变应性鼻炎患者粉尘螨皮肤点刺试验阳性764例结果分析

doi:10.6040/j.issn.1673-3770.0.2018.289

摘要/Abstract

摘要： 目的探讨变应性鼻炎(AR)患者粉尘螨皮肤点刺试验(SPT)阳性强度的影响因素及与AR症状评分的相关性。方法采用SPT诊断试剂,对就诊的拟诊AR患者进行粉尘螨SPT,并对其中SPT阳性的764例试验结果进行统计分析。结果 764例粉尘螨SPT阳性患者中,阳性等级为“+”(一级)18例,占2.36%(18/764);“++”(二级)23例,占3.01%(23/764);“+++”(三级)196例,占25.65%(196/764);“++++”(四级)527例,占68.98%(527/764)。0~4岁、5~14岁、15~29岁、30~44岁、45~59岁、60~69岁六个年龄组SPT阳性患者的阳性强度差异有统计学意义(χ2=20.138, P=0.001),SPT阳性强度随年龄组年龄范围升高而下降。男女性SPT阳性患者的阳性强度差异无统计学意义(Z=-1.503, P=0.133)。15~29岁、30~44岁年龄组内,男女性SPT阳性患者的阳性强度的差异有统计学意义(15~29岁:Z=-2.337, P=0.013; 30~44岁:Z=-3.129, P=0.001),且女性患者的阳性强度均较男性高。764例患者中仅患AR为332例(43.46%),伴随其他变应性疾病(变应性结膜炎、哮喘、变应性皮炎)为432例(56.54%),其中患2种变应性疾病为367例(48.03%),患3种为35例(4.58%),患4种为30例(3.93%),所伴随变应性疾病患者数由多到少依次为变应性结膜炎(331例)、变应性皮炎(56例)、哮喘(42例)。764例粉尘螨SPT阳性患者中,不同变应性疾病患病种类数的SPT阳性患者阳性强度差异有统计学意义(χ2=26.065, P<0.001),变应性疾病患病种类数越多则SPT阳性强度越高。粉尘螨SPT不同阳性等级之间的喷嚏评分、流涕评分、鼻塞评分、鼻痒评分、眼痒评分、流泪评分以及症状总分比较,差异均无统计学意义(喷嚏评分:F=0.207, P=0.891;流涕评分:F=0.297, P=0.827;鼻塞评分:F=0.174, P=0.913;鼻痒评分:F=0.256, P=0.857;眼痒评分:F=0.044, P=0.987;流泪评分:F=0.154, P=0.926;症状总分:F=0.211, P=0.884)。相关性分析发现,粉尘螨SPT阳性强度与喷嚏评分、流涕评分、鼻塞评分、鼻痒评分、眼痒评分、流泪评分以及症状总分间均无相关性(喷嚏评分:r_s=-0.036, P=0.387;流涕评分:r_s=-0.034, P=0.392;鼻塞评分:r_s=0.026, P=0.433;鼻痒评分:r_s=0.056, P=0.141;眼痒评分:r_s=0.039, P=0.379;流泪评分:r_s=0.041, P=0.374;症状总分:r_s=0.032, P=0.397)。结论粉尘螨SPT阳性强度受AR患者年龄及患变应性疾病种类数的影响,不受性别差异的影响,与AR症状评分之间不存在相关性。

关键词: 变应性鼻炎, 粉尘螨, 皮肤点刺试验

Abstract: Objective This study aimed to explore factors influencing a positive skin prick test for Dermatophagoides farinae(SPT-DF)in patients with allergic rhinitis(AR)and the correlation between positive SPT-DF results and AR symptoms. Methods SPT-DF was performed for suspected AR patients using SPT diagnostic reagents, and 764 SPT-DF-positive results were analyzed statistically. Results Of 764 SPT-DF-positive patients, 18(2.36%)were positive level “+”(level one); 23(3.10%)were positive level “++”(level two); 196(25.65%)were positive level “+++”(level three); and 527(68.98%)were positive level “++++”(level four). The differences in positive levels between SPT-DF-positive patients in six age groups(0-4 years, 5-14 years, 15-29 years, 30-44 years, 45-59 years, and 60-69 years)were statistically significant(χ2 = 20.138, P=0.001), and SPT-DF-positive levels decreased with advancing age-group ranges. There were no significant differences in positive levels between male and female SPT-DF-positive patients(Z=-1.503, P=0.133). In the age groups 15-29 years and 30-44 years, the positive level differences between male and female SPT-DF-positive patients were statistically significant(15-29 years, Z=-2.337, P=0.013; 30-44 years, Z=-3.129, P=0.001), with the positive levels of female patients being higher than those of male patients. Of 764 patients, 332(43.46%)had AR only. There were 432(56.54%)patients with other allergic diseases(allergic conjunctivitis, asthma, and allergic dermatitis), 367(48.03%)patients with two kinds of allergic diseases, 35(4.58%)patients with three kinds, and 30(3.93%)patients with four kinds. The number of patients with allergic diseases were as follows: allergic conjunctivitis, n=331; allergic dermatitis, n=56; and asthma, n=42. Among 764 SPT-DF-positive patients, differences in the positive levels between SPT-DF-positive patients with different numbers of allergic disease types were statistically significant(χ2=26.065, P=0.000), and the higher the number of allergic disease types, the higher the SPT-positive level. There were no significant differences in scores with respect to sneezing(F=0.207, P=0.891), runny nose(F=0.297, P=0.827), nasal congestion(F=0.174, P=0.913), nasal itching(F=0.256, P=0.857), itchy eyes(F=0.044, P=0.987), tearing(F=0.154, P=0.926), and the total symptom score(F=0.211, P=0.884)between different SPT-DF-positive levels. There was also no correlation found between SPT-DF-positive levels and scores with respect to sneezing(r_s=-0.036, P=0.387), runny nose(r_s=-0.034, P=0.392), nasal congestion(r_s=-0.026, P=0.433), nasal itching(r_s=0.056, P=0.141), itchy eyes(r_s=-0.039, P=0.379), tearing(r_s=-0.041, P=0.374), and total symptom score(r_s=0.032, P=0.397). Conclusion The SPT-DF-positive levels are affected by age and the number of allergic disease types in patients with AR, but are not affected by sex differences. The SPT-DF-positive levels have no correlation with AR symptom scores.

Key words: Allergic rhinitis, Dermatophagoides farinae, Skin prick test

中图分类号:

R765.21

洪冬冬,刘元献,邹练强,翁镌凌,邓文娴. 变应性鼻炎患者粉尘螨皮肤点刺试验阳性764例结果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 119-123.

HONG Dongdong, LIU Yuanxian, ZOU Lianqiang, WENG Juanling, DENG Wenxian. An analysis of 764 positive skin prick test results for Dermatophagoides farinae in patients with allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 119-123.

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