多重致敏儿童变应性鼻炎患者sIgE特征分析

doi:10.6040/j.issn.1673-3770.0.2021.438

摘要/Abstract

摘要： 目的了解大连地区多重致敏的儿童变应性鼻炎(AR)患者血清特异性IgE(sIgE)特点,为本地区AR精准防控提供参考。方法回顾性分析272例多重致敏的儿童AR患者sIgE结果,按性别、年龄、变应原种类和强度、吸入性和食入性变应原例次和强度进行分组,比较不同组间变应原分布情况。结果应用Pearson相关分析(r=0.587,P=0.035)在所有入组AR儿童中,多重致敏占比与年龄呈正相关,且相关性较高;多重致敏患者变应原种类数量与相应人数之间呈负相关(r=-0.913,P<0.001),且相关性较高。将患儿按年龄段分成3个组,2~5岁组、6~9岁组和10~14岁组,行统计学分析结果显示各组变应原阳性例数与变应原种类呈负相关,且相关性较高。变应原阳性例次及变应原总强度最高的前5位依次为屋尘螨/粉尘螨、艾蒿、猫、蛋清、普通豚草。吸入性和食入性变应原平均强度(t=2.410,P=0.038)差异有统计学意义。按年龄分组,6~9岁组中吸入性与食入性变应原例次差异(t=2.275, P=0.048)及平均强度差异(t=2.361, P=0.035)有统计学意义,10~14岁组中吸入性与食入性变应原平均强度差异有统计学意义(t=3.658, P=0.002)。吸入性变应原中春季、秋季及常年的例次、总强度、平均强度差异均无统计学意义。结论随着年龄增大,接触变应原种类增多,多重致敏患者也随之增多,故应定期复查过敏原。屋尘螨/粉尘螨、艾蒿、猫、蛋清、普通豚草是大连地区多重致敏的AR患儿主要致敏原,应注意重点防控。在6~9岁时应着重关注吸入性变应原致敏情况。

关键词: 儿童, 变应性鼻炎, 变应原, 特异性IgE, 多重致敏

Abstract: Objective To investigate the distribution of serum specific IgE(sIgE)in polysensitized children with allergic rhinitis(AR)in Dalian. Methods Retrospectively analyzed the sIgE results of 272 polysensitized pediatric AR patients, grouped by sex, age, allergen type and intensity, number and intensity of inhaled and ingested allergens, to compare the distribution of allergens between groups. Results Pearson correlation analysis(r=0.587, P=0.035)showed that polysensitization was positively correlated with age in all AR children, and the intensity was higher. Spearman's correlation analysis(r=-0.913, P<0.001)showed a negative correlation between the number of allergen species and the corresponding number of patients, and the intensity was higher. Based on age, the patients were divided into 3 groups, 2-5 years, 5-9 years, and 10-14 years. There was a negative correlation between the allergen-positive cases and number of allergen species in each group, and the intensity was higher. The top 5 allergen-positive cases were house dust mite/powder mite, Artemisia, cat, egg white and common ragweed. Based on age, there was a significant difference in the frequency of inhalational and ingestion allergens between the 6-9 years old group(t=2.275, P=0.048). There was significant difference in average strength between inhalation and ingestion allergens(t=2.361, P=0.035). There was a significant difference in average strength between inhalatant and ingestant allergens in the 10-14 years old group(t=3.658, P=0.002). The differences in spring, autumn and year-round among inhalatant allergens were not statistically significant in the number, total intensity and mean intensity. Conclusion As children get older and Increased types of contact allergens, the number of children with polysensitization will also increase. Allergen testing needs to be rechecked regularly. Dermatophagoides farinae / Dermatophagoides farinae, Artemisia argyi, cat, egg white and common ragweed are the main allergens of AR children with polysensitization in Dalian, and attention should be paid to prevention and control. The sensitization of ingestant allergens should be paid attention to at the age of 6-9.

Key words: Children, Allergic rhinitis, Allergen, Specific IgE, Polysensitization

中图分类号:

R765.21

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.

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.

