山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (2): 51-58.doi: 10.6040/j.issn.1673-3770.0.2024.312

• 论著 • 上一篇    下一篇

长春地区儿童变应性鼻炎变应原检测结果分析

刘畅,杨景朴,高雨,王文佳   

  1. 吉林大学第二医院 耳鼻咽喉头颈外科, 吉林 长春 130041
  • 发布日期:2025-03-26
  • 通讯作者: 王文佳. E-mail:wangwenjia2016@jlu.edu.cn

Analysis of allergen detection results in children with allergic rhinitis in the Changchun area

LIU Chang, YANG Jingpu, GAO Yu, WANG Wenjia   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Second Hospital of Jilin University, Changchun 130041, Jilin, China
  • Published:2025-03-26

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摘要： 目的 分析长春地区儿童变应性鼻炎(allergic rhinitis, AR)血清特异性免疫球蛋白E(immunoglobulin E, IgE)检测结果,了解AR患儿常见变应原及其分布特点,为长春地区AR患儿的诊疗和预防提供依据。 方法 选取2023年1月1日至12月31日就诊于吉林大学第二医院耳鼻咽喉头颈外科且行血清特异性IgE检测的长春地区AR患儿478例,分析常见变应原及其分布情况,比较变应原在不同性别、年龄组之间的致敏差别,并分析单一致敏和多重致敏情况。 结果 长春地区AR患儿吸入性变应原阳性率前4位是蒿(38.3%)、粉/户尘螨(35.6%)、猫毛皮屑(34.9%)、念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉(34.9%),食入性变应原前4位是牛奶(63.6%)、鸡蛋白(12.1%)、桃/苹果/芒果/荔枝/草莓(8.4%)、虾/蟹(6.9%)。AR患儿就诊高峰为8月(135例)和9月(109例)。常见吸入性变应原蒿和矮豚草阳性率在9月份最高(57.8%,47.7%),念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉阳性率在7月份最高(56.8%),粉/户尘螨阳性率在12月份最高(100%)。男性患儿桃/苹果/芒果/荔枝/草莓阳性率高于女性患儿(χ2=5.473,P=0.019),女性患儿虾/蟹阳性率高于男性患儿(χ2=6.440,P=0.011)。吸入性变应原、蒿、粉/户尘螨、念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉、猫毛皮屑、矮豚草、刺柏/桦、桤/杨/柳/山毛榉/橡/胡桃、食入性变应原、牛奶、鸡蛋白、虾/蟹、花生/黄豆阳性率在不同年龄组间差异均有统计学意义(P均<0.05)。随着年龄的增加,吸入性变应原阳性率升高(婴幼儿61.8%,学龄前儿童81.3%,学龄期儿童96.0%;P<0.001),食入性变应原阳性率降低(婴幼儿97.1%,学龄前儿童74.3%,学龄期儿童67.0%;P=0.001)。AR患儿多重致敏占比与年龄呈正相关(r=0.692,P=0.009)。 结论 长春地区AR儿童变应原以牛奶、蒿、粉/户尘螨为主。不同变应原阳性率分布存在性别、年龄差异,随着年龄增加,吸入性变应原阳性率升高,食入性变应原阳性率降低,多重致敏患儿也随之增多。

