西南地区2071例变应性疾病患儿变应原临床分析

Clinical analysis of allergen of 2071 cases with allergic disease in southwest China

目的探讨变应性疾病常见变应原的致病状况,为变应性疾病流行病学研究及临床诊断、治疗和预防提供重要依据。方法采用国际标准方法的皮肤点刺试验(SPT),对2 071例变应性疾病患儿做14种变应原测定,并设阳性(组胺)及阴性(生理盐水)对照;以阳性为对照判断标准。结果被检查的2 071例患儿中SPT阳性者1 101例,占53.2%(1 101/2 071)。其中,阳性率在30%以上的变应原有:粉尘螨814例,占39.3%(814/2 071);屋尘螨684例,占335%(684/2 071);其他变应原阳性率均在15%以下。吸入变应原总阳性率51.3%(1 062/2 071),吸入变应原中以粉尘螨和屋尘螨阳性率居高,分别为39.3%(814/2 071)和33%(684/2 071);食入变应原总阳性率24.0%(498/2 071),食入变应原在前2位的为鸡蛋清11.9%和海蟹14.5%。皮肤点刺结果为强阳性(++++)的以粉尘螨和屋尘螨为主,分别为20.9%和16.9%。1～14岁变应性疾病儿童吸入变应原与食入变应原阳性率随年龄增加均有升高趋势,在各年龄分组中吸入变应原与食入变应原,除了1岁～组与3岁～组比较差异无统计学意义(χ2=0.124,2.481,P>0.05),其余各年龄组两两比较均有显著性差异(P<0.01)。哮喘的吸入性、摄入性变应原皮试阳性率明显高于其他变应性疾病(χ2=71.629,142.773,P<0.01)。结论变应性疾病通常由变应原致病,吸入性变应原为常见变应原,尘螨为首要变应原。皮肤点刺实验对变应性疾病的流行病学调查及特异性免疫治疗均有一定的指导意义。

Objective To study the pathogenic conditions of the common allergens of the allergic diseases in southwest China.To provide the important evidence that the epidemiology researches,diagnosis,treatment and prevention of the allergic diseases.Methods 2 071 patients with allergic diseases were tested with 14 kinds of allergen by skin prick test of international method in contrast with histamine（positive）and normal saline（negative）.Results Of the 2 071 patients,1101 cases（53.2%）had positive SPT reactions.The commonest allergen were dermatophagoides farinae which was 39.3% positive in the 2 071 patients,the other common allergens were in order of dermatophagoides pteronyssinus（33%）,and the others were lower than 15%.The positive rates of inhaled and food allergens were 51.3%（1 062/2 071）and 24.0%（498/2 071）,respectively.dermatophagoides farinae and dermatophagoides pteronyssinus were two common inhaled allergens（39.3%and 33% respectively）.Sea-crab was the most common food allergen（22.9%）,followed by egg protein（11.9%）.The strongest response of skin prick test was usually caused by dermatophagoides farinae（20.9%）and dermatophagoides pteronyssinus（16.9%）.The positive rate of inhaled and food allergens increased with increasing age（P0.01）,except 1 year-by 3 year-（P0.05）.The positive rate of the skin prick test to the inhalant and food allergens of asthma was much higher than the others allergic diseases（χ2=71.629,142.773,P0.01）.Conclusion The allergic diseases usually have been caused by the allergens.The inhalant allergens are the common allergens.The mite allergens are the first ones in them.The skin prick test may be useful in an epidemiological survey and specific immunotherapy of allergic diseases.