北方地区猫狗毛皮屑致敏特点及变化趋势研究

Sensitization pattern of cat and dog dander allergen in 16 426 patients with allergic diseases

目的:探讨北方地区猫狗毛皮屑的致敏特点及变化趋势。方法:采用皮肤点刺试验(SPT)对2017-2019年自报过敏性疾病患者进行猫狗毛皮屑过敏原检测。皮肤指数(SI)2+及以上判断为SPT阳性,其中SI2+为轻度致敏,SI3+为中度致敏,SI4+为重度致敏。分析猫狗毛皮屑致敏率差异,比较不同性别、年龄间猫狗毛皮屑致敏率差异,分析猫狗毛皮屑致敏率随时间的变化趋势。结果:16 426例2~86岁的过敏性疾病患者完成SPT,并纳入研究。(1)猫毛皮屑致敏率显著高于狗毛皮屑(11.8%vs 6.0%,P<0.001);猫毛皮屑重度致敏率显著高于狗毛皮屑(5.9%vs 1.7%,P<0.001),而二者的轻度致敏率无显著差异。(2)猫毛皮屑致敏患者的年龄显著低于狗毛皮屑(P<0.001);未成年人猫狗毛皮屑致敏率均显著高于成年人(20.2%vs 10.9%,P<0.001;8.1%vs 5.7%,P<0.001);13~18岁组猫狗毛皮屑的致敏率最高(27.3%vs 9.9%,P<0.001),其次为7~12岁组(26.0%vs 9.2%,P<0.001);男性猫毛皮屑的致敏率显著高于女性(13.7%vs 10.7%,P<0.001),而狗毛皮屑的致敏率未见显著性别差异(6.2%vs 5.8%,P=0.411)。(3)595例(3.6%)患者对猫狗毛皮屑共同致敏,1733例(10.6%)对猫毛或狗毛皮屑过敏;单一猫毛皮屑致敏率高于单一狗毛皮屑(8.2%vs 2.3%,P<0.001);猫狗毛皮屑致敏率具有相关性(r=0.386,P<0.001)。(4)2017-2019三年间,狗毛皮屑致敏率由7.4%下降为4.6%,变化趋势具有统计学意义(χ^(2)=38.298,P<0.001);而猫皮屑致敏率变化趋势不显著,但2019年较2017和2018年仍呈上升趋势。结论:猫毛皮屑致敏率更高,且以重度致敏为主;猫狗毛皮屑致敏高峰年龄为青少年。随着时间变化,猫毛皮屑致敏率逐渐上升,狗毛皮屑致敏率逐年下降。

Objective: To explore the sensitization feature of cat and dog dander and time trend in northern region. Methods: During year 2017 to year 2019, subjects with self-reported allergic diseases received skin prick test for cat and dog dander allergen. Skin index(SI) ≥2+ was considered as positive SPT. SI2+ was defined as mild sensitization, SI3+ was defined as moderate sensitization while SI4+ was defined as severe sensitization. The age and gender difference of sensitization rate between cat and dog dander allergen was analyzed. Meanwhile, the trend of cat and dog dander sensitization rate was analyzed. Results: Overall, 16 426 subjects were enrolled in this study.(1) The sensitization rate of cat dander was significantly higher than dog dander(11.8% vs 6.0%, P<0.001). Severe sensitization rate of cat dander was significantly higher than dog dander(5.9% vs 1.7%, P<0.001) while there was no significant difference of mild sensitization rate.(2)Sensitization age of cat dander was younger than dog dander(P<0.001). Sensitization rate of cat and dog dander was higher in subjects ≤18 y compared with those >18 y(20.2% vs 10.9%, P<0.001;8.1% vs 5.7%, P<0, 001). The highest sensitization rate was presented in 13-18 y age group(27.3% vs 9.9%, P<0.001), following by 7-12 y age group(26.0% vs 9.2%, P<0.001). Sensitization rate of cat dander was higher in male than in female(13.7% vs 10.7%, P<0.001) while no gender difference was observed in dog dander sensitization(6.2% vs 5.8%, P=0.411).(3)595 subjects(3.6%) were both sensitized to cat and dog dander while 1733 subjects(10.6%) were sensitized either to cat or dog dander. Single sensitization rate of cat dander was higher than single sensitization rate of dog dander(8.2% vs 2.3%, P<0.001). There was a positive correlation between the cat and dog dander sensitization rate(r=0.386, P<0.001).(4)During 2017-2019, the sensitization rate of cat dander increased but without significantly statistic difference while dog dander sensitization rate was descending from 7.4% to 4.6% significantly(χ^(2)=38.298, P<0.001). Conclusion: Cat dander sensitization rate was higher than dog dander with a peak age in adolescence. A trend of rising for cat dander allergy and descending for dog dander allergy was observed during the past three years.