变应性鼻炎标准化变应原皮肤试验结果分析及与症状的相关性

Analysis of skin prickle test with standardized antigen and its relationship with degree of symptoms in patients with allergic rhinitis

目的探讨变应性鼻炎患者变应原的分布情况,并分析其与临床症状的关系。方法采用ALK标准化变应原制剂,对疑似变应性鼻炎症状和体征的1383例患者进行变应原皮肤点刺试验,并对阳性患者进行症状评分。结果1383例拟诊变应性鼻炎患者中变应原阳性反应者898例,阳性率64.9%。13种变应原中以螨类阳性例数为最多,包括屋尘螨、粉尘螨和热带螨,分别占总阳性例数的90.4%、87.2%和71.8%;其次为蠊类,包括德国小蠊和美洲大蠊,分别占总阳性例数的32.0%和27.3%;其余为狗毛、猫毛、艾蒿、豚草、花粉及真菌。儿童变应原阳性率明显高于成人(P<0.05);有家族过敏史患者变应原阳性率明显高于无家族过敏史患者(P<0.05);居城市者变应原阳性率高于乡村者,但二者无显著性差异(P>0.05)。对变应性鼻炎典型症状如喷嚏、流涕、鼻塞及鼻痒进行评分,总平均分值为7.71±1.46分;变应原阳性强度与变应性鼻炎症状积分无显著相关性(r=0.073,P>0.05),变应原阳性反应种类数目与变应性鼻炎症状积分呈正相关(r=0.629,P<0.05)。结论尘螨是变应性鼻炎的主要变应原。变应原阳性反应强度不能反映症状的严重程度,但阳性反应种类数目与症状的轻重程度有一定的相关性。

Objective To investigate allergen spectrum of patients with allergic rhinitis（AR）,and to analyze the relationship between skin prickle test（SPT）and degree of clinical symptoms.Methods A total of 1383 patients with allergic symptoms and signs underwent SPT with standardized antigens provided by ALK company,and the symptom was individually scored in patients with positive SPT.Results 898 of 1383（64.9%）cases showed positive results in SPT.The most common allergens found were mites including dermatophagoides pteronyssinus（90.4%）,dermatophagoides farinae（87.2%）and tropical mite（71.8%）,followed by blattella germanica（32.0%）and periplaneta Americana（27.3%）.The positive rate of SPT in children was significantly higher than that in adults（P0.05）.The positive rate of SPT in patients with family history was significantly higher than that without family history（P0.05）.The difference of positive rate of SPT between urban（higher）and rural（lower）inhabitants was statistically insignificant（P0.05）.The total mean score of typical symptoms of allergic rhinitis was 7.71±1.46.There was no correlation between the degree of positive SPT responses and the scores of symptoms.The correlation between the positive allergen number of SPT and the scores of symptoms was significant（P0.05）.Conclusion Dust mites are the most common allergens in allergic rhinitis in Shenzhen district.The positive degree of SPT could not reflect the severity of symptoms,but the number of kinds of SPT positive allergen might be related to the severity of symptoms in allergic rhinitis.