北京地区门诊患者常见吸入过敏原致敏谱

Sensitization spectrum of inhaled allergens in outpatients in Beijing area

目的了解北京地区过敏性疾病常见吸入过敏原致敏谱,探讨国产过敏原皮肤点刺试验(skin prick test,SPT)试剂的安全性。方法选取2017年1月至2020年7月就诊于本科门诊可疑过敏性鼻炎、过敏性哮喘和过敏性鼻炎合并哮喘的患者,采用32种吸入过敏原试剂进行SPT,比较年龄和疾病变应原分布,观察评价国产SPT试剂的安全性。结果最终纳入11699例患者,SPT阳性率84.3%(9865/11699);过敏原阳性率前5位分别是灰藜花粉(57.5%)、葎草花粉(50.7%)、圆柏花粉(49.5%)、柳树花粉(48.7%)、大籽蒿花粉(47.8%)。10~14岁年龄组SPT阳性检出率最高(94.2%),且与其他年龄组比较具有统计学差异(P<0.01);小于10岁患者SPT阳性率随着年龄的增长逐渐增加,40岁以上患者SPT阳性率随着年龄的增长逐渐减低。吸入过敏原以杂草花粉和树木花粉检出率最高,其次为屋尘螨和动物毛。过敏性疾病患者多合并4种及以上过敏原致敏,过敏性鼻炎和过敏性鼻炎合并哮喘患者4种及以上过敏原致敏占64.7%。所有进行SPT患者中6例患者出现不良事件(aside effect,AE),AE总体发生率为0.05%(6/11699),不良反应的严重程度均为I级。结论北京地区常见过敏性疾病中,杂草花粉和树木花粉致敏最为常见,吸入过敏原以灰藜花粉、葎草花粉、圆柏花粉为主;10~14岁SPT阳性率最高;过敏性疾病患者多合并4种及以上吸入过敏原过敏;国产SPT试剂安全性高,有助于过敏性疾病的临床评估。

Objective To understand the sensitization spectrum of common inhaled allergens for allergic diseases in Beijing area,and explore the safety of domestic skin prick test(SPT)reagent.Methods A total of 32 kinds of inhaled allergen reagents were used to conduct SPT in patients with suspected allergic diseases(allergic rhinitis,allergic asthma,and allergic rhinitis with asthma)who visited our clinic from January 2017 to July 2020.The safety of domestic SPT reagents were observed and evaluated.Results A total of 11699 patients were included,with a positive SPT rate of 84.3%(9865/11699).The top 5 allergen positive rates were pollen of Chenopodium pollen(57.5%),Humulus pollen(50.7%),Juniper pollen(49.5%),Salix(48.7%),and Artemisia pollen(47.8%).The SPT positive rate of patients aged 10-14 years was the highest(94.2%),and was statistically different from other age groups(P<0.01).The SPT positive rate of patients aged less than 10 years increased with the increase of age,while the SPT positive rate of patients aged over 40 years decreased with the increase of age.The highest detection rate of inhaled allergens was weed pollen and tree pollen,followed by house dust mite and animal of the wool.Allergic rhinitis and allergic rhinitis combined with asthma were sensitized by 4 or more allergens(64.7%).Aside effect(AE)was observed in 6 patients with SPT,the overall incidence of AE was 0.05%(6/11699),and the severity of the adverse reaction was all level I.Conclusion Among the common allergic diseases in Beijing,weed pollen and tree pollen are the most common allergens.The inhaled allergens are mainly pollen of Chenopodium,Humulus,and Juniper.The positive rate of SPT was highest in 10-14 years old.Patients with allergic diseases are more likely to be allergic to 4 or more inhaled allergens.Domestic SPT reagent is safe and helpful for clinical evaluation of allergic diseases.