1000例临床诊断变应性鼻炎儿童皮肤点刺试验结果分析

摘要

目的 研究长沙地区变应性鼻炎儿童的变应原分布及其随年龄增长的变化情况, 为预防主要的变应原提供理论依据.方法 以2013年7月至2015年2月就诊于我科门诊临床诊断为变应性鼻炎的患儿为调查对象, 所有患儿均采用变应原皮肤点刺试验 (SPT) 检测过敏原, 计算各变应原的阳性率, 并分析其与年龄变化的关系. 结果 ①在1 000例诊断为变应性鼻炎的患儿中,皮肤点刺试验阳性者687例, 阳性率为68.70%. 其中包括吸入性变应原阳性患儿534例, 阳性率为53.40% (534/1 000), 单纯尘螨过敏占212例, 阳性率21.20% (212/1 000), 占吸入性变应原的39.70% (212/534), 粉尘螨和户尘螨是最主要的两种吸入性过敏原; 其次, 蟑螂、 霉菌、 猫毛的阳性率分别为20.40% (204/1 000)、 13.60% (136/1 000) 及12.20% (122/1 000). 食入性过敏患儿178例, 阳性率17.80% (178/1 000), 单一食物过敏44例, 阳性率4.40% (44/1 000), 占食入性的24.72% (44/178), 海虾(6.60%)、 牛奶 (6.60%) 和鸡蛋 (6.40%) 是主要的食入性过敏原. ②粉尘螨、 户尘螨、 猫毛及禾草的阳性率随年龄的增长显著升高, 差异有统计学意义. ③变应原检测阳性率与性别之间无显著统计学差异. 结论 ①尘螨是长沙地区主要的过敏原, 7 ~13岁是变应性鼻炎高发年龄段. ②SPT是变应性疾病常用的检测手段, 但受其他因素的干扰, 存在假阴性及假阳性, 应谨慎判断.%Objective To study the distribution of allergens in children with allergic rhinitis in Changsha area and its relationship with the increasing ages, so as to provide theoretical basis for the prevention of common allergens. Methods Children diagnosed with allergic rhinitis from July 2013 to February 2015 were given skin prick test (SPT). Among the patients, the distribution of allergens was analyzed and the positive rate was compared with age. Results ①1 000 children were diagnosed with allergic rhinitis, including 687 cases of SPT positive, with the total positive rate of SPT of 68.70%. Among 687 positive cases, 534 cases were regarded as inhalant allergens and 212 cases as dermatophagoides, with the positive rate of 53.40%(534/1 000) and 21.20%(212/1 000) respectively;Among 534 cases of inhalant allergens, the dermatophagoides accounted for 39.70%(212/534). The dermatophagoides farina and dermatophagoides pteronyssinus were the most common inhalant allergen. Apart from that, the positive rates of cockroach, mycete and cat hair were 20.40%(204/1 000), 13.60%(136/1 000) and 12.2%(122/1 000) respectively. Among 687 positive cases, 178 cases were regarded as food allergens, with the positive rate of 17.80%(178/1 000). And 44 cases were single food allergens, with the positive rate of 4.40%(44/1 000), accounting for 24.72%(44/178). Besides, shrimp (6.60%), milk (6.60%) and egg (6.40%) were the most common food allergens.②The positive rates of cat hair and grass, dermatophagoides farina, and dermatophagoides pteronyssinus increased with age, with statistically significant difference.③There was no statistically significant difference between the positive rate and sex. Conclusions Dust mites are identified as the most common allergens among children with allergic rhinitis in Changsha area, and the highest incidence rate is in children from 7 to 13 years old. SPT is one of the most common examination methods for allergic diseases, which may lead to false negative and false positive results due to interference by some factors.