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目的了解广州地区呼吸道变态反应性疾病儿童常见变应原,为预防和治疗儿童变应性疾病提供科学依据。方法选择2006年2月至2007年3月在广州医学院第一附属医院儿科门诊符合支气管哮喘(简称哮喘)和(或)变应性鼻炎(简称鼻炎)的广州地区5岁以上患儿183例,其中男132例,年龄(8.2±0.2)岁;女51例,年龄(7.8±0.4)岁;哮喘并鼻炎者105例,哮喘患儿58例,仅鼻炎患儿20例。所有对象均进行皮肤变应原点刺试验(SPT)及血清总IgE、特异性IgE和嗜酸粒细胞计数。结果在入选的183例患儿中,SPT阳性(≥1个变应原阳性)157例(85.8%),各变应原阳性率为5.5%～75.4%,变应原中以屋尘螨致敏的阳性率最高,达79.8%,其次为粉尘螨与热带螨,分别为72.7%与65.0%,其余变应原阳性率依次为:狗毛48.6%,美洲大蠊47.0%,猫毛34.4%,德国小蠊29.5%,霉菌类19.7%,花粉类15.9%,艾蒿7.7%,豚草5.5%。螨过敏阳性患儿有146例,常合并其他一种或多种变应原阳性(115例,78.8%),而螨过敏阴性患儿(37例,20.2%)中仅有11例(29.7%)合并其他一种或多种变应原阳性(χ2=33.099,P<0.001),差异有统计学意义。各年龄组发病率特点:高龄组(>7岁)SPT阳性率为82.3%,高于低龄组(≤7岁)(79.3%),两组间SPT阳性率的差异有统计学意义(P<0.05)。在吸入变应原种类的比较中,高龄组在螨类过敏阳性率、猫毛与狗毛阳性率、蟑螂阳性率均高于低龄组,差异有统计学意义(P<0.05);两组在霉菌类及花草类阳性率的差异无统计学意义。哮喘并鼻炎、哮喘、鼻炎3组患儿均以螨类过敏最为常见,3组间除蟑螂SPT阳性率差异有统计学意义外(P<0.05),螨类、动物皮毛类、霉菌及花草类的变应原阳性率差异均无统计学意义。结论过敏性因素是儿童呼吸系统变态反应性疾病发病的重要诱发因素,在广州地区哮喘和(或)鼻炎儿童可以通过SPT检查明确过敏原,最常见的变应原是屋尘螨、粉尘螨及热带螨。随着年龄增长,呼吸道变态反应性疾病患儿对吸入性变应原更为敏感。鼻炎、哮喘、哮喘并鼻炎患儿有共同的变应原。研究不同年龄段变态反应性疾病患者的变应原特征,有助于对疾病的早期诊断和早期干预。
Objective To understand the common allergens of children with respiratory allergic diseases in Guangzhou and to provide a scientific basis for the prevention and treatment of allergic diseases in children. Methods From February 2006 to March 2007 in the First Affiliated Hospital of Guangzhou Medical College pediatric outpatient in line with bronchial asthma (and asthma) and (or) rhinitis in Guangzhou area over the age of 183 children (132 ± 0.2) years old and 51 women (aged 7.8 ± 0.4) years old. There were 105 cases of asthma with rhinitis, 58 cases of asthma and 20 cases of rhinitis only. All subjects underwent skin allergen prick tests (SPT) and total serum IgE, specific IgE and eosinophil counts. Results Of the 183 children enrolled, 157 (85.8%) were positive for SPT (≥1 allergen positive) and the positive rate of each allergen was 5.5% -75.4%. The allergens were caused by house dust mites The highest positive rate was 79.8%, followed by Dust mites and tropical mites, 72.7% and 65.0% respectively. The positive rates of the other allergens were 48.6% for dog fur, 47.0% for American cockroach and 34.4% 29.5% of German cockroaches, 19.7% of molds, 15.9% of pollen, 7.7% of mugwort and 5.5% of ragweed. There were 146 cases of children with mite allergy (115 cases, 78.8%), while 11 cases (29.7%) had mite allergy negative cases (37 cases, 20.2% ) Were positive for one or more other allergens (χ2 = 33.099, P <0.001). The difference was statistically significant. The incidence rate of each age group: The positive rate of SPT in the elderly group (> 7 years old) was 82.3%, which was higher than that in the younger group (≤7 years old) (79.3%), the difference was statistically significant between the two groups (P < 0.05). In the comparison of inhalation allergen types, the positive rate of mite allergy, the positive rate of cats and dogs, and the positive rate of cockroaches in senior group were higher than those in younger group (P <0.05) There was no significant difference in the positive rates of molds and flowers between the two groups. Asthma and rhinitis, asthma, rhinitis were the most common group of mites allergy, the positive rate of SPT among the three groups was statistically significant (P <0.05), mites, animal fur, mold and flowers Allergen positive rate differences were not statistically significant. Conclusions Anaphylaxis is an important predisposing factor in the development of allergic respiratory diseases in children. In Guangzhou, children with asthma and / or rhinitis can be identified allergens by SPT. The most common allergens are house dust mites, dust mites and Tropical mite With age, children with respiratory allergies are more sensitive to inhaled allergens. Rhinitis, asthma, asthma and rhinitis children have a common allergen. Studying the allergen characteristics of patients with allergic diseases of different ages can help early diagnosis and early intervention of the disease.