儿童扁桃体腺样体肥大与过敏相关指标对比观察

The relationship between adenotonsillar hypertrophy and allergy related indicators

目的多因素探索儿童扁桃体腺样体肥大与过敏相关指标的关系,为疾病之间的联系提供临床证据,对病因诊断和综合治疗提供依据。方法收集2020年8月~2021年7月中国医科大学附属盛京医院鼻科病房收治的扁桃体腺样体肥大患儿(病例组)120例,同时期收集门诊的健康体检儿童(对照组)50例。对比观察两组儿童的血常规检查、食物过敏原、呼吸过敏原、总IgE等指标结果的差异,并通过分层和分组分析比较年龄与季节在疾病中的作用。结果120例扁腺组患儿的过敏原阳性数量、嗜酸性粒细胞绝对值及百分比、血清总IgE与健康组相比显著升高(Z=-2.404、-3.412、-3.862、-2.58,P均<0.05)。病例组儿童常见的食物过敏原前三位为鸡蛋(32.5%)、牛奶(25.7%)、小麦面粉(14.9%),过敏强度以中弱阳性为主;呼吸过敏原前三位为交链孢霉(21.7%)、粉尘螨(19.2%)、艾蒿(8.3%),过敏强度以强阳性为主。将两组儿童的20种过敏原阳性率进行两两比较,其中粉尘螨阳性率在病例组和对照组有显著差异(19.2%vs 10%,P<0.05)。亚组分析显示病例组患儿不同年龄组的过敏原总阳性率差异无统计学意义(63.3%、69.3%、66.6%,P>0.05),不同季节组过敏原总阳性率有显著差异(63.3%、80%、83.3%、43.3%,P<0.05)。结论扁桃体腺样体肥大儿童的过敏原阳性数量、嗜酸性粒细胞绝对值及百分比、血清总IgE均显著高于健康儿童,其中粉尘螨在疾病发展中作用最显著。过敏在扁桃体腺样体肥大儿童的疾病中发挥作用或与年龄无关,但与季节显著相关。

OBJECTIVE To explore the relationship between adenotonsillar hypertrophy and allergy related indicators in children,to provide clinical evidence for the relationship between adenotonsillar hypertrophy and allergy,and to provide basis for etiological diagnosis and comprehensive treatment.METHODS From August2020 to July 2021,120 children with adenotonsillar hypertrophy(TA group)were enrolled in the Rhino logy ward of Shengjing Hospital affiliated to China Medical University,and 50 healthy children(healthy group)were enrolled in the outpatient department during the same period.The differences in blood routine examination,food allergen,respiratory allergen,total IgE and other indicators between the two groups were compared,and the roles of age and seasons in disease were analyzed by stratification and grouping.RESULTS The number of positive allergens,absolute value and percentage of eosinophil and total IgE in 120 children with adenotonsillar hypertrophy were significantly increased compared with those in the healthy group(Z=-2.404,-3.412,-3.862,-2.58,all P<0.05).The top three common food allergens in TA group were egg(32.5%),milk(25.7%)and w heat flour(14.9%).The top three respiratory allergens were Alternaria(21.7%),dust mite(19.2%)and Artemisia argyi(8.3%).The positive rates of 20 allergens were pairwise compared between the two groups,and the dust mite positive rates were significantly different between the TA group and the healthy group(19.2%vs10%,P<0.05).Subgroup analysis showed that there was no significant difference in the total positive rate of allergens among different age groups(63.3%,69.3%,66.6%,P>0.05);but there was significant difference in the total positive rate of allergens among different seasons(63.3%,80%,83.3%,43.3%,P<0.05).CONCLUSION The number of positive allergens,absolute value and percentage of eosinophil and total IgE in children with adenotonsillar hypertrophy are significantly higher than those in healthy children,and dust mite plays the most significant role in the development of disease.Allergy may play a role in adenotonsillar hypertrophy regardless of age,but it is significantly related to the season.