蜜蜂研究人群中蜂毒过敏患病率及相关危险因素分析

doi:10.6040/j.issn.1673-3770.1.2018.034

摘要/Abstract

摘要： 目的蜂毒过敏是引发严重过敏反应的常见原因之一。在我国有关蜂毒过敏的研究较少,尤其缺乏蜂毒过敏高危人群的相关数据。调查了从事蜜蜂研究人群中蜂毒过敏的患病率和临床特征,并分析其危险因素。方法 2018年9月,对中国农业科学院蜜蜂研究所和中国农业大学昆虫学系长期从事蜜蜂相关研究的人员进行横断面调查。结果共100人纳入研究:中位年龄28岁(19~56岁),女性占69.0%,其中34例(34.0%)报告在工作中发生过蜂毒过敏,大局部反应6例(6%),全身反应28例(28%)。在28例全身反应者中,1~4级全身反应分别有7、7、4、10例,4级全身反应即过敏性休克比例最高(35.7%)。 50%的全身反应者经历过最初被蜂蛰后表现为大局部反应。Logistic回归分析结果显示,暴露的水平即蜂蛰频率是蜂毒过敏的危险因素,相对于近1年蜂蛰频率为0次者,1~3次和≥4次者蜂毒过敏的OR值(95%CI)分别为6.362(2.014~20.092)和41.437(6.842~250.964)。过敏性鼻炎等患者本人或家人过敏史、蜂毒过敏家族史等反应特应性的指标与蜂毒过敏无统计学意义相关,OR(95%CI)分别为0.683(0.197~2.366),0.600( 0.131~2.749),2.582(0.201~33.099)。结论高危人群蜂毒过敏的情况不容忽视,尤需注意防护并配备急救药物和设备。

关键词: 蜂毒, 过敏反应, 患病率, 横断面调查, 危险因素

Abstract: Objective Allergic reactions to bee venom are one of the common causes of severe allergic reactions. There are few studies on bee venom allergy in China; particularly, there is a lack of data on people at high risk of bee venom allergy. This study investigated the prevalence and clinical characteristics of bee venom allergies in the bee study population and analyzed the risk factors. Methods In September 2018, a cross-sectional survey was conducted among people who had been engaged in bee-related research at the Bee Research Institute of the Chinese Academy of Agricultural Sciences and the Department of Entomology of China Agricultural University. Results A total of 100 people were included in the study: median age 28 years(range: 19-56 years); females accounted for 69.0%. Among them, 34 cases(34.0%)reported having had allergic reactions to bee venom at work, 6 cases(6%)had large local reactions, and 28 cases(28%)had systemic reaction reactions. Among the 28 systemic reaction responders, there were 7, 7, 4, and 10 cases of systemic reactions in grades 1-4, respectively. The systemic reaction of grade 4 was the commonest(35.7%). Fifty percent of systemic reaction responders experienced large local reactions after initial bee sting. Logistic regression showed that the level of exposure, that is, the frequency of bee stings was a risk factor for bee venom allergy. Compared with the respondents who were not been stung in the past year, the OR(95% CI)of bee venom allergy of 1-3 and ≥4 bee stings in the past year were 6.362 ［95% confidence interval(CI), 2.014-20.092］ and 41.437(95% CI, 6.842-250.964). There was no statistically significant correlation between respondents' personal or family history of allergies(e.g. allergic rhinitis), family history of bee venom allergy and bee venom allergy(odds ratios=0.683(95% CI, 0.197-2.366), 0.600(95% CI, 0.131-2.749)and 2.582(95% CI, 0.201-33.099), respectively). Conclusion The situation of bee venom allergy in high-risk population cannot be ignored. For high-risk groups, it is necessary to pay close attention to protection and provide emergency medicine and equipment.

Key words: Bee venom, Allergic reaction, Prevalence, Cross-sectional survey, Risk factors

中图分类号:

R392.8

崔乐,关凯,李丽莎,李俊达,王子熹,徐迎阳,王良录,尹佳. 蜜蜂研究人群中蜂毒过敏患病率及相关危险因素分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 63-66.

CUI Le, GUAN Kai, LI Lisha, LI Junda, WANG Zixi, XU Yingyang, WANG Lianglu, YIN Jia. Analysis of prevalence and related risk factors of bee venom in bee research population[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 63-66.

