变应性鼻炎发病流行病学特征及与血清IFN-γ及IL-4水平的相关性分析

Epidemiological characteristics of allergic rhinitis and its correlation with serum IFN-γand IL-4 levels

目的分析巴中市变应性鼻炎发病(AR)的流行病学特征及与血清IFN-γ及IL-4水平的相关性研究,为临床上防治AR提供理论依据。方法采用多阶段分层随机的方法调查2019年1月至2020年1月巴中市三甲医院耳鼻喉科就诊的人群,采用面对面问卷调查形式调查人群的一般情况,统计AR的发病人数,AR的主要临床症状及相关症状,合并疾病情况,根据病情严重程度分为轻度组和中重度组,抽取AR患者肘静脉血5 mL,采用变应原特异性IgE抗体检测试剂盒(免疫印迹法)测定22种变应原,采用酶联免疫吸附法测定血清IFN-γ及IL-4水平;对变应性鼻炎患者血清IFN-γ及IL-4水平与病情严重程度进行Pearson相关分析;结果1243例人群完成了问卷,AR患病率为275例(22.12%);不同年龄段AR患病率间差异具有统计学意义(χ^(2)=6.809,P<0.05),19~40年龄段AR患病率最高(28.40%);不同职业段AR患病率间差异具有统计学意义(χ^(2)=7.914,P<0.0),其工人AR患病率最高(26.48%);巴中市275例AR患者中,其中季节性变应性鼻炎153例(55.64%),常年变应性鼻炎122例(44.36%);AR患者临床症状以喷嚏234例(85.09%)和鼻塞197例(71.64%)为主;AR合并支气管哮喘59例(21.45%),合并结膜炎占28例(10.18%);AR发病高峰期主要集中在7月;22种变应原中,最常见的变应原是尘螨139例(50.55%),其次为青霉素56例(20.36%);主要诱发因素为花粉112例(40.73%)和感冒98例(35.64%);根据病情严重程度分为轻度组(n=178)和中重度组(n=97);中重度组血清IL-4水平显著高于轻度组(P<0.05);中重度组血清IFN-γ水平显著低于轻度组(P<0.05);经Pearson相关性分析,IL-4水平与病情严重程度呈正相关(r=0.492,P<0.05);IFN-γ与病情严重程度呈负相关(r=-0.459,P<0.05);结论巴中市人群AR的患病率较高,主要临床症状是喷嚏,合并症中以支气管哮喘最多,感冒和天气变化是引起AR的主要因素,可通过检测AR患者血清IFN-γ及IL-4水平判断其病情严重程度。

Objective To analyze the epidemiological characteristics of AR and its correlation with serum IFN-γand IL-4 levels in Bazhong City,and to provide theoretical basis for clinical prevention and treatment of AR.Methods Adopt the method of multistage stratified random survey from January 2019 to January 2020 bazhong 3 armour hospital otolaryngology seeing a doctor,with face to face questionnaire survey form the people generally,AR number of statistics,the main clinical symptoms and related symptoms,AR merger disease situation,according to the illness severity was divided into mild and moderately severe group,Five mL of elbow venous blood was extracted from AR patients,and 22 kinds of allergens were determined by using the allergen-specific IgE antibody detection kit(western blot).Serum IFN-γand IL-4 levels were determined by enzyme-linked immunosorbent assay.Pearson correlation analysis was performed on serum IFN-γand IL-4 levels and severity of allergic rhinitis.Results Among 1243 patients who completed the questionnaire,the prevalence of AR was 275(22.12%).There was significant difference in the prevalence of AR among different age groups(χ^(2)=6.809,P<0.05),and The prevalence of AR was the highest in 19-40 age group(28.40%).There was significant difference in AR prevalence among different occupational groups(χ^(2)=7.914,P<0.0)and the prevalence of AR in workers was the highest(26.48%).Among 275 AR patients in Bazhong City,153 cases(55.64%)had seasonal allergic rhinitis and 122 cases(44.36%)had perennial allergic rhinitis.The main clinical symptoms of AR patients were sneezing in 234 cases(85.09%)and nasal obstruction in 197 cases(71.64%).AR combined with bronchial asthma in 59 cases(21.45%),conjunctivitis in 28 cases(10.18%);the peak of AR incidence was mainly in July.Among 22 allergens,dust mite was the most common allergen in 139 cases(50.55%),followed by penicillin in 56 cases(20.36%).The main inducing factors were pollen 112 cases(40.73%)and cold 98 cases(35.64%).According to the severity of the disease,they were divided into mild group(n=178)and moderate to severe group(n=97).The serum IL-4 level in moderate and severe groups was significantly higher than that in mild group(P<0.05).The serum IFN-γlevel in moderate and severe groups was significantly lower than that in mild group(P<0.05).Pearson correlation analysis showed that il-4 level was positively correlated with disease severity(r=0.492,P<0.05).IFN-γwas negatively correlated with the severity of the disease(r=-0.459,P<0.05).Conclusion The prevalence of AR is high in Bazhong city,and the main clinical symptom is sneezing.Among the complications,bronchial asthma is the most common.Colds and weather changes are the main factors causing AR.