中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2011年
11期
921-927
,共7页
戴伟利%张杰%潘岳松%陈敏%张亚梅
戴偉利%張傑%潘嶽鬆%陳敏%張亞梅
대위리%장걸%반악송%진민%장아매
儿童%鼻炎,变应性,常年性%鼻炎,变应性,季节性%变应原
兒童%鼻炎,變應性,常年性%鼻炎,變應性,季節性%變應原
인동%비염,변응성,상년성%비염,변응성,계절성%변응원
Child%Rhinitis,allergic,perennial%Rhinitis,allergic,seasonal%Allergens
目的 分析1～3岁变应性鼻炎(allergic rhinitis,AR)患儿的特应性分布状态及其临床特征.方法 采集2009年8月至2010年11月96例1～3岁具有AR症状患儿病史资料,包括就诊年龄、性别、出现症状年龄、病史月数、个人过敏史、父母过敏史.采用敏筛定量过敏原检测系统( Allergy Screen)筛查共计19类吸入组和食物组变应原特异性lgE( specific IgE,sIgE)及血清总IgE水平.归纳该组患儿吸人性变应原和食物变应原致敏的分布状态,按月龄(A组,≥12月龄；B组,≥24月龄；C组,≥36月龄,但不满48月龄)、变应原类别及湿疹或哮喘任一阳性分组分析各临床特征因子的影响作用,Logistic回归方法分析各临床特征与变应原致敏的相互关系.结果 变应原筛查总阳性率为81.3％；吸入组变应原、食物组变应原阳性率分别为62.5％、53.1％；混合真菌阳性率最高(50.0％),其次为牛奶(34.4％)、羊肉(31.3％)、牛肉(26.0％)、屋尘螨(21.0％)、小麦(18.8％)、艾蒿(12.5％)、鸡蛋白或鸡蛋黄(11.5％).62.5％可确诊为AR,其余可暂视为非变应性鼻炎.按月龄分组进行临床特征的单因素分析提示:吸入组变应原(x2=13.699,P=0.001)、父亲患AR(x2=14.060,P=0.001)和父亲或母亲患AR(x2=7.396,P=0.025)在3个月龄组的差异均有统计学意义.个人湿疹史(P=0.034,OR =3.143)可增加变应原致敏的可能性；个人湿疹史(P=0.015,OR=3.125)和总IgE ＞200 IU/ml(P=0.030,OR =3.119)则增加吸入组变应原致敏的可能性；未筛选出对食物组变应原致敏有统计学意义的临床特征；食物组和吸人组阳性率差异无统计学意义.吸入组变应原阳性(P=0.046,OR=3.594)、有蚊虫叮咬性皮炎(P=0.002,OR=11.941)为出现湿疹或哮喘任一阳性的危险因素.结论 1～3岁具有AR症状的幼儿中,吸入组和食物组变应原均可致敏,且吸入组阳性率略高；湿疹史是患儿变应原筛查阳性的危险因素之一,血清总IgE水平升高与吸人性变应原筛查阳性率升高有关；吸入组变应原阳性、有蚊虫叮咬性皮炎和父亲患AR与出现湿疹或哮喘病史有关.
目的 分析1～3歲變應性鼻炎(allergic rhinitis,AR)患兒的特應性分佈狀態及其臨床特徵.方法 採集2009年8月至2010年11月96例1～3歲具有AR癥狀患兒病史資料,包括就診年齡、性彆、齣現癥狀年齡、病史月數、箇人過敏史、父母過敏史.採用敏篩定量過敏原檢測繫統( Allergy Screen)篩查共計19類吸入組和食物組變應原特異性lgE( specific IgE,sIgE)及血清總IgE水平.歸納該組患兒吸人性變應原和食物變應原緻敏的分佈狀態,按月齡(A組,≥12月齡；B組,≥24月齡；C組,≥36月齡,但不滿48月齡)、變應原類彆及濕疹或哮喘任一暘性分組分析各臨床特徵因子的影響作用,Logistic迴歸方法分析各臨床特徵與變應原緻敏的相互關繫.結果 變應原篩查總暘性率為81.3％；吸入組變應原、食物組變應原暘性率分彆為62.5％、53.1％；混閤真菌暘性率最高(50.0％),其次為牛奶(34.4％)、羊肉(31.3％)、牛肉(26.0％)、屋塵螨(21.0％)、小麥(18.8％)、艾蒿(12.5％)、鷄蛋白或鷄蛋黃(11.5％).62.5％可確診為AR,其餘可暫視為非變應性鼻炎.按月齡分組進行臨床特徵的單因素分析提示:吸入組變應原(x2=13.699,P=0.001)、父親患AR(x2=14.060,P=0.001)和父親或母親患AR(x2=7.396,P=0.025)在3箇月齡組的差異均有統計學意義.箇人濕疹史(P=0.034,OR =3.143)可增加變應原緻敏的可能性；箇人濕疹史(P=0.015,OR=3.125)和總IgE ＞200 IU/ml(P=0.030,OR =3.119)則增加吸入組變應原緻敏的可能性；未篩選齣對食物組變應原緻敏有統計學意義的臨床特徵；食物組和吸人組暘性率差異無統計學意義.吸入組變應原暘性(P=0.046,OR=3.594)、有蚊蟲叮咬性皮炎(P=0.002,OR=11.941)為齣現濕疹或哮喘任一暘性的危險因素.結論 1～3歲具有AR癥狀的幼兒中,吸入組和食物組變應原均可緻敏,且吸入組暘性率略高；濕疹史是患兒變應原篩查暘性的危險因素之一,血清總IgE水平升高與吸人性變應原篩查暘性率升高有關；吸入組變應原暘性、有蚊蟲叮咬性皮炎和父親患AR與齣現濕疹或哮喘病史有關.
