2017—2021年北京市某医院变态反应性皮肤病患者过敏原流行特征分析

Analysis on epidemiological characteristics of allergens with allergic skin diseases in a hospital in Beijing City from 2017 to 2021

目的探讨北京地区的临床变态反应性皮肤病患者常见过敏原流行特征,为临床诊疗及预防提供参考。方法本研究为回顾性研究,选择2017—2021年在北京大学第一医院进行过敏原检查患者中诊断为中重度特应性皮炎患者共2822例,以成人为主,>18岁占比83%(2340/2822)。采用ImmunoCAP荧光酶联免疫法对患者血清进行sIgE检测,按照年龄、性别、年度等统计各项过敏原阳性率,分析流行特征和变化趋势。结果共收集过敏原特异性IgE检测数据22503项次。2822例研究人群的过敏原阳性率40%(1122/2822),且以多重致敏为主,13~18岁人群过敏原阳性率和多重致敏率均最高。2822例研究人群以吸入过敏原为主,阳性率最高的是吸入混合(29.3%),单价吸入过敏原阳性率前五的分别是:粉尘螨(26.7%)、户尘螨(25.5%)、艾蒿(23.9%)、桦树花粉(19.2%)、苍耳(18.2%),单价食物过敏原阳性率前五的分别是:虾(15.2%)、花生(14.8%)、芝麻(14.7%)、小麦(13.2%)、牛奶(13.1%);不同年龄段过敏原阳性率分析显示,吸入性过敏原中除桦树花粉在3~12岁人群阳性率最高外,其他吸入过敏原阳性率均在13~18岁人群达到高峰;食物性过敏原中食物混合-1(常见)、牛奶、鸡蛋白、小麦在<3岁人群中阳性率最高,随年龄增长阳性率逐渐下降,其他食物过敏原阳性率均在13~18岁达高峰,虾蟹是成人阶段最主要的两种食物过敏原。2822例研究人群各项过敏原阳性率在男女之间差异不大,男性略高于女性。5年期间,过敏原阳性率总体呈上升趋势,吸入过敏原中猫毛发皮屑、狗毛发皮屑、粉尘螨、蟑螂变化幅度较大,食物过敏原阳性率变化趋势平稳。结论变态反应性皮肤病病因复杂,可能与接触过敏原、遗传、免疫、环境因素、皮肤屏障功能异常等方面有关,本研究多角度分析了北京地区变态反应性皮肤病人群过敏原流行特征,为疾病防治提供参考。

Objectives In order to provide valuable information for the diagnosis and treatment of dermatitis,the prevalence rate and trend changes of common allergens in patients with allergic skin diseases in Beijing City were investigated and analyzed.Methods This study was a retrospective data collection study.A total of 2822 patients diagnosed with moderate to severe atopic dermatitis with allergen examinations were collected from Peking University First Hospital from 2017 to 2021,most of them were adults,and 83%(2340/2822)were over 18 years old.The ImmunoCAP fluorescent enzyme-linked immunoassay system was used to quantify specific IgE.The positive rate of each allergen was counted according to age,gender and year.The epidemiological characteristics and trends were analyzed.Results In the past five years,22503 allergen-specific IgE test data were collected,and the positive rate of allergens in 40%(1122/2822)of the 2822 patients was mainly multiple sensitization,the positive rate of allergens and multiple sensitization rates were the highest in people aged 13-18 years old.The 2822 patients were dominated by inhaled allergens,and the highest positive rate was inhaled mixture(29.3%).The top five positive rates of inhaled allergens were Dermatophagoides farina(26.7%),Dermatophagoides pteronyssinus(25.5%),Mugwort(23.9%),Birch pollen(19.2%)and Siberian cocklebur(18.2%).The top five positive rates of food allergens were shrimp(15.2%),peanut(14.8%),sesame(14.7%),wheat(13.2%)and milk(13.1%).Analysis of the positive rate of allergens in different age groups showed except for the positive rate of birch pollen peaked at 3-12 years old,other inhaled allergens were the highest food allergens in 13-18 years old.Among food allergens,the positive rates of fx5,milk,egg and wheat were the highest in<3 years old,the positive rate decreased gradually with age,and the positive rate of other food allergens peaked at 13-18 years old,and the shrimp and crab was the highest in adult.The positive rate of various allergens in the 2822 patients showed little difference between male and female and the male was slightly higher than female.In the past five years,the positive rate of allergens has been on the rise.The changes of inhaled allergens in cat/dog hair dander,Dermatophagoides farina and cicadas were large,while the positive rate of food allergens was stable.Conclusions The etiology of the allergic skin diseases is complex,which may be related to allergen exposure,heredity,immunity,environmental factors,abnormal skin barrier function,etc.This study showed the distribution of allergens in patients with allergic skin diseases in Beijing City to a certain extent.It provided epidemiological data and clinical evidence for the prevention and treatment of allergic diseases.