重庆地区1105例变应性疾病患儿吸入性变应原临床分析

Clinical Analysis of Inhaled Allergen of 1105 Cases with Allergic Disease in Chongqing Area

目的探讨重庆地区吸入性变应原的分布情况及其与儿童哮喘发生之间的关系。方法选择室内尘螨、花粉、真菌、蟑螂等13种常见的吸入性变应原,对重庆医科大学附属儿童医院2005年5月-2007年1月共1105例患儿行皮肤点刺试验(SPT),计算各种变应原阳性率,并对吸入组变应原皮试结果进行统计,采用SAS8.1软件对数据进行聚类分析,进行单因素、多因素Logistic回归分析。结果被检查的1105例患儿中SPT阳性者893例,占80.81%(893/1105例)。其中,阳性率在50%以上的吸入性变应原有:粉尘螨760例,占68.80%(760/1105例);屋尘螨759例,占68.72%(759/1105例);热带螨594例,占53.08%(594/1105例),其他吸入性变应原阳性率均在15%以下。聚类分析将13种变应原聚为4大类,提示各类内具有某种相似性。以变应原为自变量,哮喘为应变量的单因素Logistic回归分析结果显示,粉尘螨、屋尘螨、热带螨、美洲大蠊这4种变应原可能与哮喘的发病有关;多因素Logistic回归分析结果显示,诸多变应原共同作用时,粉尘螨和热带螨对哮喘的发病有意义;不同年龄和性别对这13种吸入性变应原的过敏程度均有显著性差异(Pa<0.05)。结论螨类为重庆地区哮喘患儿最常见的变应原,且与哮喘的发生关系极为密切。不同性别和年龄对吸入性变应原的过敏程度不同。

Objective To explore the correlation of allergen and asthma in children in Chongqing area. Methods One thousand one hundred and five patients with allergic disease who received skin prick test （SPT） were recruited for this study. SPT was performed with a panel of allergens including dermatophagoides farinaet, dermatophagoides pteronyssinus, torrid zone mite, german cockroach, periplaneta Americana,cat hair,dog hair,moulds,and pollens. The Sift＇ findings were analyed by fuzzy grouping analysis. The correlation of the allergen and asthma was analyzed by logistic regression, the allergens in different sex and different age was analyzed by Cochran - Mantel - Haenszel Statis- tics. Results Of the 1 105 patients,893 cases （80.81%） had positive SPT reactions. The commonest allergen were dermatophagoides farinaet which was 68.80% positive in the 1 105 patients,the other common allergens were in order of dermatophagoides pteronyssinus （68. 72% ） ,torrid zone mite （53.08%） ,and the others were lower than 15%. The 13 categories sensibiligen in Chongqing area could be divided into 4 clusters ： dermatophagoides culinae, torrid zone acarid and dermatophagoides pteronyssinus ; the periplaneta Americana and German cockroach ; the pollen. Mycetes and dog hair ; the cat hair was classified with mugwort and vine wort. The probability of asthma was statistically more significant in Dermatophagoides culinae, dermatophagoides pteronyssinus, torrid zone mite, periplaneta Americana. The probability of asthma was statistically more significant in Dermatophagoides culinae and torrid zone mite. Patients in different age and different sex showed significantly different reactions in SPT. The different age （ 〉 6 years and ≤ 6 years） showed significant differences （ Pa 〈 0.05 ） in 5 allergens ： dermatophagoides culinae, torrid zone acarid, dermatophagoides pteronyssinus, Periplaneta Americana and German cockroach. The different sex showed significant differences （Pa 〈 0.05 ） in 5 allergens ： dermatophagoides culinae, torrid zone acarid, dermatophagoides pteronyssinus, cat hair and German cockroach. Conclusions Dust mites are the most prevalent causative allergen, and raise the risk of allergic asthma. There are siznificant differences in the reaction of SPT between different age and different sex.