儿童支气管哮喘与共患变应性鼻炎严重度的相关性分析

摘要

目的 观察不同年龄段支气管哮喘(哮喘)患儿中共患变应性鼻炎(AR)的情况,探讨哮喘与AR严重度的相关性.方法 选择广州地区首次就诊或既往诊断末规范治疗的2～14岁哮喘患儿,完成哮喘和AR情况调查表,检测血清变应原特异性IgE抗体.参照指南,评价哮喘和AR的严重度并进行相关性分析.结果 414例哮喘忠儿中,218例(52.7％)诊断为AR,6～＜12岁和12 ～ 14岁哮喘患儿共患AR的比率分别为62.4％ (123/197例)和 67.2％ (41/61例),明显高丁2～＜6岁的34.6％ (54/156例)(x2=33.1,P＜0.01).哮喘与AR的严重度在2～＜6岁二者无相关性(r=0.242,P=0.078),而在6～＜12岁(r=0.401,P=0.000)和12 ～14岁(r=0.516,P=0.001)二者呈显著正相关.2～14岁哮喘合并AR患儿吸入变应原阳性率排在前4位的为屋尘螨65.6％(143/218例)、粉尘螨64.7％(141/218例)、热带螨19.7％ (43/218例)和德国小蠊14.7％ (32/218例).结论 6岁以下哮喘患儿共患AR的比例低丁6岁以上的哮喘患儿.6岁以上儿章哮喘与AR的严重度呈显著正相关.屋尘螨和粉尘螨是广州地区哮喘共患AR患儿的主要吸入变应原.%Objective To observe the coexistence of allergic rhinitis (AR) in asthmatic children at different ages and to explore the correlation between the severity of asthma and AR.Methods This study was carried in asthmatic children aged 2-14 years.The questionnaire for asthma and AR was completed.All of the children underwent specific IgE (sIgE) to test common inhalant allergens.The classification and severity of asthma and AR were evaluated according to guidelines,respectively.Results Of 414 asthmatic children,218 patients (52.7％) presented with AR.The proportion of asthmatic chilren with AR less than 6 years old (34.6％,54/156 cases) was significantly lower than those aged6-＜12 years (62.4％,123/197 cases) and 12-14 years (67.2％,41/61 cases) (x2 =33.1,P＜0.01).A positive correlation was found between the severity of asthma and AR in children aged 6-＜ 12 years old (r =0.401,P =0.000) and 12-14 years old (r =0.516,P =0.001).However,there was no correlation between the severity of asthma and AR in children less than 6 years old (r =0.242,P =0.078).In 218 asthmatic children with AR,the positive rate of Dermatophagoides pteronyssinus (Der.p) was the highest (65.6％,143/218 cases),followed by Dermatophagoides farinae (Der.f) (64.7％,141/218 cases),Blomia tropicalis (19.7％,43/218 cases) and Blattella Germanica (14.7％,32/218 cases).Conclusions The proportion of asthmatic children less than 6 years old suffering from AR is lower than the children more than 6 years old.There is a positive correlation between the severity of asthma and AR in children aged 6-14 years.Der.P and Der.f are the main inhalant allergens of asthmatic children with AR in Guangzhou area.