参考文献

[1] Kong WJ, Chen JJ, Zheng ZY, et al. Prevalence of allergic rhinitis in 3-6-year-old children in Wuhan of China[J]. Clinical and experimental allergy, 2009, 39(6): 869-874. doi: 10.1111/j.1365-2222.2009.03206.x.
[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] Beutner C, Forkel S, Gupta S, et al. Sex- and age-dependent changes in polysensitization to common aeroallergens over 20 years[J]. J Asthma Allergy, 2020, 13: 725-730. doi:10.2147/JAA.S280771.
[4] Schoos AMM, Jelding-Dannemand E, Stokholm J, et al. Single and multiple time-point allergic sensitization during childhood and risk of asthma by age 13[J]. Pediatr Allergy Immunol, 2019, 30(7): 716-723. doi:10.1111/pai.13109.
[5] 程雷, 董震, 孔维佳, 等. 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.
[6] Hst A, Andrae S, Charkin S, et al. Allergy testing in children: why, who, when and how? [J]. Allergy, 2003, 58(7): 559-569. doi:10.1034/j.1398-9995.2003.00238.x.
[7] Prigione I, Morandi F, Tosca MA, et al. Interferon-gamma and IL-10 may protect from allergic polysensitization in children: preliminary evidence[J]. Allergy, 2010, 65(6): 740-742. doi:10.1111/j.1398-9995.2009.02285.x.
[8] Roberts G, Peckitt C, Northstone K, et al. Relationship between aeroallergen and food allergen sensitization in childhood[J]. Clin Exp Allergy, 2005, 35(7): 933-940. doi:10.1111/j.1365-2222.2005.02280.x.
[9] 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.
[10] Ciprandi G, Cirillo I. Monosensitization and polysensitization in allergic rhinitis[J]. Eur J Intern Med, 2011, 22(6): e75-e79. doi:10.1016/j.ejim.2011.05.009.
[11] Haanpää L, Af Ursin P, Nermes M, et al. Association of allergic diseases with children's life satisfaction: population-based study in Finland[J]. BMJ Open, 2018, 8(3): e019281. doi:10.1136/bmjopen-2017-019281.
[12] Demoly P, Passalacqua G, Pfaar O, et al. Management of the polyallergic patient with allergy immunotherapy: a practice-based approach[J]. Allergy Asthma Clin Immunol, 2016, 12: 2. doi:10.1186/s13223-015-0109-6.
[13] de Jong AB, Dikkeschei LD, Brand PLP. Sensitization patterns to food and inhalant allergens in childhood: a comparison of non-sensitized, monosensitized, and polysensitized children[J]. Pediatr Allergy Immunol, 2011, 22(2): 166-171. doi:10.1111/j.1399-3038.2010.00993.x.
[14] Kim BK, Kim JY, Kang MK, et al. Allergies are still on the rise? A 6-year nationwide population-based study in Korea[J]. Allergol Int, 2016, 65(2): 186-191. doi:10.1016/j.alit.2015.11.002.
[15] Suh MJ, Park JA, Chang SW, et al. Chronological changes in rhinitis symptoms present in school-aged children with allergic sensitization[J]. PLoS One, 2019, 14(1): e0210840. doi:10.1371/journal.pone.0210840.
[16] Fasce L, Tosca MA, Baroffio M, et al. Atopy in wheezing infants always starts with monosensitization[J]. Allergy Asthma Proc, 2007, 28(4): 449-453. doi:10.2500/aap.2007.28.2966.
[17] 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.
[18] 李亮, 郎媛媛, 张嘉懿, 等. 天津地区变应性鼻炎患儿吸入性变应原的流行病学特征分析[J]. 中国耳鼻咽喉头颈外科, 2017, 24(3): 140-143. doi:10.16066/j.1672-7002.2017.03.008. LI Liang, LANG Yuanyuan, ZHANG Jiayi, et al. Epidemiological characteristics of inhalational allergen in children with allergic rhinitis in Tianjin[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(3): 140-143. doi:10.16066/j.1672-7002.2017.03.008.
[19] 秦雅楠, 王琳, 姜彦, 等. 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. doi: 10.6040/j.issn.1673-3770.1.2018.030. QIN Yanan, WANG Lin, JIANG Yan, et al. Characteristics of the distribution of inhaled allergens in patients with allergic rhinitis in Qingdao from 2008 to 2017[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 67-72. doi: 10.6040/j.issn.1673-3770.1.2018.030.
[20] 邓月, 张健, 程寅, 等. 上海地区变应性鼻炎患者变应原特征分析[J]. 第二军医大学学报, 2020, 41(10): 1062-1067. doi:10.16781/j.0258-879x.2020.10.1062. DENG Yue, ZHANG Jian, CHENG Yin, et al. Analysis of allergen characteristics of allergic rhinitis patients in Shanghai, China[J]. Academic Journal of Second Military Medical University, 2020, 41(10): 1062-1067. doi:10.16781/j.0258-879x.2020.10.1062.
[21] 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. doi: 10.6040/j.issn.1673-3770.0.2018.120. PU Hongbo, DU Xiaodong. Allergen test results in 2 000 patients with allergic rhinitis in Wuxi District[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(4): 105-107. doi: 10.6040/j.issn.1673-3770.0.2018.120.
[22] 杨晴, 陆美萍, 程雷. 苏皖地区变应性鼻炎患者气传变应原皮肤点刺试验和血清特异性IgE检测的一致性及相关性分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 40-46. doi: 10.6040/j.issn.1673-3770.0.2020.279. YANG Qing, LU Meiping, CHENG Lei. Agreement and association analyses of skin prick testing and serum specific IgE assay for aeroallergen detection in patients with allergic rhinitis from Jiangsu and Anhui areas[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 40-46. 10.6040/j.issn.1673-3770.0.2020.279.
[23] 褚彦玲, 阎艾慧, 邰旭辉, 等. 沈阳地区AR患者血清过敏原分布及主要变应原IgE水平多因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(7): 502-506. doi:10.13201/j.issn.1001-1781.2018.07.006. CHU Yanling, YAN Aihui, TAI Xuhui, et al. Multiple-factor analysis of serum allergen distribution of patients with allergic rhinitis and level of main allergen IgE in Shenyang area[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(7): 502-506. doi:10.13201/j.issn.1001-1781.2018.07.006.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed