| 摘要: |
| 目的 分析张家口地区18岁以下变应性鼻炎（AR）患者的变应原检测结果，了解本地区AR患者食入性、吸入性变应原的分布情况。方法 选择2019年4月至2020年11月就诊于河北北方学院附属第一医院耳鼻咽喉-头颈外科454例18岁以下有AR临床表现的患者作为研究对象，通过酶联免疫捕获法对患者血清进行15种变应原特异性IgE抗体检测，分析变应原在不同年龄段、性别、就诊月份的差异。结果 454例患者中，438例（96.48%）至少有1种变应原阳性，吸入性变应原阳性率为71.59%（325/454），其中艾蒿的阳性率最高（52.20%，237/454），其次为普通豚草（28.85%，131/454）、屋尘（28.85%，131/454）；食入性变应原阳性率为67.18%（305/454），其中以鸡蛋和牛奶的阳性率较高［分别为55.51%（252/454）、34.14%（155/454）］。变应原总阳性率、吸入性变应原总阳性率、食入性变应原总阳性率在1～6岁组、7～14岁组和15～17岁组之间差异有统计学意义（P<0.01）。两两比较显示，1～6岁组吸入性变应原阳性率低于7～14岁组（χ2=18.897，P<0.001），15～17岁组与1～6岁组、7～14岁组的差异均无统计学意义（χ2=3.959，P=0.047；χ2=0.818，P=0.366）；食入性变应原阳性率1～6岁组高于7～14岁组及15～17岁组，且7～14岁组高于15～17岁组，差异均有统计学意义（P均<0.001）。进一步比较分析发现，艾蒿、普通豚草、猫上皮、柳树、粉尘螨、屋尘螨、屋尘、鸡蛋、牛奶的阳性率在3个年龄组间差异均有统计学意义（P均<0.05）。男性AR患者艾蒿、普通豚草、猫上皮、交链孢霉变应原的阳性率均高于女性（P均<0.05）。AR患者主要以单一变应原致敏为主（29.45%，129/438），变应原阳性个数与患者的性别无关。AR患者就诊人数于8月份达到高峰（37.22%，169/454）。结论 张家口地区18岁以下AR患者的主要吸入性变应原为艾蒿、普通豚草、屋尘，食入性变应原为鸡蛋、牛奶。随着患者年龄的增长食入性变应原阳性率逐渐降低。AR患者以单一变应原为主，就诊人数于8月份达到高峰。 |
| 关键词: 变应性鼻炎 张家口 未成年人 食入性变应原 吸入性变应原 |
| DOI：10.16781/j.0258-879x.2021.08.0851 |
| 投稿时间：2021-04-22修订日期：2021-05-27 |
| 基金项目:河北北方学院科技研究重点项目（YB2018015），河北省研究生创新资助项目（CXZZSS2021129）. |
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| Allergen analysis in patients with allergic rhinitis under 18 years old in Zhangjiakou area |
| CHEN Rui,ZHAO Ying,AN Jing,MA Cui,SONG Hong-ru,ZHANG Yu-tuo* |
(Institute of Pathogen Biology and Immunology, Hebei North University, Zhangjiakou 075000, Hebei, China
*Corresponding author) |
| Abstract: |
| Objective To analyze the allergen detection results in patients with allergic rhinitis under 18 years old in Zhangjiakou area, and to understand the distribution of food and inhalant allergens in patients with allergic rhinitis in this area. Methods Totally 454 patients with clinical manifestations of allergic rhinitis under 18 years old who visited the Department of Otolaryngology, Head and Neck Surgery of the First Affiliated Hospital of Hebei North University from Apr. 2019 to Nov. 2020 were selected. The sera of patients were detected for 15 types of allergens to specific immunoglobulin E (sIgE) by enzyme-linked immunosorbent assay (ELISA) and the differences of allergens in different ages, genders and months of treatment were analyzed. Results Of the 454 patients, 438 were positive for at least 1 allergen (the positive rate was 96.48%), and the positive rate of inhalant allergens was 71.59% (325/454). The most prevalent inhalant allergen was mugwort (52.20%, 237/454), followed by common ragweed (28.85%, 131/454) and house dust (28.85%, 131/454). The positive rate of food allergens was 67.18% (305/454), the most universal food allergens were egg (55.51%, 252/454) and milk (34.14%, 155/454). There were significant differences in the total positive rates of allergens, inhalant allergens and food allergens among the 1-6 years old group, 7-14 years old group and 15-17 years old group (P<0.01). The positive rate of inhalant allergens in 1-6 year old group was lower than that in 7-14 year old group (χ2=18.897, P<0.001), but there were no significant differences between 15-17 year old group and 1-6 year old group or 7-14 year old group (χ2=3.959, P=0.047; χ2=0.818, P=0.366); the positive rate of food allergens in 1-6 year old group was higher than that in 7-14 year old group and 15-17 year old group, and the positive rate in 7-14 year old group was significantly higher than that in 15-17 year old group (all P<0.001). Further comparative analysis showed significant differences in the positive rates of mugwort, common ragweed, cat epithelium, willow, house dust, house dust mite, dust mite, egg and milk among the 3 age groups (all P<0.05). The positive rates of allergens in mugwort, common ragweed, cat epithelium and Streptomyces alternaria in male AR patients were higher than those in female AR patients (all P<0.05). AR patients were mainly sensitized by single allergen (29.45%, 129/438), and the number of positive allergens was not related to the gender. The visit number of AR patients peaked in August (37.22%, 169/454). Conclusion The main inhalant allergens of AR patients under 18 years old in Zhangjiakou area are mugwort, common ragweed and house dust, and the food allergens are eggs and milk. With the increase of patients’ age, the positive rates of food allergens decrease. The patients are mainly sensitized by single allergen and the visit number of AR peaks in August. |
| Key words: allergic rhinitis Zhangjiakou minors food allergens inhalant allergens |
