北京地区变应性鼻炎患者的优化吸入过敏原谱研究

Minimum battery of test inhalant allergens needed in screening allergic rhinitis patients in Beijing

目的:调查北京、黑龙江、内蒙古、河北、山东五地吸入过敏原的致敏率,分析其地区差异,建立北京地区符合卫生经济学的优化吸入过敏原谱,确定筛查≥95%致敏人群所需的最少过敏原种类及检测顺序。方法:采用20种标准化吸入过敏原,对2011-01-2013-07期间就诊于北京同仁医院的6 285例来自北京、黑龙江、内蒙古、河北、山东五地的自报变应性鼻炎患者进行皮肤点刺试验,比较过敏原致敏率的地区差异。按照过敏原新增致敏人数的能力进行排序,确定筛查≥95%致敏人群所需的最少过敏原种类及检测顺序。结果:5 575例(88.7%)患者至少1种过敏原阳性。黑龙江、北京、河北、山东四地最常见的过敏原是粉尘螨和屋尘螨,其致敏率随纬度降低而升高;户外过敏原艾蒿、大豚草、蒲公英在该四地的致敏率随纬度降低而降低。内蒙古地区致敏率最高的3种过敏原依次为艾蒿(59.86%)、大豚草(47.62%)、蒲公英(46.26%)。应用粉尘螨、艾蒿、德国小蠊、树1、藜、特异青霉、动物毛、屋尘螨共8种过敏原可以筛查北京地区≥95%的致敏人群。结论:北京、黑龙江、河北、山东最常见的过敏原为粉尘螨,内蒙古最常见的过敏原为艾蒿。粉尘螨、艾蒿、德国小蠊、树1、藜、特异青霉、动物毛、屋尘螨共8种过敏原为北京地区优化筛查过敏原谱。

Objective：The aim was to assess the prevalence of sensitized inhalant allergens in patients with allergic rhinitis（AR）,analyze the differences of aeroallergen sensitization rates（SRs）in different areas,and define the minimal number and the type of aeroallergens required to identify patients as sensitized.Method：Six thousand two hundred and eighty five patients suffering from AR symptoms in Beijing,Heilongjiang,Inner Mongolia,Hebei and Shandong areas underwent standardized skin prick test（SPT）with 20 common aeroallergens during the period from Jan 2011 to Jul 2013 when seeking medical help in Beijing Tongren Hospital.The differences of aeroallergen sensitization rates in different areas were compared.Chi square was used in statistical analysis.Conditional approach allowed to determine the aeroallergen selection.Result：Among the 6 285 self-reported AR patients investigated,5 575（88.7%）patients had at least one positive skin prick reaction.The most common aeroallergen in Beijing,Heilongjiang,Hebei and Shandongwere house dust mites（HDMs）.SRs of HDMs in these four areas decreased with latitude increment,whereas SRs of mugwort,ragweed and dandelion in these four areas increased with latitude increment.The three most prevalent aeroallergens in Inner Mongolia were mugwort（59.86%）,ragweed（47.62%）and dandelion（46.26%）,respectively.Overall,8 allergens allowed identification≥95% of sensitized subjects in Beijing.Conclusion：Der f was the most prevalent allergen in patients with AR in Beijing,Heilongjiang,Hebei and Shandong Areas,whereas SR of mugwort was highest in Inner Mongolia.Sensitization pattern of aeroallergens varied with areas.Eight allergens allowed identification of the majority of sensitized subjects in screening panels for allergy in Beijing.