826例哮喘儿童尘螨皮肤过敏情况检测

尘螨是诱发支气管哮喘的重要变应原.近年来大量研究证实尘螨与支气管哮喘关系密切,它作为一种独立的危险致敏因素严重影响着哮喘的发病率.为此,我院于1996年5月至1999年5月对826例哮喘儿童进行尘螨过敏皮试检测,以了解哮喘与尘螨的关系.     

尘螨引起的哮喘病如何治疗

尘螨引起的哮喘病如何治疗江苏一位年轻妈妈来信问：我的孩子经过敏源检查得了尘螨性哮喘，请问什么是尘螨性哮喘，怎样治疗？尘螨性哮喘是哮喘病的一种。哮喘病是过敏引起的，导致小儿哮喘的物质称致敏原，种类繁多。通常患儿最易对某些食物如虾、蟹等；某些化学物质如油...     

不同职业人群中哮喘患者尘螨过敏情况的调查

目的了解不同职业人群中哮喘患者对尘螨的过敏情况。方法选取不同的职业人群并采用问卷调查方法，选择127名符合哮喘症状的志愿者，利用皮肤点刺试验（SPT）及血清特异性IgE（sIgE）检测其对尘螨变应原的过敏情况。结果工作中密切接触中药材的哮喘患者其SPT阳性率达60．0％，sIgE阳性率为51．1％；工作中密切接触粮食的哮喘患者其SPT阳性率达58．3％，sIgE阳性率为45．8％；而纺织车间工人中哮喘患者的阳性率为29．4％，sIgE阳性率20．6％；差异均有统计学意义（P〈0．05）。结论不同职业中哮喘患者对尘螨的过敏情况似与职业环境相关，应加强对特定职业人群的劳动保护。     

室内尘螨过敏原监控及其对儿童哮喘防控效果研究进展

过敏性哮喘患病率不断上升,与人群居住环境日趋封闭化有关.尘螨是居室内最主要的吸人性过敏原来源,并能导致人体致敏和哮喘发病.监测并认识室内尘螨过敏原暴露水平的规律,采取综合性方法对尘螨及其过敏原进行防控,是减少尘螨过敏性哮喘症状和发病的重要措施之一.该文综述了室内尘螨过敏原监控及其对儿童哮喘防控效果的研究进展.     

一起尘螨过敏性皮炎的调查处理

尘螨属于蚍螨科,普遍存在于人类居住的环境中.尘螨及其代谢产物是一种强烈的过敏源,可引起过敏性哮喘、过敏性鼻炎和特异性皮炎,严重危害人体健康,但目前尚无理想药物灭螨.作者通过对一起财务室尘螨过敏性皮炎的调查处理,对尘螨适宜的滋生增殖因素、财务室特殊环境中的防制方法进行了初步探讨. 1 基本概况 2001年9月铁路某财务室4名女工受不明害虫侵袭,先后发病,皮肤瘙痒,起皮疹,其办公桌面可见有针尖大小昆虫活动,经铁路医院皮肤科初步诊断为可疑虫媒过敏性皮炎,遂引起恐慌,人人自危,封闭办公室不敢办公,报请我站调查处理.     