关键词: 变应性鼻炎, 儿童, 变应原, 特异性免疫球蛋白E

Abstract: Objective To analyse the serum specific immunoglobulin E(IgE)detection results of children with allergic rhinitis(AR)in the Changchun area. The study will provide insights into the common allergens and their distribution characteristics in children with AR. The findings of this study will serve as a valuable basis for the diagnosis, treatment and prevention of children with AR. Methods A total of 478 children with AR who visited the Department of Otorhinolaryngology, Head and Neck Surgery of the Second Hospital of Jilin University and underwent serum specific IgE detection from January 1 to December 31, 2023 were selected for this study. The common allergens and their distribution were analysed, and the differences in allergens between different age,gender groups and monosensitisation and multisensitisation were compared. Results The top four positive rates of inhaled allergens in children with allergic rhinitis in Changchun were Artemisia(38.3%), dust mite/house mite(35.6%), cat dander(34.9%), and Candida/Penicillium nodularis/Cladophorium/Alternaria spp./Aspergillus niger(34.9%). The four main food allergens were milk(63.6%), egg white(12.1%), peach/apple/mango/lychee/strawberry(8.4%), and shrimp/crab(6.9%). The highest number of visits by children with AR was observed in August(135 cases)and September(109 cases). The positivity rate for Artemisia and dwarf ragweed reached its highest point in September(57.8%,47.7%), while the positivity rate for Candida/Penicillium nodularis/Cladophorium/Alternaria spp./Aspergillus niger reached its highest point in July(56.8%), and for dust mites/house mites in December(100%). The positive rate of peach/apple/mango/lychee/strawberry was higher in males than those in females(χ2=5.473,P=0.019), while the positive rate of shrimp/crab was higher in females than those in males(χ2=6.440,P=0.011). Statistically significant differences were identified among the different age groups for the following allergens: inhalant allergens, Artemisia, dust mite /house mite, Candida/Penicillium nodularis/Cladophorium/Alternaria spp./Aspergillus niger, cat dander, and food allergens, milk, egg white, shrimp/crab, peanuts/soybeans showed statistically significant differences among the different age groups(all P<0.05). The positive rate of inhalant allergens increased with age(P<0.001), while the positive rate of food allergens showed an opposite trend(P<0.05). Pearson correlation analysis(r=0.692,P=0.009)revealed a positive correlation between polysensitisation and age in all children with AR. Conclusion The primary allergens identified in children with AR in Changchun are milk, Artemisia, and dust/house dust mite. The study revealed gender and age-related differences in the prevalence of positive reactions. The positive rate of inhalant allergens increased with age, while the positive rate of food allergens decreased. Furthermore, the number of children with multiple sensitisation also increased with age. This comprehensive understanding provides a solid foundation for the diagnosis, treatment and prevention of children with AR in this local area.

Key words: Allergic Rhinitis, Children, Allergens, Specific immunoglobulin E

中图分类号: 

