儿童过敏性结膜炎和过敏性鼻炎的关系

Pediatric allergic conjunctivitis and allergic rhinitis

目的评价儿童过敏性结膜炎和过敏性鼻炎的关系。方法自2005年3月至2007年1月,来自武汉市儿童医院892患者,其中眼科门诊407例作为过敏性结膜炎组;五官科门诊485例为过敏性鼻炎组。记录其并发疾病、临床体征和症状、病史。479例检测患者血清总IgE及特异性IgE;88例同时患有两种疾病的进行眼结膜和鼻粘膜的刮片寻找嗜酸性粒细胞。结果在407例过敏性结膜炎组中302例(74%)、374例(92%)、116例(29%)同时患有湿疹、鼻炎和哮喘;485例过敏性鼻炎组中334例(69%)、430例(89%)、145例(30%)同时患有湿疹、鼻炎和哮喘。过敏性结膜炎合并过敏性鼻炎与过敏性鼻炎合并过敏性结膜炎无统计学差异(χ2=2.6,P>0.05);两者合并湿疹和哮喘也无统计学差异(χ2=3.08,χ2=0.21,P>0.05)。两种疾病的症状的严重程度不平行,在季节性过敏性结膜炎和常年性过敏性结膜炎患者中,其鼻部的症状比眼部的症状严重(χ2=258.2,P<0.05),而在春季角结膜炎中则相反(χ2=66.5,P<0.05)。88例刮片中50例(57%)结膜刮片和58例(66%)鼻粘膜刮片中可以找到嗜酸性粒细胞,两者之间有差异性(χ2=1.5,P>0.05)。主要的食入性过敏原是鱼、虾、蟹;吸入性过敏原是尘螨、屋尘和真菌。结论两种疾病的相似性明显多于差异性,这提示防治过敏性结膜炎在未来预防过敏性鼻炎和哮喘中应作为一项重要的纳入指标。

Objective To assess the relationship between allergic conjunctivitis and allergic rhinitis in pediatric ophthalmology and E. N. T outpatient clinic. Methods Eight hundred and ninety two patients were enrolled in survey during Mar. 2005-Jan. 2007, in those 407 cases were from ophthalmology clinic as allergic conjunctivitis team and 485 cases from E. N. T clinic as allergic rhinitis team. The comorbid disorders , histories, symptoms, signs of patients were recorded. Type 1 allergy was tested in 479 cases by a specific IgE antibody test in the blood. Eosinophils were detected in superficial conjunctival scrapings of the superior tarsal conjunctiva and mucosa surface scrapings of middle nasal meatus in 88 cases with both diseases. Results 302（74% ）, 374（92% ）, 116（29% ） in 407 cases with allergic conjunctivitis had concomitant eczeme, rhinitis and asthma respectively; 334（69%）, 430（89% ） , 145（30% ） in485 cases with allergic rhinitis had concomitant eczeme, rhinitis and asthma respectively. The prevalence of allergic conjunctivitis concomitant allergic rhinitis and allergic rhinitis concomitant allergic conjunctivitis has no difference （ χ^2 = 2.6, P 〉 0.05 ）, and the prevalence of al- lergic conjunctivitis and allergic rhinitis concomitant eczeme and asthma has no significant difference （χ^2= 3.08;χ^2 = 0. 21, P 〉 0.05 ）. The degree of severity of two kinds of disease symptoms is not parallel, in the patients with SAC and PAC, the clinical signs of AR were always severer （ χ^2 = 258.2, P 〈 0.05 ） than those of AC ; but in verse in the cases with VKC （χ^2 = 66.5, P 〈 0.05 ） and eosinophils were revealed in 50 （ 57% ） conjunctival scrapings and nasal mucosa scrapings （ χ^2 =1.5, P 〉0.05） , 47 （53% ） cases had positive results in both scrapings. The main aeroallergens were house dust mites, house dust and fungi, and the main food - allergens were fish, crab and shrimp. Conclusion Two disorders share more similarities than differences, which suggest that allergic conjunctivitis should be considered in the future guidelines on prevention the development of rhinitis and asthma.