标准化屋尘螨皮下免疫治疗儿童变应性鼻炎伴哮喘对血清屋尘螨sIgG4的影响及其临床意义

目的探究标准化屋尘螨皮下免疫治疗(SCIT)儿童变应性鼻炎(AR)伴哮喘的临床效果及对血清屋尘螨s Ig G4的影响,并分析屋尘螨sIgG4与主观指标的相关性。方法 2017年7月-2018年4月该院收治的60例AR伴哮喘患儿随机分为SCIT组和对照组各30例,均予以常规对症治疗,SCIT组另接受安脱达标准化屋尘螨变应原制剂上臂皮下注射治疗。于治疗4个月、1年后评估各项指标改善效果,包括症状评分、用药评分、疾病控制情况及血清屋尘螨sIgE、sIgG4水平。结果治疗前两组症状评分、用药评分、疾病控制情况及血清屋尘螨sIgE、sIgG4水平无统计学差异(P0.05),治疗4个月、1年后上述指标均明显改善(P0.05)。而与对照组相比,SCIT组治疗4个月、1年后症状评分、用药评分均显著低(P0.05);治疗1年后SCIT组病情控制效果更显著(P0.05);治疗4个月、1年后血清屋尘螨sIgG4水平显著高(P0.05)。Pearson分析显示治疗前,治疗4个月、1年患儿血清屋尘螨s Ig G4水平与症状评分、用药评分均呈明显负相关(P0.05),屋尘螨sIgE水平与之无明显相关性(P0.05)。结论标准化屋尘螨SCIT可有效改善AR伴哮喘患儿的临床症状,减少对症药物使用,调节血清屋尘螨sIgE、sIgG4水平,且屋尘螨sIgG4可作为评价SCIT疗效的客观指标。     

某军校尘螨致敏情况的调查

尘螨是引起Ⅰ型变态反应的主要致敏原之一。由于文献对尘螨的生态及对人的致敏性报道较少，基层防疫人员和广大指战员对此疏忽预防，导致以尘螨致敏引起支气管哮喘、过敏性鼻炎、螨虫皮炎等为主要原因就诊的人数增多。为此，我们于１９９７年５～６月对某军校进行了调查。现结合３００余例变态反应病例分析报告如下。１　材料与方法　（１）标本收集和尘螨检查：在该校８６处过敏患者及２０处健康干部、学员、战士的宿舍中，分别收集床尘（扑打枕头、床单、被、席等）和屋尘（扫室内柜面等浮尘），去除沙石、毛发等，取一刮匙粉尘（约５～１…     

尘螨是过敏原之王

尘螨是目前国内外学者公认的引起哮喘和过敏性鼻炎的重要因素。约50%~70%的过敏性哮喘、过敏性鼻炎都与尘醮有关。尘螨是一种微小的生物,体长只有0.3毫米,通常不能为肉眼所见。尘螨生命力很强,在温暖潮湿的环境中,只要有人体皮肤脱屑作为食物,尘螨就会茁壮成长并迅速繁殖。     

尘螨过敏的诊断与防治

本文集中论述了尘螨,主要是屋尘螨和粉尘螨的生活特性,并对其抗原特性,引起的过敏症状和临床诊断进行了阐述,提出了尘螨过敏的治疗原则和预防措施。     

尘螨皮试与儿童支气管哮喘关系及脱敏疗法的应用价值

为了探讨尘螨皮试与儿童支气管哮喘之间的关系及其临床治疗价值 ,对 72例和 1 0 0例分别患支气管哮喘和上呼吸道感染儿童患者 ,采用 1∶ 1 0 0的尘螨浸液进行皮试 ,观察皮肤反应 ,皮肤风团≥ 5mm者为阳性 ;将呈现阳性反应的支气管哮喘患儿随机分为脱敏治疗组和对照组 ,观察临床疗效。结果 :1支气管哮喘组和上呼吸道感染组中的皮试阳性例数分别为 65例 (90 .3% )和 2 4例 (2 4 .0 % ) ,两组的阳性率比较差异显著 (P<0 .0 1 ) ;2脱敏治疗组的有效率明显高于对照组 (P<0 .0 5) ,而 2年复发率明显低于对照组 (P<0 .0 1 )。提示 :尘螨过敏与儿童支气管哮喘关系密切 ,脱敏治疗对其有较好的疗效和预防发作的作用     

Childhood asthma and indoor allergen exposure and sensitization in Buffalo, New York