参考文献 17

[1]	Casale TB, Burks AW. Clinical practice. Hymenoptera-sting hypersensitivity[J]. N Engl J Med, 2014, 370(15):1432-1439. doi:10.1056/NEJMcp1302681.
[2]	Bilo BM, Rueff F, Mosbech H, et al. Diagnosis of Hymenoptera venom allergy[J]. Allergy, 2005, 133960(11):1339-1349. doi:10.1111/j.1398-9995.2005.00963.x.-1349.
[3]	Ring J,Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes [J]. Lancet(London, England), 1977, 1(8009):466-469. doi: 10.1016/S0140-6736(77)91953-5.
[4]	Incorvaia C, Mauro M, Pravettoni V, et al. Hypersensitivity to Hymenoptera venom: advances in diagnosis and implications for treatment[J]. Recent Pat Inflamm Allergy Drug Discov, 2011, 5(2):128-135.
[5]	Mueller HL. Diagnosis and treatment of insect sensitivity[J]. J Asthma Res, 1966, 3(4):331-333.
[6]	Bilò MB. Anaphylaxis caused by Hymenoptera stings: from epidemiology to treatment[J]. Allergy, 2011, 66(Suppl 95):35-37. doi:10.1111/j.1398-9995.2011.02630.x.
[7]	Fernandez J, Blanca M, Soriano V, et al. Epidemiological study of the prevalence of allergic reactions to Hymenoptera in a rural population in the Mediterranean area[J]. Clin Exp Allergy, 1999, 29(8):1069-1074.
[8]	Romero-Gómez, M., G.E. Suárez and F.M. Castro, Hymenoptera stings in conscripts[J]. Allergy, 1997, 52(6):680-681.
[9]	Hayashih Y, Hirata H, Watanabe M, et al. Epidemiologic investigation of hornet and paper wasp stings in forest workers and electrical facility field workers in japan[J]. Allergol Int, 2014, 63(1):21-26. doi:10.2332/allergolint.13-OA-0556.
[10]	Kochuyt AM, Van Hoeyveld E, Stevens EA. Occupational allergy to bumble bee venom[J]. Clin Exp Allergy, 1993, 23(3):190-195.
[11]	Bonadonna P, Schiappoli M, A DM, et al. Is hymenoptera venom allergy an occupational disease?[J]. Occupational and Environmental Medicine, 2008, 65(3):217-218. doi:10.1136/oem.2007.036400.
[12]	Pumphrey RS. Lessons for management of anaphylaxis from a study of fatal reactions[J]. Clin Exp Allergy, 2000, 30(8):1144-1150.
[13]	关凯, 李丽莎, 王瑞琦, 等. 蜜蜂蜂毒致严重过敏反应临床特征[J]. 中华临床免疫和变态反应杂志, 2016, 10(3):197-201. doi:10.3969/j.issn.1673-8705.2016.03.003. GUAN Kai, LI Lisha, WANG Ruiqi, et al. Clinical characteristics of anaphylaxis induced by honeybee venom[J]. Chinese Journal of Allergy & Clinical Immunology, 2016, 10(3):197-201. doi:10.3969/j.issn.1673-8705.2016.03.003.
[14]	崔乐, 王子熹, 关凯, 等. 蜂疗致蜂毒过敏的临床特征及影响因素[J]. 中华临床免疫和变态反应杂志, 2018, 12(3):277-282. doi:10.3969/j.issn.1673-8705.2018.03.004. CUI Le, WANG Zixi, GUAN Kai, et al. Clinical manifestations and risk factors of honeybee venom allergy induced by apitherapy[J]. Chinese Journal of Allergy & Clinical Immunology, 2018, 12(3):277-282. doi:10.3969/j.issn.1673-8705.2018.03.004.
[15]	Birnbaum J, Vervloet D, Charpin D. Atopy and systemic reactions to hymenoptera stings[J]. Allergy Proc, 1994,15(2):49-52.
[16]	Johansson SG, Bieber T, Dahl R, et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003[J]. J Allergy Clin Immunol, 2004, 113(5):832-836. doi:10.1016/j.jaci.2003.12.591.
[17]	Siracusa A, Folletti I, Gerth van Wijk R, et al. Occupational anaphylaxis-an EAACI task force consensus statement[J]. Allergy, 2015,70(2):141-152. doi: 10.1111/all.12541.

相关文章 15

[1]	王焕霞,王淑雅,王影,孙璇,黄杰,王兴荣. 孔源性视网膜脱离玻璃体切除术后继发黄斑前膜的危险因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 181-185.
[2]	张琳,辛运超,尚小领,解琪,刘亚超. cN0期甲状腺微小乳头状癌颈部中央区及侧颈区淋巴结转移率、危险因素及清扫策略的临床研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 62-69.
[3]	孟素坤,张纯. 小梁消融术治疗开角型青光眼患者的长期视野缺损研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 139-148.
[4]	李璐,赵杰,赵博军. 中心性浆液性脉络膜视网膜病变的发病机制与治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 118-124.
[5]	李智林,郑洲,安韡. 12例原发性甲状腺鳞状细胞癌的临床及生存分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 59-63.
[6]	肖富亮,林云,潘新良. 早期cN0 PTC预防性中央区淋巴结清扫的临床研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 64-71.
[7]	李爱军,崔小梅. 白内障术前房颤人群综合路径管理现状横断面调查[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 38-44.
[8]	张礼俊, 胥然, 罗继芳, 刘国旗, 何千, 李玮, 蒋振华. 头颈肿瘤游离皮瓣修复术后皮瓣坏死及皮瓣相关并发症影响因素分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 86-90.
[9]	刘珊珊, 韩书婧, 王晓旭, 李艳红, 倪鑫, 张杰. 儿童细菌性脑膜炎后听力损害危险因素的系统评价与Meta分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 48-54.
[10]	杨秀芬,尤冉,马秀梅,王康,王艳玲. 以医院为基础的中心性浆液性脉络膜视网膜病变流行病学调查及危险因素的研究[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 75-79.
[11]	陈东,余红,李洋,黄强,方敏. 功能性鼻内窥镜鼻窦手术粘连的潜在危险因素及其预测价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 87-91.
[12]	郝文培, 翟华蕾, 孙晓彤, 张雅妮, 朱艳辉, 孔倩倩, 程钧, 张婷. 角膜再移植原因与植片失活的危险因素分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 134-140.
[13]	黄河,欧阳晖. 下咽癌共病食管癌的高危因素及预后分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 82-86.
[14]	郎永耀,杨云,刘晴,徐林弟,林子萍. 咽喉反流性疾病的影响因素及治疗效果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 119-123.
[15]	姜秀颖,李元彬. 后房型人工晶体脱位的临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 105-110.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed