上海不同地区变应性哮喘及变应性鼻炎患儿的变应原分析

Analysis of Allergen in Children with Allergic Asthma and Allergic Rhinitis in Different Area of Shanghai

目的分析上海不同地区变应性哮喘和变应性鼻炎患儿的变应原分布特点及意义,为防治儿童变应性呼吸道疾病提供理论依据。方法对2005年9月-2006年12月上海3家医院收治的502例变应性哮喘和变应性鼻炎患儿以及375例成人患者,采用12种德国Allergopharma变应原点刺液进行变应原皮肤点刺试验(SPT)。结果1.儿童组SPT阳性率80.9%,显著低于成人组的98.9%(χ2=69.278P=0.001),<7岁儿童组SPT阳性率低于≥7岁儿童组。2.SPT阳性患儿阳性率最高的变应原为粉尘螨,其次为猫上皮和狗上皮,阳性率分别为92.9%、35.7%和19.0%。3.儿童组中单纯哮喘患儿SPT阳性率的(67.7%),显著低于单纯鼻炎患儿(81.5%)和鼻炎并哮喘患儿(86.5%)(P=0.039,0.001)。4.上海市区患儿SPT阳性率(82.7%),显著高于上海郊区患儿阳性率(72.0%)(χ2=7.443P=0.006)。结论保持居住环境、家居用品清洁,减少尘螨接触,不养猫、狗等宠物,对减少儿童变应性哮喘和变应性鼻炎发病有很大帮助;儿童SPT阳性率受年龄影响;变应性鼻炎患儿在诊断治疗中较哮喘更应警惕变应原的检测和回避。

Objective To analyze the distribution and significance of allergen in children with allergic asthma and allergic rhinitis in different area of Shanghai, and to provide evidence for preventing allergic respiratory disease. Methods Five hundred and two children with allergic asthma and allergic rhinitis and 375 adult with the same disease were selected from Sep. 2005 to Dec. 2006, from 3 hospitals in Shanghai. All of them got the allergens skin prick tests（SPT） with 12 allergens from German Allergopharma. Results 1. The positive percentage of SPT in patients of children was 80.9% , which was evidently lower than that in patients of adult （98.9%） （Х^2 = 69. 278 P = . 001 ）. The positive percentage in 〈 7 years group was lower than that in ≥7 years group. 2. In SPT positive patients of children, the allergen with most high positive percentage was dermatophagoides farinae, then cat epithelia and dog epithelia followed, respectively 92.9%, 35.7% and 19.0%. 3. The SPT positive percentage in asthmatic - non - rhinitis children was 67.7%, which was markedly lower than that in rhinitis - non - asthmatic children （81.5%） and in rhinitis - asthmatic children （ 86, 5% ） （ P = 0. 039, 0. 001 ）. 4. The SPT po-sitive percentage of urban children patients was 82.7 %, which was higher than that of the patients in suburbs （ 72.0% ） （Х^2 = 7. 443 P = 0. 006 ）. Conclusions Keeping the living environment and commodities clean, avoiding the contact with dermatophagoides farinae and be away from pets such as cat and dog are benefit, which can reduce the development of allergic asthma and allergic rhinitis in children. The positive percentage of SPT in children was influenced by age. It should pay more attention to detect and avoid allergens when diagnosing and treating allergic rhinitis in children than doing that in asthma of children.