This nested case-control study examined the association between prevalent asthma and indoor allergen sensitization and/or exposure among children (aged 5-17 years) in Buffalo, New York. The study included a self-administered questionnaire, clinical interviews, skin allergen sensitivity tests and home dust sampling for house dust mites, cat, dog, cockroach and mouse allergens. After adjusting for multiple confounders, asthma cases had higher odds of being sensitized to Der p dust mites (odds ratio [OR]=1.94, 95% confidence interval (CI): 1.13-3.35), cat (OR=1.96, 95% CI: 1.13-3.39), or dog allergens (OR=1.89, 95% CI: 1.10-3.22) than the controls. A significantly positive association between asthma status presence of cat allergen in the child's mattress (ORs: 2.61, 95% CI: 1.09-6.28) was also found. Children with both sensitization and environmental exposure to cat allergens had higher odds of asthma (OR=7.08, 95% CI: 2.12-23.62) than those who were only sensitized to cat allergen (OR=2.31, 95% CI: 1.01-5.32) or had only home exposures (OR=1.47, 95% CI: 0.47-4.65). The association between allergen sensitization and asthma was more consistent than for home exposures. The findings help to confirm the role of allergen sensitization and home exposure in regard to asthma, and suggest that both, individually and jointly, are associated with asthma.     

Allergy to house dust mites and asthma

House dust mites have been shown to be important sources of indoor allergens associated with asthma and other allergic conditions. Asthma is a chronic respiratory disease that affects millions of people worldwide, and numerous scientific studies have shown that the prevalence of asthma is increasing. The most common dust mite species around the world include Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), Euroglyphus maynei (Em) and Blomia tropicalis (Bt). Over the past three decades, many important allergens from these species have been identified and characterized at the molecular level. The biological function of several house dust mite allergens has been elucidated, with many of them showing enzymatic activity. However, Bt allergens remain the least studied, even though this mite is very common in tropical and subtropical regions of the world, including Puerto Rico. Therefore, it is very important to include Bt in diagnostic and therapeutic strategies for house dust mite induced allergy and asthma, particularly in areas where Bt exposure and sensitization is high. Recombinant DNA technology, as well as other molecular biology and immunological techniques, have played a fundamental role in advances towards a better understanding of the biology of house dust mites and their role in allergic diseases. This kind of study also contributes to the understanding of the complex immunologic mechanisms involved in allergic reactions. The development of effective diagnostic and therapeutic approaches depends on the continuity of research of house dust mite allergens. The objectives of this review are to describe the most important aspects of house dust mite allergy and to acquaint the scientific community with the latest findings pertaining to house dust mite allergens, particularly those derived from Bt.     

哮喘患者居室内尘螨孳生种类、密度及其与抗原浓度的相关性研究

目的调查海口市哮喘患者居室孳生尘螨种类、密度及其与抗原浓度的相关性。方法采集哮喘患者居室尘样,在光镜下分类、计数,并用ELISA法测定Der P1浓度。结果制片616张,鉴定出16种螨,其中热带无爪螨占71.75%,屋尘螨占9.25%。哮喘患者居室尘样螨孳生密度和抗原浓度均高于正常对照组,差异均有统计学意义(P<0.01),二者间相关性显著(r=0.716,P<0.01)。结论热带无爪螨为本地区优势螨种,居室尘螨抗原浓度的检测似可替代活螨计数法评价室内尘螨孳生情况。     

Prevalence of bronchial hyperresponsiveness in children: the relationship between asthma and skin reactivity to allergens in two communities

A coastal population mainly reactive to house dust mite was compared with an inland population mainly reactive to other allergens to investigate whether exposure to house dust mite plays a part in initiating childhood asthma. Respiratory symptoms, asthma, bronchial hyperresponsiveness, hay fever and atopy were all more common in the dry inland area than in the humid coastal area. In both areas 38% of children were atopic. Coastal children had more skin reactivity to house dust mites and inland children were more reactive to grass pollen extracts. The findings suggest that the clinical presentation of asthma may be related more to the total burden of aeroallergens than to exposure to a particular allergen.     