목적 분석1～3세변응성비염(allergic rhinitis,AR)환인적특응성분포상태급기림상특정.방법 채집2009년8월지2010년11월96례1～3세구유AR증상환인병사자료,포괄취진년령、성별、출현증상년령、병사월수、개인과민사、부모과민사.채용민사정량과민원검측계통( Allergy Screen)사사공계19류흡입조화식물조변응원특이성lgE( specific IgE,sIgE)급혈청총IgE수평.귀납해조환인흡인성변응원화식물변응원치민적분포상태,안월령(A조,≥12월령；B조,≥24월령；C조,≥36월령,단불만48월령)、변응원유별급습진혹효천임일양성분조분석각림상특정인자적영향작용,Logistic회귀방법분석각림상특정여변응원치민적상호관계.결과 변응원사사총양성솔위81.3％；흡입조변응원、식물조변응원양성솔분별위62.5％、53.1％；혼합진균양성솔최고(50.0％),기차위우내(34.4％)、양육(31.3％)、우육(26.0％)、옥진만(21.0％)、소맥(18.8％)、애호(12.5％)、계단백혹계단황(11.5％).62.5％가학진위AR,기여가잠시위비변응성비염.안월령분조진행림상특정적단인소분석제시:흡입조변응원(x2=13.699,P=0.001)、부친환AR(x2=14.060,P=0.001)화부친혹모친환AR(x2=7.396,P=0.025)재3개월령조적차이균유통계학의의.개인습진사(P=0.034,OR =3.143)가증가변응원치민적가능성；개인습진사(P=0.015,OR=3.125)화총IgE ＞200 IU/ml(P=0.030,OR =3.119)칙증가흡입조변응원치민적가능성；미사선출대식물조변응원치민유통계학의의적림상특정；식물조화흡인조양성솔차이무통계학의의.흡입조변응원양성(P=0.046,OR=3.594)、유문충정교성피염(P=0.002,OR=11.941)위출현습진혹효천임일양성적위험인소.결론 1～3세구유AR증상적유인중,흡입조화식물조변응원균가치민,차흡입조양성솔략고；습진사시환인변응원사사양성적위험인소지일,혈청총IgE수평승고여흡인성변응원사사양성솔승고유관；흡입조변응원양성、유문충정교성피염화부친환AR여출현습진혹효천병사유관.
Objective To study the atopy spectrum and its related factors in 1 to 3 years old children with allergic rhinitis.Methods Ninety-six children with allergic rhinitis,aged between 1 and 3years old,referred to ENT department of Beijing Children's Hospital between August 2009 and November 2010 were retrospectively reviewed.Data were recorded for patients' age,age stratification,sex,the age of first symptom,the duration of history,and the allergic history of children,the allergic history of parents.The screening tests on inhalant and food allergens were conducted by immunoblot assay using the Allergy Screen system.The total serum IgE level was also measured.The distribution of the inhalant and food allergens was summarized.The influence of the clinical characteristics was analyzed according to the age subgroup determined by month,allergen category and positiveness of eczema or asthma Logistic regression was used to analyze the relationship of clinical characteristics and allergen spectrum.Results The total positive rates of allergic screening test rate were 81.3％.The inhalant and food allergens were 62.5％ and 53.1％ respectively.The commonest allergy was mixed fungal(50.0％ ),followed by milk(34.4％ ),lamb (31.3％),beef(26.0％ ),dust mite ( 21.0％ ),wheat ( 18.8％ ),mugwort ( 12.5％ ),egg white or egg yolk( 11.5％ ).62.5％ of patients could be diagnosed as AR,the remaining could be diagnosed temporarily as non-allergic rhinitis temporarily.Single factor analysis of clinical characteristics in different subgroup determined by month showed that:inhalant allergen(positive/negative) ( x2 =13.699,P =0.001 ),father suffered from AR( x2 =14.060,P =0.001 ),and father or mother suffered from AR ( x2 =7.396,P =0.025) were statistically significant at three monthly age groups.The personal history of eczema ( OR =3.143,P=0.034 ) might increase the possibility of sensitization to allergens.The personal history of eczema ( OR=3.125,P=0.015) and the total serum IgE level ＞ 200 IU/ml ( OR=3.119,P=0.030)might increase the possibility of sensitization to inhalant allergens.No clinical features for food allergen sensitization was statistically significant.There was no significant difference in positive rates between inhalant and food allergens groups.The presence of inhalant allergens ( OR=3.594,P=0.046 ),insect bites dermatitis ( OR=11.941,P=0.002) were the risk factors for positiveness of eczema or asthma,and the father with AR ( OR=0.251,P=0.040 ) as protective factors.Conclusions Inhalant and food allergens all can be sensitized in the children with AR symptoms between 1 to 3 years old,and the positive rate of inhalant group is slightly higher.The differences of the inhalant allergen (positive/negative) and father suffered from AR are statistically significant at three monthly age groups.The history of eczema is the risk factor for allergen screening positive.Serum total IgE ＞ 200 IU/ml and eczema history are risk factors for inhalant allergen screening positive.The factors of inhalatant allergens,insect bites dermatitis and father suffered from AR relate to any positive of eczema or asthma.
