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.

参考文献 9

[1]	章如新. 变应性鼻炎的研究进展[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 3-6. doi:10.6040/j.issn.1673-3770.0.2016.241. ZHANG Ruxin. Prospect and progress of allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(4): 3-6. doi:10.6040/j.issn.1673-3770.0.2016.241.
[2]	Li J, Sun B, Huang Y, et al. A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China[J]. Allergy, 2009, 64(7): 1083-1092. doi:10.1111/j.1398-9995.2009.01967.x.
[3]	GBD Mortality Collaborators. Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2018, 392(10159): 1684-1735. doi:10.1016/S0140-6736(18)31891-9.
[4]	中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24. doi: 10.3760/cma.j.issn.1673-0860.2016.01.004. Subspecialty Group of Rhinology, Branch of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Guidelines for the diagnosis and treatment of allergic rhinitis(2015, Tianjin)[J]. Chinese Journal Of Otorhinolaryngology Head And Neck Surgery, 2016, 51(1):6-24. doi: 10.3760/cma.j.issn.1673-0860.2016.01.004
[5]	Tschopp JM, Sistek D, Schindler C, et al. Current allergic asthma and rhinitis: diagnostic efficiency of three commonly used atopic markers(IgE, skin prick tests, and Phadiatop). Results from 8329 randomized adults from the SAPALDIA Study. Swiss Study on Air Pollution and Lung Diseases in Adults[J]. Allergy, 1998, 53(6): 608-613.
[6]	周晶, 阎萍, 张丹, 等. 上海南部5843例变应性鼻炎患者变应原皮肤点刺试验变应原的初步分析[J]. 临床耳鼻咽喉头颈外科杂志, 2014(2): 102-107,112. doi:10.13201/j.issn.1001-1781.2014.02.010. ZHOU Jing, YAN Ping, ZHANG Dan, et al. Preliminary analysis of SPT tests on 5 843 allergic rhinitis patients from south Shanghai area[J]. Journal of Clinical Otorhinolaryngology, 2014(2): 102-107,112. doi:10.13201/j.issn.1001-1781.2014.02.010.
[7]	夏贤, 张绍芬, 周光炎. 雌激素及其受体对T淋巴细胞免疫功能的调节[J]. 国外医学(妇产科学分册), 2007, 34(2): 98-101. doi:10.3969/j.issn.1674-1870.2007.02.006.
[8]	刘燕, 邢志敏, 王旻, 等. 变应性鼻炎患者主客观指标相关性研究[J]. 中国免疫学杂志, 2014, 30(2): 252-254. doi:10.3969/j.issn.1000-484X.2014.02.025. LIU Yan, XING Zhimin, WANG Min, et al. Correlation study between subjective and objective indicators in allergic rhinitis patients[J]. Chinese Journal of Immunology, 2014, 30(2): 252-254. doi:10.3969/j.issn.1000-484X.2014.02.025.
[9]	中华医学会耳鼻咽喉科学分会,中华耳鼻咽喉科杂志编辑委员会.变应性鼻炎诊断标准及疗效评定标准(1997年,海口)[J].中华耳鼻咽喉科杂志,1998,33(3):134-135. Branch of Otorhinolaryngology, Chinese Medical Association, Chinese Journal of Otorhinolaryngology Editorial Board. Attachment: diagnostic criteria and efficacy evaluation criteria of allergic rhinitis(revised in 1997, Haikou)[J]. Chinese Journal of Otorhinolaryngology, 1998, 33(3):134-135.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

[1]	秦雅楠,王琳,姜彦,闫舒,陈敏,于龙刚,李娜. 2008~2017年青岛地区变应性鼻炎常见吸入性变应原分布[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 67-72.
[2]	杜经纬,冯俊,马鹏,李志勇,李红光. 鼻腔冲洗联合鼻用糖皮质激素对AR患者FeNO、肺功能及生活质量的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 124-127.
[3]	齐岩,刘俊其,彭舒娅,罗凯,张名霞,王振霖. 鼻内镜下选择性翼管神经切断术对伴有变应性鼻炎的慢性鼻窦炎的疗效观察[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 109-113.
[4]	郭胤仕,卢慧. Ⅱ型固有淋巴细胞在变应性鼻炎发病机制中的作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 9-12.
[5]	曹成,许昱. 变应性鼻炎患者舌下免疫治疗的临床依从性192例分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 114-118.
[6]	邱前辉,高俊潇. 特异性免疫治疗对过敏性鼻炎和哮喘的同步控制和远期疗效[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 33-37.
[7]	金兴,胡大宇,朱丽,邓芙蓉,刘俊秀. PM_2.5与变应性鼻炎患者上气道阻力的相关性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 77-80.
[8]	李丽莎,关凯,王子熹,崔乐. 大气污染物对于变应性鼻炎症状严重度的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 81-87.
[9]	洪海裕, 许光福, 杨烁伟,苏荣飞,黄伊厘,池梦诗,王玮豪,杨钦泰. 探究广东地区变应性鼻炎合并支气管哮喘的危险因素[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 94-98.
[10]	卢汉桂,林歆胜,姚丹勉,魏永新,李创伟. 变应性鼻炎大鼠IL-35的表达及对辅助性T细胞免疫调节的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 66-70.
[11]	王坛,武珂,李连庆,宫丽丽. 皮下免疫治疗注射后出现全身不良反应的伴发因素及处理[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 71-74.
[12]	浦洪波,杜晓东. 无锡地区2 000例变应性鼻炎变应原检测结果分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 105-107.
[13]	陈鸣,俞雪飞. 浅谈伴有变应性鼻炎的慢性鼻窦炎的治疗[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 18-22.
[14]	吴湘萍. 患者管理方式对变应性鼻炎舌下含服粉尘螨滴剂疗效的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 68-72.
[15]	李松,王宗贵,杨景朴,张竹萍. 鼻内镜下翼管神经切断术进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 72-76.