成都地区儿童青少年变应性鼻炎患者变应原分布特点及影响因素分析

Analysis of allergen distribution characteristics and influencing factors in children and adolescents with allergic rhinitis in Chengdu

目的 探讨成都地区儿童青少年变应性鼻炎患者变应原分布情况,并分析其影响因素。方法 采用方便抽样方法选择2023年1—12月在成都市6家医院(4家三甲综合医院、1家三甲中医院、1家三乙综合医院)就诊的儿童青少年变应性鼻炎患者作为鼻炎组,并选择同期就诊的非变应性鼻炎儿童青少年作为对照组,对鼻炎组患者进行血清特异性IgE检测,并采用自制调查问卷对2组儿童青少年进行问卷调查,采用描述性分析方法对变应原分布情况进行分析,并采用单、多因素分析方法对儿童青少年变应性鼻炎患病的影响因素进行分析。结果 成都地区儿童青少年变应性鼻炎患者经检测,吸入性变应原阳性患者1 240例,阳性率91.45%;食物性变应原阳性患者602例,阳性率44.40%;吸入性变应原前3名的变应原分别是粉尘螨/屋尘螨、屋尘、榆树/柳树/杨树(花粉);食物性变应原前3名的变应原分别是蟹/虾/扇贝、淡水鱼、芒果/菠萝。不同年龄段儿童青少年变应原阳性率不同,≤13岁儿童的吸入性过敏原均为粉尘螨/屋尘螨较高,食物性过敏原均为蟹/虾/扇贝较高,14~17岁青少年的吸入性过敏原以粉尘螨/屋尘螨较高,食物性过敏原以芒果/菠萝的阳性率较高。多因素logistic回归分析结果显示,居住地为城镇(OR=1.676)、饮食习惯荤食为主(OR=2.122)、吸烟/被动吸烟(OR=1.835)、户外活动时间<1 h/d(OR=1.879)、支气管哮喘(OR=4.282)、腺样体肥大(OR=9.465)、既往过敏史(OR=1.929)、父母过敏性鼻炎(OR=2.465)是成都地区儿童青少年变应性鼻炎患病的影响因素。结论 成都地区儿童青少年变应性鼻炎患者的变应原分布以吸入性变应原为主,居住地为城镇、饮食习惯荤食为主、吸烟/被动吸烟、户外活动时间<1 h/d、支气管哮喘、腺样体肥大、既往过敏史、父母过敏性鼻炎是成都地区儿童青少年变应性鼻炎患病的影响因素。

Objective To investigate the distribution of allergens in children and adolescents with allergic rhinitis in Chengdu,as well as to analyze the influencing factors.Methods A convenient sampling method was used to select children and adolescents with allergic rhinitis treated in 6 hospitals in Chengdu(4 tertiary comprehensive hospitals,1 tertiary traditional Chinese medicine hospital,and 1 tertiary comprehensive hospital) from January to December 2023 as the rhinitis group.Non-allergic rhinitis children and adolescents who visited during the same period were selected as the control group.Serum specific IgE testing was performed on patients in the rhinitis group,and a self-made questionnaire was used to conduct a survey on both groups.Descriptive analysis was used to analyze the distribution of allergens,while univariate and multivariate analyses were employed to analyze the influencing factors of allergic rhinitis in children and adolescents.Results After testing,1 240(91.45%) children and adolescents with allergic rhinitis in Chengdu tested positive for inhalation allergens,and 602(44.40%) tested positive for food allergens.The top three inhalation allergens were dust mites/house dust mites,house dust,and elm/willow/poplar pollen.The top three food allergens were crab/shrimp/scallop,freshwater fish,and mango/pineapple.The positivity rate of allergens varied among different age groups of children and adolescents.In those under 13 years old,dust mites/house dust mites accounted for a higher proportion of inhalation allergens;whereas crab/shrimp/scallop accounted for a higher proportion of food allergens.Among adolescents aged 14-17 years old,dust mites/house dust mites accounted for a higher proportion of inhalation allergens;meanwhile,mango/pineapple accounted for a higher proportion of food allergens.Multivariate Logistic regression analysis showed that urban residence(OR=1.676),dietary habits dominated by meat(OR=2.122),smoking/passive smoking(OR=1.835),outdoor activity time< 1 h/d(OR=1.879),bronchial asthma(OR=4.282),adenoid hypertrophy(OR=9.465),previous allergy history(OR=1.929),and parental allergic rhinitis(OR=2.465) were the influencing factors for allergic rhinitis in children and adolescents in Chengdu.Conclusions The allergens in children and adolescents with allergic rhinitis in Chengdu are mainly inhalation allergens.Urban residence,dietary habits dominated by meat,smoking/passive smoking,outdoor activity time <1 h/d,bronchial asthma,adenoid hypertrophy,previous allergy history,and parental allergic rhinitis are the influencing factors for allergic rhinitis in children and adolescents in Chengdu.