京津冀地区自报过敏性鼻炎病人吸入过敏原检测临床相关性分析

doi:10.3969/j.issn.1006-7795.2017.05.008

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (5): 665-670.doi: 10.3969/j.issn.1006-7795.2017.05.008

京津冀地区自报过敏性鼻炎病人吸入过敏原检测临床相关性分析

娄鸿飞^1,2, 马思远¹, 赵岩², 曹飞飞³, 贺飞², 王向东², 王成硕^1,2, 张罗^1,2,3

1. 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科, 北京 100730;
2. 北京市耳鼻咽喉科研究所鼻病研究北京市重点实验室, 北京 100005;
3. 首都医科大学附属北京同仁医院变态(过敏)反应科, 北京 100730

收稿日期:2017-07-07 出版日期:2017-09-21 发布日期:2017-10-18
通讯作者: 张罗 E-mail:dr.luozhang@139.com
基金资助:
国家自然科学基金重点项目（81630023），国家自然科学基金青年基金项目（81400444），国家自然科学基金面上项目（81470678），国家自然科学基金重点国际合作研究项目（81420108009），北京市医院管理局青苗人才培养"使命"计划（SML20150203），北京市医院管理局青苗人才培养"青苗"计划（QML20150202）。

Sensitization patterns for aeroallergens in self-reported allergic rhinitis within Beijing, Tianjin, and Hebei region

Lou Hongfei^1,2, Ma Siyuan¹, Zhao Yan², Cao Feifei³, He Fei², Wang Xiangdong², Wang Chengshuo^1,2, Zhang Luo^1,2,3

1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;
2. Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otorhinolaryngology, Beijing 100005, China;
3. Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

Received:2017-07-07 Online:2017-09-21 Published:2017-10-18
Supported by:
This study was supported by National Natural Science Foundation of China (81630023, 81400444, 81470678), National Science Fund for the Major International Joint Research Program (81420108009), Beijing Municipal Administration of Hospitals' Mission Plan (SML20150203), Beijing Municipal Administration of Hospitals' Youth Program (QML20150202).

摘要/Abstract

摘要： 目的调查京津冀地区自报过敏性鼻炎（allergic rhinitis，AR）病人吸入过敏原的致敏率，分析阳性过敏原的年龄及性别差异，阐明过敏原与过敏性鼻炎症状、合并症的临床相关性。方法采用20种标准化过敏原，对2011年1月至2013年7月就诊于首都医科大学附属北京同仁医院的6 236例京津冀地区自报过敏性鼻炎病人进行皮肤点刺试验（skin prick test，SPT）。记录病人鼻部症状视觉模拟评分和哮喘、过敏性结膜炎病史。应用χ²检验比较不同年龄、性别病人的阳性过敏原及其致敏率，应用Spearman相关分析评价过敏原的临床相关性。结果 5 530例病人（88.7%）至少1种过敏原阳性。京津冀地区自报过敏性鼻炎病人最常见的过敏原是粉尘螨和屋尘螨，致敏率分别为47.3%和41.7%，其在自报过敏性鼻炎成年病人中的致敏率随年龄增长而下降，男性高于女性。尘螨致敏与过敏性鼻炎的持续性、严重程度均无关，但户外过敏原的致敏率在中重度过敏性鼻炎病人显著高于轻度过敏性鼻炎病人，在持续性过敏性鼻炎病人显著高于间歇性过敏性鼻炎病人。SPT中尘螨的皮肤指数与过敏性鼻炎症状无关，艾蒿、禾本花粉的皮肤指数与过敏性鼻炎症状正相关。≥ 54%的AR合并哮喘或过敏性结膜炎病人呈现4种以上过敏原阳性。尘螨、德国小蠊阳性与AR合并哮喘或过敏性结膜炎无相关性，户外过敏原（艾蒿、蒲公英、大豚草）的致敏率在AR合并哮喘或过敏性结膜炎病人中显著高于无合并症AR病人。结论尘螨是京津冀地区自报过敏性鼻炎病人中最常见的吸入过敏原。吸入过敏原致敏率在不同的年龄、性别差异有统计学意义。过敏性鼻炎伴合并症病人多重致敏率高。户外过敏原致敏率与过敏性鼻炎症状严重程度正相关，其在过敏性鼻炎合并症病人中的致敏率升高。

关键词: 过敏性鼻炎, 过敏原, 致敏, 合并症, 临床相关性

Abstract: Objective The aim was to assess the patterns of aeroallergen sensitizations in patients with self-reported allergic rhinitis (AR), analyze the differences of aeroallergen sensitization rates in different age groups and genders, and demonstrate the clinical relevance of positive aeroallergen with AR symptoms and allergic comorbidities. Methods A total of 6 236 patients suffering from AR symptoms in Beijing, Tianjin and Hebei region underwent standardized skin prick test (SPT) with 20 common aeroallergens during the period from January 2011 to July 2013 when seeking medical help in Beijing Tongren Hospital. Nasal symptom visual analogue score and the history of asthma and allergic conjunctivitis were recorded. Chi-square and Spearman correlation tests were used in statistical analysis. Results Among the 6 236 self-reported AR patients investigated, 5 530 (88.7%) had at least one positive skin prick reaction. The most common aeroallergen in this area were house dust mites (HDMs), with the sensitization rates (SRs) as 47.3% for Der f and 41.7% for Der p, respectively. SRs of HDMs decreased with age and were higher in males compared to females. Higher SRs of outdoor aeroallergens were observed in moderate-severe AR and persistent AR, whereas HDM SRs were not different between AR classifications. Skin index (SI) of HDMs was not relevant to AR symptoms, but SIs of mugwort and grass pollen were positively correlated with the severity of AR symptoms. More than 4 positive allergens were found in over 54% of patients with AR and comorbidities. HDMs and Blatella were not associated with AR and allergic comorbidities, whereas SRs of outdoor allergens (mugwort, dandelion and ragweed) were significantly higher in patients with AR and comorbidities compared to only AR patients. Conclusion Dust mites were the most prevalent allergens in patients with AR in Beijing, Tianjin and Hebei region. Sensitization pattern of aeroallergens varied with age and genders. Higher SRs and multiple sensitizations were associated with AR comorbidities. SRs of outdoor allergens were positively correlated with severity of AR.

Key words: allergic rhinitis, aeroallergen, sensitization, comorbidities, clinical relevance

中图分类号:

R765.21

娄鸿飞, 马思远, 赵岩, 曹飞飞, 贺飞, 王向东, 王成硕, 张罗. 京津冀地区自报过敏性鼻炎病人吸入过敏原检测临床相关性分析[J]. 首都医科大学学报, 2017, 38(5): 665-670.

Lou Hongfei, Ma Siyuan, Zhao Yan, Cao Feifei, He Fei, Wang Xiangdong, Wang Chengshuo, Zhang Luo. Sensitization patterns for aeroallergens in self-reported allergic rhinitis within Beijing, Tianjin, and Hebei region[J]. Journal of Capital Medical University, 2017, 38(5): 665-670.

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京津冀地区自报过敏性鼻炎病人吸入过敏原检测临床相关性分析

Sensitization patterns for aeroallergens in self-reported allergic rhinitis within Beijing, Tianjin, and Hebei region

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