链格孢菌在支气管哮喘儿童中致敏特点分析

Analysis of sensitization characteristics of Alternaria alternata in children with bronchial asthma

目的分析链格孢菌在新疆地区的致敏特点,探讨该地区近年来支气管哮喘儿童吸入性过敏原变化的原因。方法本研究为横断面研究。采用非随机抽样方法,选取2022年1~2月在乌鲁木齐市第一人民医院小儿咳喘诊治科就诊的支气管哮喘儿童139例,通过ImmunoCAP过敏原定量检测技术检测其吸入过敏原特异性IgE及血清总IgE。结果链格孢菌的致敏率排在首位[53.2%(74/139)],其次是豚草、艾蒿[均为46.0%(64/139)],树花粉组合41.7%(58/139)。不同年龄组哮喘患儿吸入过敏原特异性IgE结果比较,>6岁组猫毛屑(22.6%比12.1%,χ2=13.15,P=0.009)、狗毛屑阳性率(17.9%比9.1%,χ2=13.19,P=0.006)高于≤6岁组,其余各吸入过敏原组间的阳性率差异无统计学意义(P值均>0.05)。链格孢菌的致敏较强,等级在2~4级之间,粉尘螨、户尘螨较弱,在1~2级之间。随着链格孢菌致敏阳性等级的增加,树草花粉类、动物毛屑类、尘螨类的吸入过敏原阳性率也增加。结论链格孢菌的致敏率超过本地区既往排在前列的艾蒿、豚草等户外的过敏原物质,链格孢菌致敏应该予以重视及预防,为本地区哮喘儿童更加精准的过敏原特异性免疫治疗提供参考依据。

Objective To analyze the sensitization characteristics of Alternaria alternaria in Xinjiang and to explore the causes of inhaled allergen changes in children with bronchial asthma in Xinjiang in recent years.Methods This was a cross-sectional study.Non-random sampling was used.Children with bronchial asthma treated in the Department of Pediatric Cough and Wheezing,Urumqi First People′s Hospital from January to February 2022 were selected to detect inhaled allergen sIgE and tIgE by ImmunoCAP technology.Results The sensitization rate of Alternaria alternata ranked first,with 53.2%(74/139),followed by ragweed and mugwort,with each 46.0%(64/139),tree and grass pollens 41.7%(58/139).The results of inhaled allergen sIgE in asthmatic children of different age groups showed that cat dander(12.1%vs 22.6%,χ2=13.15,P=0.009)and dog dander(9.1%vs 17.9%,χ2=13.19,P=0.006)were significantly different between≤6 years old and>6 years old.There was no significant difference of the positive rate of inhaled allergen in other groups(all P>0.05).Alternaria alternata showed strong sensitization of grade 2-4,and dermatophagoides farinae and dermatophagoides pteronyssinus showed weaker sensitization of grade 1-2.The positive rate of inhaled allergens of tree and grass pollens,animal dander,and dust mites increased with the increase of positive grade of Alternaria alternata.Conclusions The sensitization rate of Alternaria alternata exceeds that of outdoor allergens such as artemisia mugwort and ragweed,which previously ranked top in this area.The sensitization of Alternaria alternaria should be paid attention to and prevented,so as to provide reference for allergen-specific immunotherapy for children with asthma in this area.