中国城市支气管哮喘儿童与非支气管哮喘儿童食物过敏患病情况比较

摘要

Objective To explore the prevalence and clinical characteristics of food allergy in bronchial asth-matic children less than 14 years old in China. Methods A case - controlled study was designed. The questionnaires were given to children,who were diagnosed to be asthmatic during the national epidemiological survey of asthma in chil-dren in 31 cities from September 2009 to August 2010. Non - asthmatic children,matched with the cases in age and gender,were selected during the same survey as control subjects if they were matched with the cases in age and sex. In-formation regarding the food allergen and symptom of food - induced anaphylaxis was analyzed. The difference in food allergy was compared between children with or without bronchial asthma. Results As a result,9235 asthmatic children and 11391 control subjects were enrolled in the case - control study. There were 14. 66％(1354 / 9235 cases)of the asthmatic children who had food allergy,compared to 3. 99％(455 / 11391 cases)of the non - asthmatics children, and the findings showed a significant difference (χ2 = 725. 25,P < 0. 001). The most common food allergens were fish and shrimp in both groups,and the difference was not significant [44. 09％ (597 / 1354 cases)vs. 42. 20％ (192 / 455 cases),χ2 = 0. 50,P > 0. 05]. The rate of peanut allergy was 4. 58％ (62 / 1354 cases)and 1. 54％ (7 / 455 cases) (χ2 = 8. 58,P < 0. 05),respectively. And the rates of fruit allergy in the asthmatic group and the non - asthmatic group were 14. 03％(190 / 1354 cases)and 27. 69％(126 / 455 cases)(χ2 = 44. 01,P < 0. 05),respectively. Cutaneous and nasal symptoms were common clinical manifestations. The rates of rash,pruritus,and swelling sympions were 47. 27％(640 / 1354 cases)and 61. 32％(279 / 455 cases)(χ2 = 26. 90,P < 0. 001),respectively for asthmatic group and non -asthmatic group. Rates of nasal symptoms were 17. 13％(232 / 1354 cases)and 10. 55％(48 / 455 cases)(χ2 = 11. 29, P = 0. 001),respectively in the asthmatic group and the non - asthmatic groups. Respiratory symptoms,such as cough and wheezing,were 25. 33％(343 / 1354 cases)and 5. 49％(25 / 455 cases)(χ2 = 80. 72,P < 0. 001)in 2 groups. Twenty cases of 1354 asthmatic children had severe food allergy,while such severe conditions occurred only 1 child without asthma (455 cases)occurred severe condition (1. 48％ vs. 0. 22％,χ2 = 4. 96,P < 0. 05). Conclusion The-rate of food allergen sensitization is highly prevalent in the children with asthma. Compared to those without asthma, and their types of food allergen and clinical symptoms are different from the latter.%目的 了解我国14岁以下支气管哮喘(哮喘)儿童食物过敏的患病率及临床特点.方法 采用病例对照研究,对2009年9月至2010年8月在全国31个城市进行的城市儿童哮喘流行病学调查中确诊哮喘的儿童同时进行现场食物过敏问卷调查,获得食物过敏患病率及临床特征.选取同一地区年龄、性别相匹配的非哮喘儿童作为对照,调查其食物过敏情况.比较分析哮喘儿童与非哮喘儿童食物过敏患病的异同点.结果 共9235例哮喘儿童和11391例非哮喘儿童纳入分析.哮喘儿童的食物过敏患病率为14.66％(1354/9235例),高于非哮喘儿童(3.99％,455/11391例),差异有统计学意义(χ2=725.25,P<0.001).哮喘儿童与非哮喘儿童最常见的过敏食物均为鱼、虾,比例分别为44.09％(597/1354例)、42.20％(192/455例),二者比较差异无统计学意义(χ2=0.50,P>0.05).哮喘儿童和非哮喘儿童花生过敏的比例分别为4.58％(62/1354例)、1.54％(7/455例),水果过敏的比例分别为14.03％(190/1354例)、27.69％(126/455例),二者比较差异均有统计学意义(χ2=8.58、44.01,均P<0.05).临床表现:哮喘儿童与非哮喘儿童食物过敏均以皮疹、瘙痒等皮肤黏膜症状最常见,分别占47.27％(640/1354例)和61.32％(279/455例),差异有统计学意义(χ2=26.90,P<0.001);鼻部症状的比例分别为17.13％(232/1354例)、10.55％(48/455例),差异有统计学意义(χ2=11.29,P=0.001);咳嗽、喘息的比例分别为25.33％(343/1354例)、5.49％(25/455例),差异有统计学意义(χ2=80.72,P<0.001).哮喘儿童严重过敏反应的比例为1.48％(20/1354例),高于非哮喘儿童(0.22％,1/455例),差异有统计学意义(χ2=4.96,P<0.05).结论 哮喘儿童的食物过敏患病率远高于非哮喘儿童,其过敏食物的种类、临床表现等与非哮喘儿童均有所不同.