张家口地区388例变应性鼻炎患者吸入性变应原谱及危险因素分析

Investigation of the aeroallergens spectrum and related risk factors in 388 patients with allergic rhinitis in Zhangjiakou area

目的探讨张家口地区变应性鼻炎(AR)患者吸入性变应原的分布情况及相关危险因素。方法对2019年4月-2020年8月就诊于河北北方学院附属第一医院耳鼻咽喉头颈外科的532例疑似AR患者进行变应原血清特异性IgE检测,选取同期该院门诊及住院患者家属(呼吸科、皮肤科及耳鼻喉科家属除外)245名设为对照组,对AR患者和对照组进行AR问卷调查,统计分析调查结果。结果532例疑似AR患者中,388例(72.9%)至少一种变应原呈阳性。AR患者阳性率排名前3位的吸入性变应原依次为艾蒿(89.9%)、普通豚草(44.1%)、猫上皮(21.4%)。在单一变应原阳性患者中,艾蒿阳性检出率(86.0%)明显高于其他变应原。在变应原的阳性程度分布中,艾蒿以2级、3级及6级为主,屋尘和屋尘螨以1级为主,其他变应原均以2级为主。不同月份、地区、年龄段的AR患者变应原阳性检出率差异有统计学意义(P<0.05),7~9月份的变应原阳性检出率明显高于其他月份、坝上地区明显高于坝下地区,且变应原阳性率随年龄增长而逐渐降低。不同性别AR患者普通豚草、猫上皮、屋尘、屋尘螨及交链孢霉5种吸入性变应原的阳性检出率差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,既往过敏史、父/母患AR、哮喘史、吸二手烟、熬夜以及年龄3~24岁为AR发病的高危因素(OR>1);经常锻炼身体为AR的有效保护因素(OR<1)。结论张家口地区的主要吸入性变应原为艾蒿、普通豚草。变应原的分布与月份、地区及患者的性别、年龄具有一定相关性。发生AR的危险因素主要有既往过敏史、哮喘史、父/母患AR、年龄等。

Objective To investigate the distribution of inhaled allergens and analyze the related risk factors among allergic rhinitis(AR)patients in Zhangjiakou area.Methods Serum specific IgE antibody of inhaled allergens was detected in 532 suspected AR patients in the Department of Otolaryngology,Head and Neck Surgery of the First Affiliated Hospital of Hebei North University form April 2019 to August 2020.A total of 245 family members of outpatient and inpatient patients(except family members of respiratory department,dermatology department and otolaryngology department)in the same period were selected as the control group.AR questionnaire survey was conducted in the AR patients and control group,and the survey results were statistically analyzed.Results Of the 532 patients with suspected allergic rhinitis,388(72.9%)were positive for at least one allergen.The top three positivity rates of inhalation allergens were mugwort(89.9%),common ragweed(44.1%)and cat epithelium(21.4%)among the AR patients.In the single allergen positive patients,the mudwort has a much higher positive detection rate(86.0%).The positive degree of allergens was mainly distributed in class 2,class 3 and class 6 of mugwort,in class 1 of house dust and house dust mite,and in class 2 of other allergens.There were statistically significant differences in the allergen positive rate of AR patients in different months,regions and ages(P<0.05).The allergen positivity rate from July to September was significantly higher than that in other months,in bar-upper region was significantly higher than that in bar-lower region,and the positive rate of allergen gradually declined with the increase of age.The differences of allergens in ragweed,cat epithelium,house dust,house dust mite and streptomyces alternaria between genders of AR patients were statistically significant(P<0.05).Multivariate logistic analysis showed that previous allergies,parents with allergic rhinitis,history of asthma,secondhand smoke exposure,staying up late,age 3-24 years old were AR high-risk factors(OR>1),regular physical exercise was an effective protective factor for AR(OR<1).Conclusions The most common inhalation allergens in Zhangjiakou area are mugwort and common ragweed.The distribution of allergens is correlated with the month,region,and gender and age of the patients.Previous allergies,history of asthma,parents having allergic rhinitis,age and so on are risk factors for AR.