重庆地区6 197例变应性鼻炎儿童吸入性变应原临床分析

Clinical analysis of common inhaled allergens in 6 197 children with allergic rhinitis in Chongqing

摘要:

目的：探讨重庆地区儿童变应性鼻炎患者吸入性变应原原谱特点及其影响因素。方法：选取2006年1月至2012年4月就诊于重庆医科大学附属儿童医院耳鼻喉科的重庆地区4月~12岁过变应性鼻炎患儿6 197例，对其进行皮肤点刺试验（skin prick test,SPT），分析变应原阳性率、阳性反应程度及阳性种类数与性别、年龄、居住环境的相关性。结果：①在6 197例变应性鼻炎患儿中，4 048例（65.32%）具有特应性，屋尘螨（65.06%）、粉尘螨（63.35%）和热带螨（40.07%）阳性率及其阳性程度居于前3位。②2006年至2012年间变应原特应性阳性率（依次为50.64%、80.21%、81.20%、82.36%、77.34%、71.18%、56.01%）先急剧上升，然后趋于稳定再缓慢下降（r=－0.104，P=0.000）。③随着年龄的增长，变应原阳性率、阳性程度及阳性种类均增加（r分别为0.115、0.120、0.080；P分别为0.000、0.000、0.000），性别特应性差异具有统计学差异（幼儿期：61.9% vs. 63.8%，P=0.739；学龄前期：73.6% vs. 69.7%，P=0.030；学龄期：78.4% vs. 73.4%，P=0.002）。④在男童的幼儿期和学龄前期变应性鼻炎患儿中，主城区患儿变应原特应性阳性率明显高于郊县（幼儿期：43.8% vs. 64.7%，P=0.023；学龄前期：68.4% vs. 74.6%，P=0.027）。结论：重庆地区儿童变应性鼻炎患儿大都具有特应性，屋尘螨、粉尘螨和热带螨是主要的吸入性变应原，随着年龄增长，特应性程度增加，性别差异更明显。

Abstract:

Objective：To investigate the distribution characteristics of inhaled allergens and its influencing factors in children with al－lergic rhinitis（AR） in Chongqing. Methods：All cases were collected from otorhinolaryngological department of the Children’s Hos－pital of Chongqing Medical University from 1st January，2006 to 29th April，2012. Totally 6 197 children with allergic rhinitis from 4 months to 12 years old in Chongqing urban districts were enrolled. All the patients underwent skin prick test（SPT） with 13 standard－ized common inhalant allergens. The correlation between the positive rates，grades，categories of allergens and gender，age，living en－vironment was analyzed. Results：①Of the 6 197 AR patients，4 048（65.32%） were atopic；dermatophagoides pteronyssinus（65.06%），dermatophagus farinae（63.35%） and blomia tropicalis（40.07%） were the top three prevalent inhalant allergens. ②From 2006 to 2012，the SPT positive rate increased sharply，then tended to be stable，and then decreased slowly（50.64%，80.21%，81.20%，82.36%，77.34%，71.18%，56.01%）. ③With the growth of age，the positive rates，grades and categories of SPT increased，and the preponderance of atopy in boys was more significant. ④In the male infancy and preschool children with AR，the SPT positive rate of central downtown patients was significantly increased compared with those in the suburbs. Conclusion：Dermatophagoides ptero-nyssinus，derma-tophagus farinae and blomia tropicalis are the most prevalent in－halant allergens in AR disease in Chongqing urban districts. With the growth of age，children with allergic rhinitis，espe－cially boys，are more susceptible to inhalant allergens.