具有变应性鼻炎症状的518例儿童变应原致敏性高危因素分析

The high risk factors of allergen sensitization among 518 children with allergic rhinitis symptoms

目的 初步探讨1 ～16岁具有变应性鼻炎（allergic rhinitis,AR）症状的儿童变应原致敏性的高危因素.方法 采集2011年4月至2012年11月518例1 ～16岁具有AR症状患儿的病史资料,包括基本情况、发病特点、伴发其他变应性疾病、生长发育史及遗传史等.采用UniCAP 100系统测定过敏原,分析1 ～16岁儿童AR变应原致敏性（特异性IgE≥Ⅲ级）的高危因素.以SPSS 17.0软件进行数据处理和统计学分析.结果 330/518例（63.7％）确诊为AR,首要变应原为真菌混合（52.4％）;变应原特异性IgE≥Ⅲ级占相应变应原阳性例数百分率最高者为真菌混合（71.1％）.单因素分析结果显示,病史月数（x2=-3.591）、是否伴发过敏性结膜炎（x2=12.325）、家中有无饲养猫或狗（x2=5.615）在AR与非变应性鼻炎两组间差异有统计学意义（P值均＜0.05）.在AR患儿中,按变应原阳性级别是否≥Ⅲ级分组进行临床特征的单因素分析显示,伴发哮喘（x2=4.097）、母乳喂养（x2=4.186）、住楼房或平房（x2=4.360）、卧室朝向阳面或阴面（x2=4.656）在两组间差异有统计学意义（P值均＜0.05）.在AR患儿中,按年龄分组进行单因素分析结果显示,病史月数（x2=64.999）、伴发湿疹（x2=24.056）、伴发虫咬性皮炎（x2=9.148）、家中有猫或狗（x2=8.529）、母亲患AR（x2=9.565）在不同年龄组中的差异有统计学意义（P值均＜0.05）.结论 病史较长、伴发过敏性结膜炎及家中有猫或狗是AR的危险因素.在AR患儿中,非母乳喂养及卧室朝阴面是吸入组变应原特异性IgE≥Ⅲ级的危险因素.

Objective To study the high risk factors of allergen sensitization among 1-16 years old children with allergic rhinitis （AR） symptoms.Methods Medical history was collected from 518 children with AR symptoms aged 1 to 16 years old between April 2011 and November 2012,including five aspects：basic information,disease characteristics,associated with other allergic diseases,growth and development history and genetic history and so on.The allergens were determined by UniCAP 100 system.The high risk factors of allergen sensitization（sIgE ≥ grade Ⅲ） among 1-16 years old children with AR symptoms were analyzed.The data processing and statistical analysis were conducted by SPSS 17.0 software.Results Three hundred and thirty of 518 patients （63.7％） could be diagnosed as AR.The primary allergen was mixed fungal（52.4％）.The highest percentage of allergen sIgE ≥ grade Ⅲ accounted for the corresponding allergen positive cases was 71.1％ （mixed fungal）.Single factor analysis of clinical characteristics in the groups of AR and non AR showed that the history of months （x2 =-3.591）,concomitant allergic conjunctivitis （x2 =12.325） and cats or dogs at home （x2 =5.615） were statistically significant between the two groups（all P ＜ 0.05）.In children with AR,single factor analysis of clinical characteristics in the groups of whether positive allergen level ≥ grade Ⅲ showed that the concomitant asthma （x2 =4.097）,breastfeeding（x2 =4.186）,the housing situation （x2 =4.360） and the bedroom toward （x2 =4.656） were statistically significant between the two groups （all P ＜ 0.05）.In children with AR,single factor analysis of clinical characteristics in different age groups showed that the history of months（x2 =64.999）,concomitant eczema （x2 =24.056）,concomitant insect bite dermatitis （x2 =9.148）,cats or dogs at home （x2 =8.529） and mother suffered from AR （x2 =9.565） were statistically significant in different age groups （all P ＜ 0.05）.Conclusion The study revealed that the longer of history,concomitant allergic conjunctivitis and cats or dogs at home are risk factors for AR;In children with AR,not breastfeeding and the bedroom toward back are risk factors for inhalation allergen sIgE ≥ grade Ⅲ.