  • R765.21
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组、小儿学组. 儿童变应性鼻炎诊断和治疗指南(2022年,修订版)[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(4): 392-404. doi:10.3760/cma.j.cn115330-20220303-00092 Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Sub-specialty Groups of Rhinology and Pediatrics, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association.Guideline for diagnosis and treatment of pediatric allergic rhinitis(2022, revision)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2022, 57(4): 392-404. doi:10.3760/cma.j.cn115330-20220303-00092
[2] Petriz NA, Antonietti C, Parente C, et al. Epidemiological study of allergic rhinitis in a population of children seen at the Department of Pediatrics of a general hospital. Cross-sectional study[J]. Arch Argent Pediatr, 2024, 122(4): e202310173. doi:10.5546/aap.2023-10173.eng
[3] Chrysouli K, Theodorakopoulos C, Saratsiotis A, et al. Allergic rhinitis in children: an underestimated disease[J]. Indian J Otolaryngol Head Neck Surg, 2024, 76(2): 1759-1764. doi:10.1007/s12070-023-04402-z
[4] 黄天昊, 武大伟, 魏永祥. 变应性鼻炎相关心理障碍研究进展[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(8): 876-880. doi:10.3760/cma.j.cn115330-20200828-00707 HUANG Tianhao, WU Dawei, WEI Yongxiang. Research progress of allergic rhinitis-related psychological disorders[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2021, 56(8): 876-880. doi:10.3760/cma.j.cn115330-20200828-00707
[5] Xiang L, Liu FX, Zhi LL, et al. Safety of semi-depot house dust mite allergen extract in children and adolescents with allergic rhinitis and asthma[J]. Immunotherapy, 2021, 13(3): 227-239. doi:10.2217/imt-2020-0232
[6] Li YQ, Cheng L, Chen XN, et al. Efficacy evaluation of a pollen blocker cream against dust-mite allergy: a multicenter, randomized, double-blind, placebo-controlled crossover trial[J]. Am J Rhinol Allergy, 2015, 29(5): e129-33. doi:10.2500/ajra.2015.29.4218
[7] Nurmatov U, van Schayck CP, Hurwitz B, et al. House dust mite avoidance measures for perennial allergic rhinitis: an updated Cochrane systematic review[J]. Allergy, 2012, 67(2): 158-165. doi:10.1111/j.1398-9995.2011.02752.x
[8] Gellrich D, H gerle C, Becker S, et al. Is quantitative SIgE serology suitable for distinguishing between silent sensitization and allergic rhinitis to Dermatophagoides pteronyssinus [J]. J Investig Allergol Clin Immunol, 2019, 29(2): 124-131. doi:10.18176/jiaci.0299
[9] 郝蕴, 王向东, 张罗. 变应性鼻炎检测方法的新进展[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(5): 532-537. doi:10.3760/cma.j.cn115330-20190409-00264 HAO Yun, WANG Xiangdong, ZHANG Luo. Recent advances in the detection methods of allergic rhinitis[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2020, 55(5): 532-537. doi:10.3760/cma.j.cn115330-20190409-00264
[10] Montoro J, Antolín-Amérigo D, Artés M, et al. Impact of climate change-related environmental factors on allergen production and the epidemiology and severity of allergic diseases[J]. J Investig Allergol Clin Immunol, 2024, 34(6): 358-366. doi:10.18176/jiaci.0988
[11] 孙凤卫, 周含, 张立松. 北京地区儿童过敏性鼻炎过敏原筛查结果分析[J]. 中国耳鼻咽喉头颈外科, 2023, 30(11): 719-722. doi:10.16066/j.1672-7002.2023.11.008 SUN Fengwei, ZHOU Han, ZHANG Lisong. Analysis of allergen screening results of children with allergic rhinitis in Beijing area[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2023, 30(11): 719-722. doi:10.16066/j.1672-7002.2023.11.008
[12] 王杰, 叶志成, 徐玮. 上海地区儿童变应性鼻炎患者血清变应原检测分析[J]. 医学信息, 2023, 36(4): 61-66. doi:10.3969/j.issn.1006-1959.2023.04.012 WANG Jie, YE Zhicheng, XU Wei. Analysis of serum allergens detection results of children with allergic rhinitis in Shanghai[J]. Journal of Medical Information, 2023, 36(4): 61-66. doi:10.3969/j.issn.1006-1959.2023.04.012
[13] 李玲, 瞿斐. 杭州地区1 573例变应性鼻炎患儿过敏原流行特征分析[J]. 中国妇幼保健, 2023, 38(23): 4669-4674. doi:10.19829/j.zgfybj.issn.1001-4411.2023.23.036 LI Ling, QU Fei. Maternal and Child Health Care of China, 2023, 38(23): 4669-4674. doi:10.19829/j.zgfybj.issn.1001-4411.2023.23.036
[14] 李静,刘长山,王雪艳. 天津地区4 488例儿童过敏性鼻炎吸入性变应原谱分析[J]. 中华实用儿科临床杂志, 2022, 37(24): 1866-1872. doi:10.3760/cma.j.cn101070-20220619-00741 LI Jing, LIU Changshan, WANG Xueyan. Analysis of the inhalant allergen spectrum in 4 488 children with allergic rhinitis in Tianjin[J]. Chinese Journal of Applied Clinical Pediatrics, 2022, 37(24): 1866-1872. doi:10.3760/cma.j.cn101070-20220619-00741
[15] 阿布利克木·依明,陆金山,韩治国,等. 新疆地区变应性鼻炎儿童常见变应原的分布[J]. 中国耳鼻咽喉颅底外科杂志, 2022, 28(5): 29-33. doi:10.11798/j.issn.1007-1520.202222203 ABULIKEMU·Yiming, LU Jinshan, HAN Zhiguo, et al. Analysis of common allergens distribution in children with allergic rhinitis in Xinjiang[J]. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 2022, 28(5): 29-33. doi:10.11798/j.issn.1007-1520.202222203
