上海地区变应性疾病患儿真菌变应原反应特点

Characteristic of Moulds Allergen on Children with Allergic Disorders in Shanghai Area

目的探讨上海地区变应性疾病患儿真菌变应原反应的临床特点。方法采用国际标准化的变应原试剂,对2002年1月-2007年11月788例变应性疾病患儿行皮肤点刺试验(SPT),检测混合真菌Ⅰ(室外混合真菌)和混合真菌Ⅱ(室内混合真菌)的反应性。并比较真菌Ⅰ和Ⅱ阳性情况在性别、年龄、季节分布和临床表现方面的差异。应用SAS8.0软件进行统计学处理。结果真菌变应原SPT呈阳性反应者99例。男68例,女31例;年龄(5.12±2.66)岁;真菌Ⅰ阳性者83例,真菌Ⅱ阳性者6例,真菌Ⅰ和Ⅱ均阳性者10例;真菌Ⅰ的反应率(11.80%)显著高于真菌Ⅱ(1.02%)(P<0.01);真菌变应原SPT反应率和性别无明显关系(P>0.05);在≤3岁患儿中反应率(19.98%)高于>3岁者(10.88%)(P<0.01);真菌变应原反应率和季节分布无明显关系(P>0.05);真菌Ⅱ引起的皮肤过敏症状的反应率(6.81%)高于呼吸道过敏症状的反应率(2.14%)(P<0.05);真菌Ⅰ引起的呼吸道过敏症状的反应率(11.86%)和皮肤过敏症状的反应率(14.77%)无明显差异(P>0.05)。结论上海地区变应性疾病患儿中,真菌变应原SPT呈阳性反应者占12.56%,以室外真菌为主。季节分布无显著差异,在≤3岁的儿童中真菌引起的过敏应受到重视,室内真菌可引起更多的皮肤过敏症状。环境控制对预防真菌过敏和改善过敏症状很重要。

Objective To explore the relationship between moulds allergen and clinical characteristic of children with allergic disorders in Shanghai area. Methods Totally 788 children with allergic disorders were assayed with international standard of allergen agents （ mould Ⅰ ： mixed with ahernaria and cladosporium ere; mould Ⅱ ： mixed with aspergillus and penieillium ere ） by means of skin prick test （SPT） from Jan. 2002 to Nov. 2007. The comparisons of the positive mould Ⅰ and mould Ⅱ were clone in several aspects such as sex, age, seasons and clinic symptoms. The data were analyzed by SAS 8.0 software. Results In 99 children with moulds allergenic SPT positive,68 cases were boys and 31 cases were girls with an average age of （5.12 ±2.66） years,83 eases were mould Ⅰ positive, 6 cases were mould Ⅱ positives, 10 cases were both mould Ⅰ and Ⅱ positive. Statistical analysis showed that the reactivity of mixed mould Ⅰ was higher than that of mixed mould Ⅱ （P 〈 0.01 ） ,the positive percentage of the moulds SPT had no obvious relation with sex and seasons （Pa 〉 0.05 ） ,but the reactivity of children before 3 years old （ 19.98% ） was higher than that of children after 3 years old （ 10.88% ） （ P 〈 0.01 ）. Although the allergic symptoms caused by mould Ⅰ were not different in skin and respiratory tract, mould Ⅱ caused more allergic symptoms in skin than that in respiratory tract （P 〈 0.05 ）. Conclusions In Shanghai area, 12.56% children with allergic disorders were moulds allergenic SPT positive. Outdoor mould was more common, with no significant seasonal prevalence. We should pay attention to allergy caused by moulds in children before 3 years old. Allergic skin diseases were commonly caused by indoor moulds. Environmental control measures of these allergens should be considered the first -line treatment measures.