100例后天因素所致儿童OSAHS变应原检测结果分析

Analysis of Allergen Detection Results in 100 Children withOSAHS Caused by Acquired Factors

目的 通过统计解放军总医院第四医学中心耳鼻咽喉头颈外科病区收治后天因素所致儿童阻塞性睡眠呼吸暂停低通气综合症(obstructive sleep apnea hypopnea syndrome, OSAHS)变应原及IgE检测结果,探究OSAHS儿童过敏情况。方法 选取2021年2月至2021年11月在解放军总医院第四医学中心耳鼻咽喉头颈外科因扁桃体伴腺样体肥大导致3~12岁儿童OSAHS而行扁桃体伴腺样体切除手术的100例完整临床资料。采用免疫印迹法,共检测吸入性变应原10种,食入性变应原9种,血清总IgE 1组。分析OSAHS儿童变应原和过敏情况。结果 吸入性变应原阳性率最高的种类依次为:真菌、猫毛、屋尘、夏秋花粉、户尘螨、早晚春花粉。食入性变应原阳性率种类依次为:牛奶、腰果、鸡蛋白、苋及虾。过敏原种类阳性1项有37人次,同时合并2项有20人次,同时合并3项及以上有11人次,总过敏原阳性人数为68人次,总阳性率为68%。吸入性及食入性过敏原阳性率由高到低前六位种类依次为:牛奶、猫毛皮屑、真菌、腰果、夏秋花粉组、屋尘。不同年龄组及不同睡眠呼吸暂停阻塞程度患儿其变应原阳性率统计中3~6岁年龄组儿童过敏源阳性率最高,其次为6~9岁年龄组,9~12岁年龄组阳性率最低。不同睡眠呼吸暂停阻塞程度患儿过敏原阳性率与其阻塞程度呈正相关。结论 后天因素导致的儿童OSAHS与过敏原刺激相关,且患儿发病年龄越小,过敏易感程度越高,3~6岁年龄组儿童过敏源阳性率最高,儿童OSAHS睡眠呼吸阻塞程度与过敏仍需进一步大样本统计分析。

Objective To investigate the allergen and IgE detection results of OSAHS in children due to acquired factors admitted to the Otolaryngology Head and Neck Surgery Ward of the Fourth Medical Center of the General Hospital of the People′s Liberation Army,and to explore the allergic situation of children with OSAHS.Methods The complete clinical data of 100 cases of OSAHS children aged 3 to 12 years who underwent tonsillectomy with adenoids due to tonsillar and adenoid hyperplasia were selected from February 2021 to November 2021 in the Department of Otolaryngology,Head and Neck Surgery of the Fourth Medical Center of Chinese People′s Liberation Army(PLA)General Hospital.By Western Blot,10 kinds of inhaled allergens,9 kinds of ingestion allergens and 1 group of serum total IgE were detected.The allergens and allergies of children with OSAHS were analyzed.Results The highest positive rates of inhaled allergens were fungi,cat hair,house dust,summer and autumn pollen,house dust mites,morning and evening spring pollen.The positive rates of ingestion allergens were milk,cashew nut,egg white,amaranth and shrimp.There were 37 allergen positive patients with 1 item,20 patients with 2 items,and 11 patients with 3 or more items.The total number of allergen positive patients was 68,and the total positive rate was 68%.The top six types of inhaled and ingested allergens from high to low were milk,cat dander,fungus,cashew nut,summer and autumn pollen group,house dust.The positive rate of allergens in children of different age groups and different degrees of sleep apnea obstruction was the highest in the age group of 3 to 6 years,followed by the age group of 6 to 9 years,and the age group of 9 to 12 years.The positive rate of allergens in children with different sleep apnea obstruction was positively correlated with the obstruction degree.Conclusion Children with OSAHS caused by acquired factors are associated with allergen stimulation,and the younger the onset age of the disease,the higher the susceptibility to allergies.The age group of 3-6 years old has the highest positive rate of allergens.Further large-scale statistical analysis is needed to determine the degree of sleep respiratory obstruction and allergies in children with OSAHS.