿58例,仅鼻炎患儿20例.所有对象均进行皮肤变应原点刺试验(SPT)及血清总IgE、特异性IgE和嗜酸粒细胞计数.结果 在人选的183例患儿中,SPT阳性(≥1个变应原阳性)157例(85.8%),各变应原阳性率为5.5%~75.4%,变应原中以屋尘螨致敏的阳性率最高,达79.8%,其次为粉尘螨与热带螨,分别为72.7%与65.0%,其余变应原阳性率依次为:狗毛48.6%,美洲大蠊47.0%,猫毛34.4%,德国小蠊29.5%,霉菌类19.7%,花粉类15.9%,艾蒿7.7%,豚草5.5%.螨过敏阳性患儿有146例,常合并其他一种或多种变应原阳性(115例,78.8%),而螨过敏阴性患儿(37例,20.2%)中仅有11例(29.7%)合并其他一种或多种变应原阳性(x2=33.099,P<0.001),差异有统计学意义.各年龄组发病率特点:高龄组(>7岁)SPT阳性率为82.3%,高于低龄组(≤7岁)(79.3%),两组间SPT阳性率的差异有统计学意义(P<0.05).在吸入变应原种类的比较中,高龄组在螨类过敏阳性率、猫毛与狗毛阳性率、蟑螂阳性率均高于低龄组,差异有统计学意义(P<0.05);两组在霉菌类及花草类阳性率的差异无统计学意义.哮喘并鼻炎、哮喘、鼻炎3组患儿均以螨类过敏最为常见,3组间除蟑螂SPT阳性率差异有统计学意义外(P<0.05),螨类、动物皮毛类、霉菌及花草类的变应原阳性率差异均无统计学意义.结论 过敏性因素是儿童呼吸系统变态反应性疾病发病的重要诱发因素,在广州地区哮喘和(或)鼻炎儿童可以通过SPT检查明确过敏原,最常见的变应原是屋尘螨、粉尘螨及热带螨.随着年龄增长,呼吸道变态反应性疾病患儿对吸入性变应原更为敏感.鼻炎、哮喘、哮喘并鼻炎患儿有共同的变应原.研究不同年龄段变态反应性疾病患者的变应原特征,有助于对疾病的早期诊断和早期干预.
目的 瞭解廣州地區呼吸道變態反應性疾病兒童常見變應原,為預防和治療兒童變應性疾病提供科學依據.方法 選擇2006年2月至2007年3月在廣州醫學院第一附屬醫院兒科門診符閤支氣管哮喘(簡稱哮喘)和(或)變應性鼻炎(簡稱鼻炎)的廣州地區5歲以上患兒183例,其中男132例,年齡(8.2-4-0.2)歲;女51例,年齡(7.8士0.4)歲;哮喘併鼻炎者105例,哮喘患兒58例,僅鼻炎患兒20例.所有對象均進行皮膚變應原點刺試驗(SPT)及血清總IgE、特異性IgE和嗜痠粒細胞計數.結果 在人選的183例患兒中,SPT暘性(≥1箇變應原暘性)157例(85.8%),各變應原暘性率為5.5%~75.4%,變應原中以屋塵螨緻敏的暘性率最高,達79.8%,其次為粉塵螨與熱帶螨,分彆為72.7%與65.0%,其餘變應原暘性率依次為:狗毛48.6%,美洲大蠊47.0%,貓毛34.4%,德國小蠊29.5%,黴菌類19.7%,花粉類15.9%,艾蒿7.7%,豚草5.5%.螨過敏暘性患兒有146例,常閤併其他一種或多種變應原暘性(115例,78.8%),而螨過敏陰性患兒(37例,20.2%)中僅有11例(29.7%)閤併其他一種或多種變應原暘性(x2=33.099,P<0.001),差異有統計學意義.各年齡組髮病率特點:高齡組(>7歲)SPT暘性率為82.3%,高于低齡組(≤7歲)(79.3%),兩組間SPT暘性率的差異有統計學意義(P<0.05).在吸入變應原種類的比較中,高齡組在螨類過敏暘性率、貓毛與狗毛暘性率、蟑螂暘性率均高于低齡組,差異有統計學意義(P<0.05);兩組在黴菌類及花草類暘性率的差異無統計學意義.哮喘併鼻炎、哮喘、鼻炎3組患兒均以螨類過敏最為常見,3組間除蟑螂SPT暘性率差異有統計學意義外(P<0.05),螨類、動物皮毛類、黴菌及花草類的變應原暘性率差異均無統計學意義.結論 過敏性因素是兒童呼吸繫統變態反應性疾病髮病的重要誘髮因素,在廣州地區哮喘和(或)鼻炎兒童可以通過SPT檢查明確過敏原,最常見的變應原是屋塵螨、粉塵螨及熱帶螨.隨著年齡增長,呼吸道變態反應性疾病患兒對吸入性變應原更為敏感.鼻炎、哮喘、哮喘併鼻炎患兒有共同的變應原.研究不同年齡段變態反應性疾病患者的變應原特徵,有助于對疾病的早期診斷和早期榦預.
