CAJ | 학술논문

目的分析5年后学龄前儿童变应性鼻炎(allergic rhinitis,AR)相关症状的转化方向,致敏变应原的种类变化,探讨AR与哮喘的关系.方法通过对2006至2007年流行病学调查中248例确诊为AR的儿童(AR组)及217名未被确诊为AR的儿童(非AR组)进行再次电话调查问卷随访,并对63例AR组患儿再次进行变应原皮肤点刺试验,将结果汇总、录入,以SPSS 17.0软件进行统计学分析.结果 AR组随访应答216例,非AR组应答156名.随年龄增长,37.0％(80/216)的AR组患儿的症状控制,其中70.0％(56/80)的患儿接受过治疗；63.0％ (136/216)的AR组患儿的症状未控制,在AR症状持续的136例患儿中,49.3％(67/136)接受过治疗,差异有统计学意义(x2=0.833,P=0.003).前次调查中诊断为AR的患儿,5年后合并哮喘的人数增多,发生率从12.5％(27/216)增加至14.8％(32/216),差异有统计学意义(x2=-0.491,P=0.484).而非AR组调查对象中患哮喘的儿童概率由前次的2.6％(4/156)提高至本次的3.2％ (5/156),但差异无统计学意义(x2 =0.114,P=0.736).在AR组中,前次调查中有27例哮喘儿童,本次调查27例哮喘患儿中11例哮喘已控制,未再发作,这11例中7例患儿的AR症状也得到控制；本次调查中哮喘症状仍在持续的16例患儿中,13例AR仍在持续,二者差异有统计学意义(x2=5.423,P＜0.05).本次皮肤点刺试验中变应原阳性总数较前次检测减少,同时首位变应原由前次的交链孢霉变为本次的粉尘螨.有21例受检儿童出现与前次不同的变应原阳性,最少出现1种,最多有7种,大豚草出现数量最多,真菌最少.结论随年龄增长,学龄前儿童AR患儿5年后有37.0％达到临床症状控制,儿童AR与哮喘密切相关,致敏变应原随着年龄增长可以发生变化.
목적 분석5년후학령전인동변응성비염(allergic rhinitis,AR)상관증상적전화방향,치민변응원적충류변화,탐토AR여효천적관계.방법 통과대2006지2007년류행병학조사중248례학진위AR적인동(AR조)급217명미피학진위AR적인동(비AR조)진행재차전화조사문권수방,병대63례AR조환인재차진행변응원피부점자시험,장결과회총、록입,이SPSS 17.0연건진행통계학분석.결과 AR조수방응답216례,비AR조응답156명.수년령증장,37.0％(80/216)적AR조환인적증상공제,기중70.0％(56/80)적환인접수과치료；63.0％ (136/216)적AR조환인적증상미공제,재AR증상지속적136례환인중,49.3％(67/136)접수과치료,차이유통계학의의(x2=0.833,P=0.003).전차조사중진단위AR적환인,5년후합병효천적인수증다,발생솔종12.5％(27/216)증가지14.8％(32/216),차이유통계학의의(x2=-0.491,P=0.484).이비AR조조사대상중환효천적인동개솔유전차적2.6％(4/156)제고지본차적3.2％ (5/156),단차이무통계학의의(x2 =0.114,P=0.736).재AR조중,전차조사중유27례효천인동,본차조사27례효천환인중11례효천이공제,미재발작,저11례중7례환인적AR증상야득도공제；본차조사중효천증상잉재지속적16례환인중,13례AR잉재지속,이자차이유통계학의의(x2=5.423,P＜0.05).본차피부점자시험중변응원양성총수교전차검측감소,동시수위변응원유전차적교련포매변위본차적분진만.유21례수검인동출현여전차불동적변응원양성,최소출현1충,최다유7충,대돈초출현수량최다,진균최소.결론 수년령증장,학령전인동AR환인5년후유37.0％체도림상증상공제,인동AR여효천밀절상관,치민변응원수착년령증장가이발생변화.
Objective To observe the development of allergic rhinitis (AR) in preschool children,and the variation of sensitization to airborne allergens 5 years later,also the link between AR and asthma.Methods Two hundred and fourty-eight children with AR (AR group) and 217 non-AR children (non-AR group)were surveyed using a questionnaire and examined by otolaryngologists with skin prick test (SPT) between 2006 and 2007.Among them,63 children were asked to return to hospital to participate in a routine ENT examination and SPT for common inhalant allergens.All statistical analysis was performed by a professional statistician using SPSS 17.0 statistical software.Results Two hundred and sixteen questionnaires were acquired in AR group and 156 questionnaires were acquired in non-AR group.(1) The remission of AR occurred in 37.0％ (80/216) 5-years later,70.0％ (56/80) children who had remission of AR symptoms received the correct medication; there was only 49.3％ (67/136) children who had nonremission of AR symptoms received the correct medication,and there was a statistically significant difference (x2 =0.114,P =0.736).(2) Asthma prevalence was increased from 12.5％ (27/216) to 14.8％ (32/216) in AR group children,there was no statistically significant difference (x2 =-0.491,P =0.484).The prevalence of asthma was increased slightly from 2.6％ (4/156) to 3.2％ (5/156) in no-AR group children,there was no statistically significant difference (x2 =0.114,P =0.736).When asthma in AR group children had tendency of remission,AR could also be controlled,and there was a statistically significant difference (x2 =5.423,P ＜ 0.05).(3) The total number of sensitization allergen decreased compared to the originally test.Dermatophagoidesfarina was the most common allergen in our survey,while in the originally test,Alternaria tenuis was the most common allergen.There was agedependent tendency to sensitize to new classes of allergens was present in children with AR,the number of children sensitized to fungal was minimum.Conclusions Remission of AR in preschool children occurred in 37.0％ 5 years later.There is a strong relationship between childhood AR and childhood asthma.Sensitization to the airborne allergens may change with age.