88例婴幼儿变应性鼻炎临床特征及药物治疗后回访

Clinical characteristics of 88 infants or young children with allergic rhinitis and follow⁃up after drug treatment

目的通过对88例婴幼儿变应性鼻炎(allergic rhinitis,AR)的临床资料进行分析,探讨婴幼儿变应性鼻炎的临床特征和药物治疗后症状改善情况。方法对2020年2月1日至8月1日在广州医科大学附属第一医院小儿呼吸科门诊就诊的88例初诊婴幼儿AR患者进行回顾分析,并于就诊后6~12个月进行电话回访,总结婴幼儿AR的临床特征、合并症和药物治疗效果。结果88例3~36个月婴幼儿AR,其中轻度AR 34例(38.6%),中重度AR 54例(61.4%)。临床症状发生率从高到低依次为流涕87.5%(77/88)、鼻塞87.5%(77/88)、喷嚏47.7%(42/88)和鼻痒37.5%(33/88)。合并症发生率依次为咳嗽56.8%(50/88),打鼾52.3%(46/88),喘息27.3%(24/88),张口呼吸12.5%(11/88)。血清特异性Ig E检测阳性比率排在前3位的是牛奶53.4%(47/88)、尘螨46.6%(41/88)、鸡蛋36.4%(32/88)。药物治疗2~8周后鼻炎症状缓解率在轻度AR中为94.1%(32/34),明显高于中重度AR的75.9%(41/54)(χ^(2)=4.883,P=0.027)。中重度AR中24.1%在回访时症状仍有反复,明显高于轻度AR组5.9%(2/34)(χ^(2)=4.883,P=0.027)。结论婴幼儿AR症状以流涕、鼻塞突出,合并症主要有咳嗽、打鼾。主要变应原为尘螨、牛奶和鸡蛋。轻度AR治疗后症状缓解比率优于中重度AR,中重度AR症状易反复。

Objective By analyzing the clinical data from 88 infants or young children with allergic rhini⁃tis(AR),we explore the clinical characteristics of AR in those pediatric patients as well as the improvement in symptoms after drug treatment.Methods A retrospective analysis was conducted on 88 infants or young children initially diagnosed with AR who visited the pediatric respiratory clinic of the first affiliated hospital of Guangzhou medical university from February 1,2020 to August 1,2020.Telephone follow-ups were conducted from 6 to 12 months after the first visit.Based on the follow-up results,we summarized the clinical characteristics,complications,and efficacy of therapies of AR in infants and young children.Results Among 88 infants or young children aged 3 to 36 months with AR,34(38.6%)had mild AR and 54(61.4%)had moderate to severe AR.Runny nose and nasal congestion were the most common clinical symptom(87.5%,77/88),followed by sneezing(47.7%,42/88)and nasal itching(37.5%,33/88).Coughing(56.8%,50/88)was the most common complications,followed by snoring(52.3%,46/88),wheezing(27.3%,24/88)and mouth breathing(12.5%,11/88).The top three positive rates of serum specific IgE testing were 53.4%(47/88)in milk,46.6%(41/88)in dust mites and 36.4%(32/88)in eggs.After 2 to 8 weeks of medication uses,the remission rate of rhinitis symptoms was significantly higher in mild AR than in moderate to severe AR[94.1%(32/34)vs.75.9%(41/54),χ^(2)=4.883,P=0.027].24.1%of patients with moderate to severe AR still had recurrent symptoms at follow-up visits,which was significantly higher than 5.9%in the mild AR group(χ^(2)=4.883,P=0.027).Conclusion The main symptoms of AR in infants and young children are runny nose and nasal congestion,and the main complications include cough and snoring.The main allergens are dust mites,milk,and eggs.The symptom relief rate is better in mild AR than in moderate to severe AR after treatment.The symptoms in moderate to severe AR are prone to relapse.