广州地区呼吸道疾病患儿16种常见变应原检测分析

Analysis and measurement of sixteen common allergens in children with respiratory disorders in Guangzhou

目的了解广州地区呼吸道疾病患儿对16种常见变应原的过敏情况，同时探讨不同年龄组之间的变应原阳性率差异，并比较致敏程度。方法选择2007年8月至2008年3月广州医学院第一附属医院呼吸科门诊和儿科门诊初诊为支气管哮喘、过敏性鼻炎、呼吸道感染等患儿320例为研究对象，其中婴幼儿组（≤3岁）214例，儿童组（〉3岁）106例。采用德国FOOKEALLERG—O—LIQ—SYSTEM变应原检测系统，通过免疫捕获法检测血清中常见的16种变应原特异性免疫球蛋白E（SIgE）抗体。结果在所有患儿中，其中261例（81．56％）SIgE呈阳性，59例（18．44％）呈阴性。16种变应原SIgE阳性率为屋尘螨（36．88％）、粉尘螨（35．31％）、热带螨（24．06％）、狗毛（6．56％）、猫毛（8．75％）、德国小蠊（16．56％）、蜜蜂毒素（0．94％）、屋尘（45．63％）、全蛋（45．94％）、牛奶（46．25％）、小麦面粉（6．88％）、玉米粉（1．25％）、花生（9．06％）、大豆（5．94％）、螃蟹（2．81％）、虾（4．38％）。婴幼儿组SIgE的阳性率为81．78％，以食物性变应原（牛奶、全蛋）为主；儿童组的阳性率为81．13％，以吸人性变应原（尘螨）为主（X^2＝0．02．P=0．89）。儿童组尘螨的过敏阳性率均高于婴幼儿组（P〈0．05），且儿童组屋尘螨和粉尘螨的过敏程度多在3级以上。婴幼儿组各级阳性率比较平均。两组对热带螨的过敏程度均较低，多在3级以下。婴幼儿组牛奶和全蛋过敏阳性率高于儿童组（P〈0．05），两组的过敏程度均在3级以下。结论儿童组与婴幼儿组对常见变应原的总阳性率差异无统计学意义，只是对不同变应原阳性率及过敏程度的差异。儿童组主要是对吸人性变应原产生过敏，婴幼儿组主要是对食物性变应原产生过敏，应以不同年龄段来分析儿童变应原检测结果。

Objective To explore the sensitization of 16 common allergens in children with respiratory diseases in Guangzhou, and to investigate the differences of allergens positive rate and compare the sensitization severity of two different age groups. Methods From August 2007 to March 2008, 320 children primarily diagnosed as bronchial asthma, allergic rbinitis or respiratory infections in our respiratory or pediatric department as out-patients were enrolled in the study. In those children, 214 children were no more than 3 years （infants group ） and 106 children were more than 3 years （elder children group）. Specific IgE （SIgE） antibodies of sixteen common allergens were measured by serologic test with immunocapture methods using ALLERC-O-LIQ-SYSTEM （Dr. Fooke Laboratory, Germany）. Results Fifty-nine cases （18.44%） were SIgE negative and 261 cases （81.56%） were SIgE positive. The positive rates of SIgE for 16 common allergens were Dermatophagoides pteronyssinus （ 36.88% ）, Dermatophagoides farinae （ 35.31% ）, tropical mites （ 24.06% ）, dog furs （6.56%）, cat furs （ 8.75% ）, German cockroach （ 16.56% ）, honey bee venom （0.94%）, house dust （45.63%）, whole-eggs （45.94%）, milk （46.25%）, wheat flour （6.88%）, corn flour （1.25%）, peanuts （9.06%）, soybeans （5.94%）, crabs （2.81% ） and shrimp （4.38%）. The SIgE positive rate was 81.78% in infants group and 81.13% in elder children group（X^2=0.02, P=0.89）. Allergy to foods （such as milk, whole-eggs） was more common in infants group, while allergy to inhalational allergens （such as dust mites） was more common in elder children group. For dust mite allergies, the SIgE positive rate was higher in eider children group than that of infants group（P〈0.05）. The elder children group had stronger response more than grade 3 to Dermatophagoides pteronyssinus and Dermatophagoides farinae. The SIgE positive rate in different grades was not significant in infants group. And weak responses mostly less than grade 3 to tropical mites were shown in both groups. For milk and whole-eggs allergies, the SIgE positive rate was higher in infants group than that of elder children group（P〈O.05）. Responses less than grade 3 to milk and whole-eggs were shown in both groups. Conclusions The overall rate of sensitization is not different between infants group and elder children group. The differences of incidence and sensitization severity caused by allergens should be noted. The predominant causes of sensitization are inhalational allergens in elder children group, and food allergens in the infants. The results of allergen based on children age should be analyzed.