中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2014年
3期
177-183
,共7页
向莉%付亚南%王静%王群
嚮莉%付亞南%王靜%王群
향리%부아남%왕정%왕군
哮喘%儿童%尘螨过敏原%控制
哮喘%兒童%塵螨過敏原%控製
효천%인동%진만과민원%공제
Asthma%Child%House dust mite allergens%Control
目的 动态监测哮喘患儿家庭内尘螨过敏原含量变化规律,了解其与患儿哮喘控制评估水平、尘螨致敏程度及呼出气一氧化氮浓度的相关性.方法 选取北京地区48例尘螨过敏性哮喘患儿,在1年内4个季节分别收集其家庭内床垫、枕头、卧室地板、客厅地板及沙发处灰尘样本,采用酶联免疫吸附分析方法(ELISA)测定以上灰尘样本中户尘螨过敏原第一组分(Derp 1)和粉尘螨过敏原第一组分(Derf 1)的含量;荧光酶联免疫法测定患儿血清尘螨特异性IgE(sIgE)的浓度及分级;记录各次临床随访期患儿的哮喘控制测试(ACT)或儿童哮喘控制测试(C-ACT)评分值以及根据患儿哮喘症状等指标得到的临床哮喘控制评估水平结果.结果 全部灰尘样本Der f 1平均含量为0.13μg/g,显著高于Der p1平均含量(0.02 μg/g,P＜0.05),床垫、枕头及沙发灰尘样本Derf1含量分别为0.69 μg/g,0.42μg/g,0.22 μg/g,均显著高于卧室及客厅地板灰尘样本(0.07 μg/g、0.07 μg/g).发现仅夏季床垫灰尘样本Der f 1含量与患儿哮喘控制评估水平呈负相关关系(r=-0.318,P=0.036);夏季各区域灰尘样本Der f 1含量和秋季的枕头灰尘样本Der p 1含量分别与ACT/C-ACT评分呈负相关关系.冬季的床垫灰尘样本Der f 1含量与患儿血清粉尘螨sIgE浓度级别呈正相关关系,各季节室内多个区域样本中Der p 1含量与患儿血清户尘螨和粉尘螨sIgE浓度级别呈正相关关系.结论 本地区尘螨过敏性哮喘患儿室内尘螨过敏原类型以Der f 1为主,床垫、枕头及沙发区域是尘螨过敏原的主要来源.室内尘螨过敏原含量对患儿的哮喘控制水平、尘螨致敏程度的影响呈现季节、区域和螨种依赖性.
目的 動態鑑測哮喘患兒傢庭內塵螨過敏原含量變化規律,瞭解其與患兒哮喘控製評估水平、塵螨緻敏程度及呼齣氣一氧化氮濃度的相關性.方法 選取北京地區48例塵螨過敏性哮喘患兒,在1年內4箇季節分彆收集其傢庭內床墊、枕頭、臥室地闆、客廳地闆及沙髮處灰塵樣本,採用酶聯免疫吸附分析方法(ELISA)測定以上灰塵樣本中戶塵螨過敏原第一組分(Derp 1)和粉塵螨過敏原第一組分(Derf 1)的含量;熒光酶聯免疫法測定患兒血清塵螨特異性IgE(sIgE)的濃度及分級;記錄各次臨床隨訪期患兒的哮喘控製測試(ACT)或兒童哮喘控製測試(C-ACT)評分值以及根據患兒哮喘癥狀等指標得到的臨床哮喘控製評估水平結果.結果 全部灰塵樣本Der f 1平均含量為0.13μg/g,顯著高于Der p1平均含量(0.02 μg/g,P＜0.05),床墊、枕頭及沙髮灰塵樣本Derf1含量分彆為0.69 μg/g,0.42μg/g,0.22 μg/g,均顯著高于臥室及客廳地闆灰塵樣本(0.07 μg/g、0.07 μg/g).髮現僅夏季床墊灰塵樣本Der f 1含量與患兒哮喘控製評估水平呈負相關關繫(r=-0.318,P=0.036);夏季各區域灰塵樣本Der f 1含量和鞦季的枕頭灰塵樣本Der p 1含量分彆與ACT/C-ACT評分呈負相關關繫.鼕季的床墊灰塵樣本Der f 1含量與患兒血清粉塵螨sIgE濃度級彆呈正相關關繫,各季節室內多箇區域樣本中Der p 1含量與患兒血清戶塵螨和粉塵螨sIgE濃度級彆呈正相關關繫.結論 本地區塵螨過敏性哮喘患兒室內塵螨過敏原類型以Der f 1為主,床墊、枕頭及沙髮區域是塵螨過敏原的主要來源.室內塵螨過敏原含量對患兒的哮喘控製水平、塵螨緻敏程度的影響呈現季節、區域和螨種依賴性.
