张家口市变态反应性皮肤病患者过敏原临床结果分析

Analysis of Clinical Results of Allergens in Patients with Allergic Skin Diseases in Zhangjiakou City

目的分析张家口市常见变态反应性皮肤病患者过敏原种类及分布概况。方法选择2012年10月-2015年8月我院皮肤科诊断变态反应性皮肤病患者580例,使用德国Mediwise公司生产的Alleryscreen系统,采用免疫印迹实验检测患者血清总IgE、变应原特异性IgE水平,以血清总IgE>100 IU/ml,或者以血清变应原特异性IgE水平>0.35 IU/ml为阳性,统计分析吸入性、食物性变应原阳性率。结果入组变态反应性皮肤病患者580例,急/慢性荨麻疹297例,湿疹皮炎189例,过敏性紫癜94例,其中检出存在过敏原患者312例,检出率53.79%。男性157例(50.32%),女性155例(49.68%),性别比例差异无统计学意义(P>0.05)。急/慢性荨麻疹过敏原阳性率55.21%,常见过敏原为户尘螨、粉尘螨、狗/猫毛皮屑;湿疹皮炎过敏原阳性率55.03%,常见过敏原为狗/猫毛皮屑、牛奶、牛羊肉;过敏性紫癜过敏原阳性率46.81%,常见过敏原为狗/猫毛皮屑、户尘螨/粉尘螨、牛羊肉。吸入性过敏原阳性123例,食物性过敏原阳性34例,重叠阳性者155例。吸入性过敏原前四位分别为户尘螨/粉尘螨(25.00%)、狗/猫毛皮屑(20.51%)、蟑螂(10.26%)、矮豚草/蒿(8.02%)。食物性过敏原前四位分别是牛奶(11.86%)、鱼虾蟹(8.97%)、羊肉(6.41%)、鸡蛋(4.81%)。对一类过敏原反应阳性113例,对两类以上过敏原反应阳性199例。结论张家口地区常见的过敏原为户尘螨/粉尘螨、狗/猫毛皮屑、牛奶及蟑螂等,其中吸入性过敏原阳性率高于食物性过敏原;过敏原阳性患者以吸入与食物性重叠存在较为多见,以多种、多组变应原阳性较为常见。

Objective To analyze the types and distribution of allergens in patients with allergic skin diseases in Zhangjia- kou city. Methods From October 2012 to August 2015 in the department of Dermatology coming form our hospital,the patients with 580 cases diagnosed of allergic skin disease were selected to study, using Alleryscreen system produced by Germany Mediwise company by Western blot assay, serum total IgE and allergen specific IgE levels were detecded . With serum total IgE〉100 IU/ml, or serum allergen-specific IgE level〉0.35 IU/ml as a positive diagnostic criteria, The positive rate of inhalation allergens and food allergen positive rate were analyzed. Results There were 580 cases of allergic skin diseases ,297 cases of acute/chronic urticari- a, 189 cases of eczema and dermatitis ,94 cases of allergic purpura. Among them,312 cases were found to be allergen, the detection rate was 53.79%. There were no significant differences in sex ratio among the 157 cases 32% in the male and 155 cases 49.68% in the female （P〉0.05）. The positive rate of allergen in acute and chronic urticaria was 55.21% , and the common allergens were Common allergens for household dust mites, dust mites, dog/cat dander. The positive rate of eczema dermatitis allergen was 55.03 %. Common allergens for dogs/cat dander, milk, beef and mutton, allergic purpura allergen positive rate was 46.81% , the common allergens for clogs/cat dander, dust mites/dust mites, There were 123 cases of positive inhalation allergens, 34 cases of food allergens, and 155 cases of overlap positive patients. The first four inhalants were dust mite/dust mite （25.00%）, dog/cat dander （20.51%） ,cockroach（ 10.26% ） and dwarf ragweed/artemisia（ 8. 02% ）. The first four food allergens were milk（ ll. 86% ） , fish and shrimp（8.97% ） ,lamb（6.41% ） ,eggs （4.81%）. There were 113 patients with allergen-positive reaction and 199 patients with positive reaction to two or more allergens. Conclusion In Zhangjiakou the most common allergen of Dermatophagoides pteronyssinus,Dermatophagoides farinae/dog/cat dander, milk and cockroaches. Among them, the positive incidence rate of in- haled allergens was higher than that of food allergens. The positive rate of allergens was more common in many kinds of allergens. There was a common view of the patients with allergen-positive inhalation and food-borne overlap is more common. Positive rate of different kinds of allergens in a variety of groups of allergen positive are more common.