东莞地区变应性鼻炎患者吸入过敏原分析及血清sIgE分泌特点探索

Analysis of inhaled allergens and characteristics of serum sIgE secretion in patients with allergic rhinitis in Dongguan area

目的分析东莞地区鼻炎患者吸入过敏原检测结果和血清特异性免疫球蛋白E(sIgE)分泌特点。方法回顾性分析554例鼻炎患者的临床资料,根据鼻炎类型分为变应性鼻炎(AR)组(AR患者,262例)和非变应性鼻炎(NAR)组(NAR患者,292例)。对比两组患者临床资料,吸入过敏原阳性检出情况;分析吸入过敏原的线性逐步回归分析自变量赋值情况,并进一步作吸入过敏原导致s IgE阳性的逐步Logistic回归分析;对比不同年龄、不同性别AR患者的s IgE阳性检出情况。结果两组年龄分布情况对比差异无统计学意义(P>0.05);AR组男性占比66.41%、sIgE检测结果阳性率91.60%、sIgE阳性种类≥2种占比85.88%均明显高于NAR组的57.53%、39.04%、22.95%,差异具有统计学意义(P<0.05)。AR组的粉尘螨、户尘螨、狗毛皮屑、猫毛皮屑、矮豚草、TxCHN1(桤/杨/柳/山毛榉/橡/胡桃)、T11/T15(悬铃木/白蜡)以及蟑螂阳性率分别为85.88%、83.59%、11.83%、11.83%、3.82%、3.05%、2.67%、9.54%,明显高于NAR组的26.71%、23.97%、4.11%、3.08%、1.03%、0.34%、0、2.05%,差异具有统计学意义(P<0.05);两组的蒿和MX4(念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉)阳性率对比差异无统计学意义(P>0.05)。以结果是否阳性作为因变量(Y,阳性=1,阴性=0),以粉尘螨、户尘螨、狗毛皮屑、猫毛皮屑、蒿、矮豚草、TxCHN1、T11/T15、MX4、蟑螂作为自变量(X,阳性=1,阴性=0),检验水准α=0.05。根据以上量化赋值,经Logistic逐步回归分析,粉尘螨、户尘螨、狗毛皮屑、猫毛皮屑是s IgE阳性的危险因素(P<0.05)。不同年龄AR患者的蟑螂阳性率对比差异具有统计学意义(P<0.05),18~39岁和≥40岁患者的阳性率最高;不同年龄患者的粉尘螨、户尘螨、狗毛皮屑、猫毛皮屑、蒿、矮豚草、TxCHN1、T11/T15以及MX4阳性率比较差异均无统计学意义(P>0.05)。男性AR患者的猫毛皮屑阳性率15.52%高于女性AR患者的4.55%,蒿阳性率0低于女性AR患者的2.27%,差异具有统计学意义(P<0.05);男性和女性AR患者的粉尘螨、户尘螨、狗毛皮屑、矮豚草、TxCHN1、T11/T15、MX4、蟑螂阳性率对比差异均无统计学意义(P>0.05)。结论s IgE检测有助于明确过敏原的分布特点,尘螨类是最常见的吸入过敏原,AR患者多为多重过敏原阳性。

Objective To analyze the detection results of inhaled allergens and the characteristics of serum specific immunoglobulin E(sIgE)secretion in rhinitis patients in Dongguan area.Methods The clinical data of 554 patients with rhinitis were retrospectively analyzed and divided into allergic rhinitis(AR)group(AR patients,262 cases)and non-allergic rhinitis(NAR)group(NAR patients,292 cases)according to the type of rhinitis.The clinical data,and the positive detection of inhalation allergens of the two groups were compared;the linear stepwise regression analysis of inhalation allergens was analyzed for the assignment of independent variables,and further stepwise Logistic regression analysis of sIgE positivity due to inhalation allergens was performed;the positive detection of sIgE in AR patients of different ages and genders was compared.Results There was no statistically significant difference in age distribution between the two groups(P>0.05).The male ratio of AR group was 66.41%,the sIgE positive rate was 91.60%,and the sIgE positive≥2 species accounted for 85.88%,which were significantly higher than those of 57.53%,39.04%,and 22.95%of NAR group,and the differences were statistically significant(P<0.05).The positive rates of dust mite,house dust mite,dog dander,cat dander,dwarf ambulatus,TxCHN1(alder/poplar/willow/beech/oak/walnut),T11/T15(sycamore/white wax)and cockroach in AR group were 85.88%,83.59%,11.83%,11.83%,3.82%,3.05%,2.67%,and 9.54%,which were significantly higher than those of 26.71%,23.97%,4.11%,3.08%,1.03%,0.34%,0,and 2.05%in the NAR group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the positive rates of artemisia and MX4(Candida/Penicillium Notatum/Mycospora/Alternaria/Aspergillus Niger)between the two groups(P>0.05).Whether the results were positive or not was taken as the dependent variable(Y,positive=1,negative=0),and dust mites,house dust mites,dog dander,cat dander,artemisia,dwarf ragweed,TxCHN1,T11/T15,MX4,cockroaches were taken as the independent variable(X,positive=1,negative=0),and the test levelα=0.05.According to the above quantitative values,the Logistic stepwise regression analysis showed that dust mites,household dust mites,dog dander,and cat dander were the risk factors for sIgE positive(P<0.05).The positive rate of cockroaches in AR patients of different ages was statistically significant(P<0.05),and the positive rate was highest in patients aged 18-39 years and≥40 years.There were no statistically significant differences in the positive rates of dust mites,house dust mites,dog dander,cat dander,artemisia,TxCHN1,T11/T15 and MX4 among different age groups(P>0.05).The positive rate of cat dander in male AR patients was 15.52%,which was higher than that of 4.55%in female AR patients,and the positive rate of artemisia was 0,which was lower than that of 2.27%in female AR patients.The differences were statistically significant(P<0.05).There were no statistically significant differences in the positive rates of dust mites,house dust mites,dog dander,dwarf ragweed,TxCHN1,T11/T15,MX4 and cockroaches between male and female AR patients(P>0.05).Conclusion sIgE detection helps to clarify the distribution characteristics of allergens.Dust mite species are the most common inhaled allergens,and AR patients are mostly positive for multiple allergens.