北京地区1～12岁儿童变应性鼻炎变应原谱分析

Analysis of allergen spectrum among 1-12 years old children with allergic rhinitis in Beijing region

目的调查北京地区1~12岁儿童变应性鼻炎(AR)患者吸入组变应原的分布。方法采用敏筛定量过敏原检测系统(Allergy Screen)及其专用体外变应原诊断试剂测定663例1~12岁儿童变应性鼻炎患者血清中吸入组变应原的sIgE,并比较北京地区不同年龄段吸入组变应原阳性率的变化趋势。结果①所有患者吸入组变应原均呈阳性反应,首要变应原为混合真菌(61.4%),其次为户尘螨(32.6%)、屋尘(28.2%)、艾蒿(23.8%)等;各类变应原sIgE≥Ⅲ级占相应变应原阳性例数百分率前三位依次为艾蒿(70.9%,112/158)、混合真菌(63.9%,260/407)、户尘螨(56.5%,122/216);②随年龄增长,混合真菌阳性率总体呈下降趋势,户尘螨阳性率呈增高趋势;户尘螨阳性在A^D组中的分布有统计学意义(χ2=17.757,P<0.001);③艾蒿(χ2=10.636,P=0.014)、混合真菌(χ2=8.298,P=0.040)及屋尘(χ2=11.681,P=0.005)sIgE≥Ⅲ级在A^D组的相应变应原阳性病例中的分布有统计学意义;④属牧草类的葎草和矮豚草变应原sIgE≥Ⅲ级占相应阳性例数百分率的变化曲线在艾蒿的变化曲线之下,但又高于木本植物树花粉的变化曲线;⑤单一混合真菌变应原阳性最常见;其次为双重变应原阳性,最常见双重阳性组合为混合真菌+户尘螨。结论北京地区儿童AR患儿主要吸入组变应原以混合真菌为主;随年龄增长,各类变应原阳性率有趋势性变化;秋季杂草花粉的致敏性强于牧草,牧草的致敏性则强于木本植物树花粉;单一变应原阳性最常见。

Objective To investigate the inhalant allergen spectrum among 1-12 years old children with allergic rhinitis in Beijing region. Methods A sensitive quantitative allergen screen system（Allergy Screen）and its allergen diagnosis reagent in vitro were carried out in 663 children（ 1-12 years old） with allergic rhinitis in BeiJing region for the slgE of inhalant allergen. The trend of inhaled allergen positive rate in different ages was also observed. Results ① All the patients showed positive reaction to inhalation allergen. The most common allergen found in patients was mixed fungi （61.4%）, followed by house dust mite（32.6% ）, house dust（28.2% ） and mugwort（23.8% ） ect. The top three allergens of sIgE/〉 HI grade accounting corresponding positive cases were mugwort （70.9%, 112/158 ）, the mixed fungi （63.9%, 260/407） and house dust mite （56.5%, 122/216）. ②With the growth of age, the positive rate of mixed fungi was overall downward trend. The positive rate of household dust mites was overall upward trend. Distribu- tion of house dust mite in groups A-D was statistically significant （X2 = 17. 757, P 〈 0.001 ）. ③ The distribution of mugwort （X2 = 10. 636,P =0.014）, mixed fungi （X2 =8. 298,P =0.040） and house dust（X2 = 11. 681 ,P =0. 005） of slgE t〉 Ill grade in A - D groups was statistically significant. ④ The curve of the percentage of a pasture class humulus scandens and dwarf ragweed allergen slgE I〉 llI grade accounted corresponding positive cases was lower than the curve of the mugwort, but higher than the curve of the woody plants tree pollen. ⑤ Patients with single positive allergen of mixed fungi were the most common, followed by dual positive allergens. The most common dual allergens combination was mixed fungi plus house dust mite. Conclusion The primary allergen in children with allergic rhinitis in Beijing region is mixed fungi. With the growth of age, all kinds of allergens have its trend changes. The allergy strength of fall weed pollen is stronger than pasture, and pasture is stronger than woody plants tree pollen. Single positive allergen is the most common.