목적 료해엄주지구호흡도변태반응성질병인동상견변응원,위예방화치료인동변응성질병제공과학의거.방법 선택2006년2월지2007년3월재엄주의학원제일부속의원인과문진부합지기관효천(간칭효천)화(혹)변응성비염(간칭비염)적엄주지구5세이상환인183례,기중남132례,년령(8.2-4-0.2)세;녀51례,년령(7.8사0.4)세;효천병비염자105례,효천환인58례,부비염환인20례.소유대상균진행피부변응원점자시험(SPT)급혈청총IgE、특이성IgE화기산립세포계수.결과 재인선적183례환인중,SPT양성(≥1개변응원양성)157례(85.8%),각변응원양성솔위5.5%~75.4%,변응원중이옥진만치민적양성솔최고,체79.8%,기차위분진만여열대만,분별위72.7%여65.0%,기여변응원양성솔의차위:구모48.6%,미주대렴47.0%,묘모34.4%,덕국소렴29.5%,매균류19.7%,화분류15.9%,애호7.7%,돈초5.5%.만과민양성환인유146례,상합병기타일충혹다충변응원양성(115례,78.8%),이만과민음성환인(37례,20.2%)중부유11례(29.7%)합병기타일충혹다충변응원양성(x2=33.099,P<0.001),차이유통계학의의.각년령조발병솔특점:고령조(>7세)SPT양성솔위82.3%,고우저령조(≤7세)(79.3%),량조간SPT양성솔적차이유통계학의의(P<0.05).재흡입변응원충류적비교중,고령조재만류과민양성솔、묘모여구모양성솔、장랑양성솔균고우저령조,차이유통계학의의(P<0.05);량조재매균류급화초류양성솔적차이무통계학의의.효천병비염、효천、비염3조환인균이만류과민최위상견,3조간제장랑SPT양성솔차이유통계학의의외(P<0.05),만류、동물피모류、매균급화초류적변응원양성솔차이균무통계학의의.결론 과민성인소시인동호흡계통변태반응성질병발병적중요유발인소,재엄주지구효천화(혹)비염인동가이통과SPT검사명학과민원,최상견적변응원시옥진만、분진만급열대만.수착년령증장,호흡도변태반응성질병환인대흡입성변응원경위민감.비염、효천、효천병비염환인유공동적변응원.연구불동년령단변태반응성질병환자적변응원특정,유조우대질병적조기진단화조기간예.
Objective To evaluate the common allergies in respiratory allergic diseases of children in Guangzhou urban districts and to provide the evidence for preventing allergic diseases.Methods All eases were collected from Pediatric Out-patient Department of the First Affiliated Hospital of Guangzhou Medical College from February 1st,2006 to March 30th,2007.183 children were above 5 years old,whose diagnoses were asthma and(or) allergic rhinitis,and lived in Guangzhou urban districts.In 183 cases,132 were males females.Among 183 patients,58 cases were asthma,20 cases were rhinitis and 105 cases were asthma andrhinitis.All the patients underwent skin prick tests(SPT) with 13 common aeroallergens,total IgE(TIgE),specific IgE(sIgE) and eosinophil count in serum.Results Among 183 patients,157(85.8%) had at least one positive skin reaction.The rates of positive skin reaction with 13 common aeroallergens were from 5.5 % to 75.4%.The positive rate of Dermatophagoides pteronyssinus(Der p) was the highest(79.8%),then followed up by Dermatophagoides farinae(Der f)(72.7%),Blomia tropicalis(65.0%),dog hair(48.6%),American cockroach(47.0%),cat hair(34.4%),Blatella germanica (29.5%),mixed moulds(19.7%),mixed grass pollens(15.9%),Artemisia vulgaris(7.7%),Ambrosia artemisifolia(5.5%).The patients (146/183 cases) who were positive reactivity in mites were concomitant reactivity to multiple allergens (115/146 cases,78.8%).Only 11 cases with negative reactivity in acaridan were combined with multiple allergens(11/37 cases,29.7%).There was statistical significance between in positive/negative skin reaction with aearidan(X2=33.099,P<0.001).The group of above 7 years old(>7 group) was more statisticallysignificant than the group of lower 7 years old(≤7 group)in the allergic positive rates (P<0.05),andalso more significant in mites (Der P,Der f,Blomia tropicalis),cat hair,dog hair,cockroach (P<0.05).But there was no difference in mixed moulds and mixed grass pollens between>7 group and≤7 group(all P>0.05).Mites(Der P,Der f and Blomia tropicalis) were the most common aeroallergens in patients withasthma,or rhinitis,and both asthma and rhinitis.Apart from that of cockroach(P<0.05),there was no significant difference in the positive rates of mites(Der P,Der f and Blomia tropicalis),cat,dog,mixedmoulds,mixed grass pollens among three groups(all P>0.05).Conclusions The allergy is the important factor in respiratory allergy disease.Those patients with asthma and(or) allergic rhinitis usually have the positive SPT.House dust mites were the most prevalent allergens in children with asthma and(or) rhinitis in Guangzhou urban districts.With age growing,the children with respiratory allergic disease are more sensitiveto aeroallergens.There are the same allergens among asthma and(or) rhinitis.To estimate allergen patterns of sensitizations in patients from different geographic areas,age groups as well as asthma and(or) rhinitis contribute to earlier diagnosis and earlier prevention.