목적 동태감측효천환인가정내진만과민원함량변화규률,료해기여환인효천공제평고수평、진만치민정도급호출기일양화담농도적상관성.방법 선취북경지구48례진만과민성효천환인,재1년내4개계절분별수집기가정내상점、침두、와실지판、객청지판급사발처회진양본,채용매련면역흡부분석방법(ELISA)측정이상회진양본중호진만과민원제일조분(Derp 1)화분진만과민원제일조분(Derf 1)적함량;형광매련면역법측정환인혈청진만특이성IgE(sIgE)적농도급분급;기록각차림상수방기환인적효천공제측시(ACT)혹인동효천공제측시(C-ACT)평분치이급근거환인효천증상등지표득도적림상효천공제평고수평결과.결과 전부회진양본Der f 1평균함량위0.13μg/g,현저고우Der p1평균함량(0.02 μg/g,P＜0.05),상점、침두급사발회진양본Derf1함량분별위0.69 μg/g,0.42μg/g,0.22 μg/g,균현저고우와실급객청지판회진양본(0.07 μg/g、0.07 μg/g).발현부하계상점회진양본Der f 1함량여환인효천공제평고수평정부상관관계(r=-0.318,P=0.036);하계각구역회진양본Der f 1함량화추계적침두회진양본Der p 1함량분별여ACT/C-ACT평분정부상관관계.동계적상점회진양본Der f 1함량여환인혈청분진만sIgE농도급별정정상관관계,각계절실내다개구역양본중Der p 1함량여환인혈청호진만화분진만sIgE농도급별정정상관관계.결론 본지구진만과민성효천환인실내진만과민원류형이Der f 1위주,상점、침두급사발구역시진만과민원적주요래원.실내진만과민원함량대환인적효천공제수평、진만치민정도적영향정현계절、구역화만충의뢰성.
Objective The prevalence of allergic asthma has been rising continually which is correlated with the increasingly closed living environment.House dust mites are the major sources of indoor aeroallergens which induce asthma in sensitized people.To monitor the seasonal variation of house dust mite (HDM)-allergens exposure level in the asthmatic children,which was evaluated to show its correlation with the level of asthma control,HDM allergic sensitization and fraction of exhaled nitric oxide,and to provide basic data for HDM environmental control.Method A total of 48 HDM-allergic asthmatic children were enrolled from the asthma clinic in the hospital from March 2011 to January 2012 (boys 34 and girls 14,aging from 3 to 14 years,mean age 8 years and 4 months) in the present study.Dust samples from mattresses,pillows,bedroom floor,living room floor and sofas were collected in each season within one year in the household of all the enrolled patients.The concentrations of Der p 1 and Der f 1 were measured by the enzyme-linked immunosorbent assay (ELISA).To record the Asthma Control Test (ACT) score or Children Asthma Control Test (C-ACT) score for each patient and to collect the data of doctor monitoring asthma control level each time when the patient was clinic visited.The concentration and its classification of the serum specific IgE to HDM was determined by fluoroenzyme-immunometric assay.Result The average concentration of Der f 1 of all dust samples was significantly higher than that of Der p 1 (0.13 μg/g vs 0.02 μg/g,P ＜ 0.05).The concentrations of Der f 1 from mattresses,pillows and sofas dust samples were significantly higher than those from bedroom floor and living room floor dust samples (0.69 μg/g,0.42 μg/ g and 0.22 μg/g vs 0.07 μg/g and 0.07 μg/g,P ＜ 0.05).The Der f 1 exposure level from mattress dusts in summer but no others was negatively correlated with asthma control level (r =-0.318,P =0.036).The Der f 1 exposure level from any area dusts in summer and the Der p 1 exposure level from pillows dusts in autumn was negatively correlated with ACT/C-ACT score respectively.The Der f 1 from mattress dusts in winter was positively correlated with classification of sIgE to Der f 1.The Der p 1 exposure level from most areas in each season was positively correlated with classification of sIgE to Der f 1 and Der P 1.Conclusion Der f I was the predominant mite allergen in household dust and mainly came from mattresses,pillows and sofas.The role of the HDM allergen exposure level on the asthma control level and HDM allergic sensitization for the asthmatic children were depended on its area,season and HDM species,which suggested that the future assessment of clinical effect by the HDM environmental control should consider these factors.
