北京某儿童医院2015至2020年儿童常见吸入变应原的特征及变化分析

The characteristics and change of aeroallergens in children from 2015 to 2020 in a hospital of pediatric in Beijing

目的探讨2015至2020年首都儿科研究所附属儿童医院过敏性疾病就诊患儿常见吸入变应原的临床分布特征及其变化。方法回顾性纳入2015年1月1日至2020年12月31日就诊于首都儿科研究所附属儿童医院,怀疑过敏性疾病并进行了血清吸入变应原特异性IgE(sIgE)检测的患儿(0~14岁),sIgE检测采用Phadia1000检测系统的放射变应原吸附试验荧光酶联免疫法。分析这6年期间变应原的特征及变化趋势,计数资料使用构成比描述,率的比较采用卡方检验。结果共纳入4608例次检测,患儿共4575例,年龄(5.4±2.9)岁、中位数5.0岁,男性3176例(68.9%)、女性1432例(31.1%),北方地区患儿4294例次(93.2%)、南方地区患儿295例次(6.4%)、未知地区19例次(0.4%)。入组患儿的常见变应原为点青霉、分枝孢菌、烟曲霉、交链孢菌混合物(1956/4457例次,43.9%)及交链孢霉(276/630例次,43.8%),其次为蒿(300/889例次,33.7%)、葎草(12/38例次,31.6%)及豚草、蒿、雏菊、蒲公英、黄花混合物(909/2874例次,31.6%)。6年间霉菌、草花粉、树木花粉过敏均呈上升趋势,霉菌(2015年38/130例次、29.2%,2020年1574/3233例次、48.7%)、草花粉(2015年11/77例次、14.3%,2020年1069/3072例次、34.8%)上升显著,差异均有统计学意义(χ^(2)分别为18.953、49.559,P=0.000);树木花粉呈上升趋势(2015年1/10例次、10.0%,2020年516/2122例次、24.3%),但差异无统计学意义(χ^(2)=1.111,P=0.292)。尘螨(2015年36/146例次、24.7%,2020年321/1408例次、22.8%)、宠物毛皮屑(2015年7/33例次、21.2%,2020年411/2398例次、17.1%)变应原阳性率基本保持稳定(χ^(2)=0.258,P=0.611;χ^(2)=0.379,P=0.538)。2015年最常见的变应原为霉菌(38/130例次、29.2%),其次为尘螨(36/146例次、24.7%),而2020年最常见的变应原仍为霉菌(1574/3233例次、48.7%),其次为草花粉(1069/3072例次、34.8%)、树木花粉(516/2122例次、24.3%)。结论霉菌可能是北京地区过敏性疾病患儿最常见的吸入变应原,随着时间的推移,草花粉、树木花粉逐渐超过尘螨成为除霉菌之外的常见变应原。

Objective To analyze the characteristics of clinical distribution and change of aeroallergens in children with allergic diseases from 2015 to 2020.Methods Children who visited Capital Institute of Pediatrics affiliated Children′s Hospital,suspected of allergic diseases and received serum aeroallergens specific immunoglobulin E(sIgE)test were retrospectively enrolled(1 to 14 years old).sIgE was detected by Phadia1000 system with radioallergosorbent test fluorescent enzyme-linked immunoassay.The characteristics and change of the aeroallergens among the 6 years was analyzed.Enumeration data were expressed by percentage and categorical variables were compared by the independent samples t-test and Pearsonχ2 test.Results In total 4608 tests(4575 patients)of children were enrolled,the average age was(5.4±2.9)years old,with the median age of 5.0 years old.3176 were boys(68.9%),and 1432 were girls(31.1%).4294 children were from the north of China(93.2%),295 children were from the south of China(6.4%),and 19 children were from unknown regions(0.4%).In total the most common aeroallergen was mold mixture(1956/4457 tests,43.9%)and Alternaria alternata(276/630 tests,43.8%),followed by Artemisia(300/889 tests,33.7%),Humulus scandens(12/38 tests,31.6%)and grass mixture(909/2874 tests,31.6%).Among the 6 years,mold,grass pollen and tree pollen sensitization increased,and mold[38/130(29.2%)vs 1574/3233(48.7%)],grass pollen[11/77(14.3%)vs 1069/3072(34.8%)]increased significantly(χ^(²) was 18.953 and 49.559,respectively,P=0.000).Positive rate of tree pollen increased[1/10(10.0%)vs 516/2122(24.3%)],but did not have statistical significance(χ^(²)=1.111,P=0.292).Dust mite[36/146(24.7%)vs 321/1408(22.8%)]and hair of pets[7/33(21.2%)vs 321/1408(17.1%)]sensitization didn′t change greatly(χ2=0.258,P=0.611;χ^(²)=0.379,P=0.538).In 2015,the most common aeroallergens was mold(38/130,29.2%),followed by dust mite(36/146,24.7%),while in 2020,the most common aeroallergens was still mold(1574/3233,48.7%),with grass pollen(1069/3072,34.8%)and tree pollen(516/2122,24.3%)ranked after.Conclusion Mold might be the most common aeroallergens in allergic children in Beijing area.With time went on,dust mite was gradually exceeded by grass pollen and tree pollen.