重庆地区10 183例多中心来源儿童过敏原皮肤点刺结果分析

Analysis of skin prick tests results of 10 183 children with multi-center sources of allergens in Chongqing area

摘要:

目的： 了解重庆地区儿童常见过敏原情况，为重庆市儿童过敏性疾病的预防和治疗提供科学依据。方法： 对重庆市区及周边区县2018年1月至2020年6月进行过敏原皮肤点刺试验检测的6所医院共10 183名（男6 245例，女3 938例）患儿进行回顾性研究，采用卡方检验或Fisher确切概率法进行统计分析。结果： 大于1种过敏原检测阳性的占61.40%。吸入性过敏原阳性前3位疾病为：支气管哮喘（45.71%）、慢性咳嗽（22.79%）、变应性鼻炎（16.06%）。在支气管哮喘、慢性咳嗽、变应性鼻炎、咳嗽变异性哮喘、腺样体肥大、结膜炎中，吸入性阳性率高于食入性阳性（P<0.05）；但是，过敏性皮炎中食入性阳性率明显高于吸入性阳性率（P=0.007）。不同吸入性过敏原在不同阳性反应强度分布上具有统计学差异（P=0.000），户尘螨、粉尘螨以“+++”至“++++”阳性反应为主；不同食入性过敏原在不同阳性反应强度分布上具有统计学差异（P=0.000），鸡蛋以“+++”至“++++”阳性反应为主。不同花粉中玉米花粉作为过敏原阳性占比最高，为6.62%。不同年龄组在不同性别之间的过敏原分布具有统计学差异（P=0.004），其中3~6岁组相比于6~18岁组过敏原阳性占比更高，且男孩过敏原阳性检出率高于同年龄组女孩（P=0.006）。不同年龄过敏原阳性检出结果显示，吸入性过敏原阳性率随年龄呈递增趋势，食入性过敏原1岁以内阳性检出率最高。不同季度之间吸入性与食入性过敏原阳性检出具有统计学差异（P=0.000），其中第一季度比第三季度低（P=0.000），第二季度比第三季度高（P=0.004），第四季度比第三季度低（P=0.049）。结论： 重庆地区儿童吸入性过敏原以户尘螨、粉尘螨、蟑螂为主，食入性过敏原以海蟹、鸡蛋、海虾为主；倾向于低年龄段（3~6岁）、男性、4~6月高流行趋势，并且主要以呼吸道疾病形式检出。本研究为重庆市儿童过敏原疾病的治疗和预防指明了方向，具有重要的参考价值。

Abstract:

Objective: To understand the common allergens of children, and to provide a scientific reference for the prevention and treatment of allergic diseases of children in Chongqing. Methods: A retrospective study was conducted among 10 183 children (6 245 males and 3 938 females) who had skin prick tests for allergens in 6 different hospitals in the urban area of Chongqing and its surrounding districts and counties from January 2018 to June 2020. The statistical analysis was made by chi-square test/Fisher’s exact test. Results: The positive rate of more than one allergen detection was 61.40%. The top three positive rates of inhalation allergen in different allergic diseases were bronchial asthma (45.71%), chronic cough (22.79%) and allergic rhinitis (16.06%). In bronchial asthma, chronic cough, variant rhinitis, cough variant asthma, conjunctivitis, adenoid hypertrophy, the positive detection rate of inhalation was higher than that of ingestion (P<0.05). The positive detection rate of ingestion in allergic dermatitis was significantly higher than that of inhalation (P=0.007). There were differences in the intensity distribution of positive responses to different inhaled allergens (P=0.000), and the positive responses of house dust mites and dust mites were mainly "+++" to "++++". There were differences in the intensity distribution of positive reactions to different ingestion allergens (P=0.000), and eggs were mainly positive reactions of "+++" to "++++". The highest positive proportion of allergens detected in corn pollen was 6.62%, among the different pollens. The distribution of allergens in different age groups between different genders was statistically different (P=0.004). Among them, the proportion of positive allergens in 3-6 years old is higher than that in the 6-18 year old group, and the positive detection rate of boys is higher than that of girls of the same age group, and the difference was statistically significant (P=0.006). The positive detection rate of inhaled allergens increased with age, and the positive detection rate of ingested allergens was highest within 1 year of age. There was a statistical difference between inhaled and ingested allergens between different quarters (P=0.000), in which the first quarter was lower than the third quarter (P=0.000), the second quarter was higher than the third quarter (P=0.004), and the fourth quarter was lower than the third quarter (P=0.049). Conclusion: The inhaled allergens of children in Chongqing are mainly household dust mites, dust mites and cockroaches, and the ingested allergens are mainly sea crabs, eggs and shrimp. The epidemic trend tends to 3-6 years old and 6-18 years old, male, and high prevalence from April to June, and it is mainly detected in the form of respiratory disease. This study provides direction for the treatment and prevention of children’s allergen diseases in Chongqing, with important reference value.