蜜蜂研究人群中蜂毒过敏患病率及相关危险因素分析

Analysis of prevalence and related risk factors of bee venom in bee research population

目的蜂毒过敏是引发严重过敏反应的常见原因之一。在我国有关蜂毒过敏的研究较少,尤其缺乏蜂毒过敏高危人群的相关数据。调查了从事蜜蜂研究人群中蜂毒过敏的患病率和临床特征,并分析其危险因素。方法 2018年9月,对中国农业科学院蜜蜂研究所和中国农业大学昆虫学系长期从事蜜蜂相关研究的人员进行横断面调查。结果共100人纳入研究:中位年龄28岁(19～56岁),女性占69.0%,其中34例(34.0%)报告在工作中发生过蜂毒过敏,大局部反应6例(6%),全身反应28例(28%)。在28例全身反应者中,1～4级全身反应分别有7、7、4、10例,4级全身反应即过敏性休克比例最高(35.7%)。50%的全身反应者经历过最初被蜂蛰后表现为大局部反应。Logistic回归分析结果显示,暴露的水平即蜂蛰频率是蜂毒过敏的危险因素,相对于近1年蜂蛰频率为0次者,1～3次和≥4次者蜂毒过敏的OR值(95%CI)分别为6.362 (2.014～20.092)和41.437(6.842～250.964)。过敏性鼻炎等患者本人或家人过敏史、蜂毒过敏家族史等反应特应性的指标与蜂毒过敏无统计学意义相关,OR(95%CI)分别为0.683 (0.197～2.366),0.600 (0.131～2.749),2.582 (0.201～33.099)。结论高危人群蜂毒过敏的情况不容忽视,尤需注意防护并配备急救药物和设备。

Objective Allergic reactions to bee venom are one of the common causes of severe allergic reactions. There are fewstudies on bee venom allergy in China;particularly,there is a lack of data on people at high risk of bee venom allergy. This study investigated the prevalence and clinical characteristics of bee venom allergies in the bee study population and analyzed the risk factors.Methods In September 2018,a cross-sectional survey was conducted among people who had been engaged in bee-related research at the Bee Research Institute of the Chinese Academy of Agricultural Sciences and the Department of Entomology of China Agricultural University. Results A total of 100 people were included in the study: median age 28 years( range: 19-56 years);females accounted for 69.0%. Among them,34 cases( 34.0%) reported having had allergic reactions to bee venom at work,6 cases( 6%) had large local reactions,and 28 cases( 28%) had systemic reaction reactions. Among the 28 systemic reaction responders,there were 7,7,4,and 10 cases of systemic reactions in grades 1-4,respectively. The systemic reaction of grade 4 was the commonest( 35.7%). Fifty percent of systemic reaction responders experienced large local reactions after initial bee sting. Logistic regression showed that the level of exposure,that is,the frequency of bee stings was a risk factor for bee venom allergy. Compared with the respondents who were not been stung in the past year,the OR( 95% CI) of bee venom allergy of 1-3 and ≥4 bee stings in the past year were 6.362 [95% confidence interval( CI),2.014-20.092]and 41.437( 95% CI,6.842-250.964). There was no statistically significant correlation between respondents’ personal or family history of allergies( e.g. allergic rhinitis),family history of bee venom allergy and bee venom allergy( odds ratios = 0.683( 95% CI,0. 197-2. 366),0. 600( 95% CI,0. 131-2. 749) and 2. 582( 95% CI,0.201-33.099),respectively). Conclusion The situation of bee venom allergy in high-risk population cannot be ignored.For high-risk groups,it is necessary to pay close attention to protection and provide emergency medicine and equipment.