[16] 李全生, 江盛学, 李欣泽, 等. 中国气传致敏花粉的季节和地理播散规律[J]. 解放军医学杂志, 2017, 42(11): 951-955. doi:10.11855/j.issn.0577-7402.2017.11.03 LI Quansheng, JIANG Shengxue, LI Xinze, et al. Seasonal and geographical dispersal regularity of airborne pollens in China[J]. Medical Journal of Chinese People's Liberation Army, 2017, 42(11): 951-955. doi:10.11855/j.issn.0577-7402.2017.11.03
[17] Ebisawa M, Ito K, Fujisawa T, et al. Japanese guidelines for food allergy 2017[J]. Allergol Int, 2017, 66(2): 248-264. doi:10.1016/j.alit.2017.02.001
[18] 杨欢, 肖异珠, 罗晓燕, 等. 特应性斑贴试验在诊断特应性皮炎患儿鸡蛋、牛奶过敏中的价值[J]. 中华皮肤科杂志, 2010, 43(6): 378-381. doi:10.3760/cma.j.issn.0412-4030.2010.06.003 YANG Huan, XIAO Yizhu, LUO Xiaoyan, et al. Application of atopy patch test in diagnosing egg and milk allergy among children with atopic dermatitis[J]. Chinese Journal of Dermatology, 2010, 43(6): 378-381. doi:10.3760/cma.j.issn.0412-4030.2010.06.003
[19] 王梦娟, 刘长山. 天津地区儿童血清变应原特异性IgE分布情况[J]. 中华实用儿科临床杂志, 2021, 36(4): 290-295. doi:10.3760/cma.j.cn101070-20191224-01285 WANG Mengjuan, LIU Changshan. Distribution of serum allergen specific IgE in children in Tianjin[J]. Chinese Journal of Applied Clinical Pediatrics, 2021, 36(4): 290-295. doi:10.3760/cma.j.cn101070-20191224-01285
[20] 刘畅, 方宏艳, 刘敩, 等. 长春地区秋季变应性鼻炎蒿属花粉致敏特征分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 13-19. doi:10.3760/cma.j.cn101070-20191224-01285 LIU Chang, FANG Hongyan, LIU Xiao, et al. Analysis of sensitization characteristics of Artemisia pollen in autumn allergic rhinitis in the Changchun area of China[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 13-19. doi:10.3760/cma.j.cn101070-20191224-01285
[21] 姜涛, 李锐, 华娜, 等. 大连地区儿童变应性鼻炎患者血清特异性IgE分析[J]. 中国儿童保健杂志, 2021, 29(8): 918-921. doi:10.11852/zgetbjzz2020-1724 JIANG Tao, LI Rui, HUA Na, et al. Analysis of serum specific IgE in children with allergic rhinitis in Dalian[J]. Chinese Journal of Child Health Care, 2021, 29(8): 918-921. doi:10.11852/zgetbjzz2020-1724
[22] 王云梦, 方宏艳, 刘敩, 等. 长春及周边地区秋季变应性鼻炎变应原分布特点及临床特征分析[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(12): 1124-1129. doi: 10.13201/j.issn.2096-7993.2021.12.014 WANG Yunmeng, FANG Hongyan, LIU Xiao, et al. Analysis of allergen distribution and clinical characteristics of autumn allergic rhinitis in Changchun and surrounding areas[J]. J Clin Otorhinolaryngol Head Neck Surg, 2021, 35(12): 1124-1129. doi: 10.13201/j.issn.2096-7993.2021.12.014
[23] 孙立薇. 长春地区变应性鼻炎患者吸入性变应原分析[J]. 吉林:吉林大学, 2019.
[24] 李琪, 张云飞, 许政敏. 复旦大学附属儿科医院2413例过敏性鼻炎患儿过敏原筛查结果分析[J]. 中国实用儿科杂志, 2019, 34(3): 209-211. doi:10.19538/j.ek2019030612 LI Qi, ZHANG Yunfei, XU Zhengmin. Analysis of allergen screening results in 2413 children with allergic rhinitis in Children's Hospital of Fudan University[J]. Chinese Journal of Practical Pediatrics, 2019, 34(3): 209-211. doi:10.19538/j.ek2019030612
[25] Hu ZB, Xue JR, Pan M, et al. Prevalence of allergen sensitization among children with allergic rhinitis in Changzhou, China: a retrospective observational study[J]. BMC Pediatr, 2023, 23(1): 466. doi:10.1186/s12887-023-04291-9
[26] 周薇, 赵京, 车会莲, 等. 中国儿童食物过敏循证指南[J]. 中华实用儿科临床杂志, 2022, 37(8): 572-583. doi:10.3760/cma.j.cn101070-20220313-00257 ZHOU Wei, ZHAO Jing, CHE Huilian, et al. Evidence-based guidelines for children's food allergy in China[J]. Chinese Journal of Applied Clinical Pediatrics, 2022, 37(8): 572-583. doi:10.3760/cma.j.cn101070-20220313-00257
[27] Kim KW, Kim EA, Kwon BC, et al. Comparison of allergic indices in monosensitized and polysensitized patients with childhood asthma[J]. J Korean Med Sci, 2006, 21(6): 1012-1016. doi:10.3346/jkms.2006.21.6.1012
[28] 鹿伟理, 姜涛, 李宪华. 多重致敏儿童变应性鼻炎患者sIgE特征分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 260-265, 274. doi:10.6040/j.issn.1673-3770.0.2021.438 LU Weili, JIANG Tao, LI Xianhua. Analysis of SIgE in polysensitized children with allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 260-265, 274. doi:10.6040/j.issn.1673-3770.0.2021.438
[29] Huang YR, Wang CS, Cao FF, et al. Comparison of long-term efficacy of subcutaneous immunotherapy in pediatric and adult patients with allergic rhinitis[J]. Allergy Asthma Immunol Res, 2019, 11(1): 68-78. doi:10.4168/aair.2019.11.1.68
[30] Yang JY, Shen Z, Liu LF, et al. Clinical efficacy and safety of artesimia annua-sublingual immunotherapy in seasonal allergic rhinitis patients based on different intervention time[J]. Int Arch Allergy Immunol, 2022, 183(8): 852-859. doi:10.1159/000524108
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