过敏性鼻炎儿童发生支气管哮喘的影响因素分析

  目的  探讨过敏性鼻炎患儿发生支气管哮喘的危险因素，为鼻炎患儿发生哮喘的早期诊断、治疗和预防提供依据。  方法  纳入2019年11月至2020年10月在首都儿科研究所变态反应科门诊就诊的单纯过敏性鼻炎患儿(117例)和过敏性鼻炎继发哮喘患儿(111例)，采集病史，检测过敏原，对其临床特征、过敏原种类及危险因素等进行统计分析。  结果  单因素分析显示，鼻炎病程、鼻炎严重度、鼻炎类型、季节特征、宠物接触史、过敏性疾病家族史、霉菌、豚草、粉尘螨和户尘螨致敏与过敏性鼻炎患儿哮喘的发生相关(χ2值分别为6.15，8.79，3.99，9.44，5.17，4.43，8.48，10.38，6.18，5.31，P值均 < 0.05)。多因素Logistic回归分析显示，鼻炎严重度(OR=7.03)、过敏性疾病家族史(OR=8.24)、霉菌(OR=5.19)、粉尘螨(OR=25.25)与过敏性鼻炎患儿哮喘的发生呈正相关(P值均 < 0.05)，粉尘螨致敏患儿的风险最高。  结论  儿童过敏性鼻炎继发哮喘受多种因素影响，其中鼻炎严重度、过敏性疾病家族史、尘螨致敏是最主要的因素。     

螨过敏性哮喘患者居室一年四季尘螨密度与发病关系

目的探索螨过敏性哮喘患者一年四季居室内尘螨密度与哮喘发病的关系。方法对43例螨浸液皮试阳性的哮喘患者，每季度采集其卧室中床垫、被褥、沙发和枕头等处的积尘，用解剖显微镜计数尘螨，同时由患者逐日记录哮喘发作状况、早晚呼气峰流速值和用药情况等。结果居室一年四季间尘螨密度差异有显著性(P<0．05)。秋季尘螨密度最高[秋季(149．93±83．11)N／0．25m2，春季(45．64±28．50)N／0．25m2，夏季(65．25±23．41)N／0．25m2，冬季(8．11±3．56)N／0．25m2]，且秋季哮喘发作次数较频，峰流速较低，用药品种较多，与其他季节相比差异有显著性(P<0．05)。结论螨过敏性哮喘患者卧室中尘螨密度与哮喘发病有关，控制尘螨孳生有可能减轻或控制哮喘发作。     

皮肤点刺在过敏性鼻炎变应原检测中的应用

目的：了解过敏性鼻炎伴发或不伴发哮喘的变应原种类的差异性。方法：对收治的155例过敏性鼻炎件发或不伴发哮喘患者的变应原进行统计分析。结果：过敏性鼻炎和过敏性鼻炎伴发哮喘患者最常见的变应原是尘螨，其中粉尘螨分别占63．41％和75．34％；屋尘螨分别占65．85％和73．97％。差异均无统计学意义。结论：皮肤点刺试验对过敏性鼻炎的诊断及防治有重要的参考和指导意义。     

Environmental tobacco smoke, indoor allergens, and childhood asthma

Both environmental tobacco smoke and indoor allergens can exacerbate already established childhood albeit primarily through quite disparate mechanisms. In infancy and childhood, environmental tobacco smoke (ETS) exposure is associated with measures of decreased flow in the airways, bronchial hyperresponsiveness, and increased respiratory infections, but the relationship between ETS and allergy is poorly understood. Indoor allergens from dust mite, cockroach, and cat can be associated with asthma exacerbation in children sensitized to the specific allergens. The precise role of either ETS or indoor allergens in the development of asthma is less well understood. The strong and consistent association between ETS and asthma development in young children may relate to both prenatal and postnatal influences on airway caliber or bronchial responsiveness. Dust mite allergen levels predict asthma in children sensitized to dust mite. The tendency to develop specific IgE antibodies to allergens (sensitization) is associated with and may be preceded by the development of a T-helper (Th)2 profile of cytokine release. The importance of either ETS or indoor allergens in the differentiation of T cells into a Th2-type profile of cytokine release or in the localization of immediate-type allergic responses to the lung is unknown. This article evaluates the strength of the evidence that ETS or indoor allergens influence asthma exacerbation and asthma development in children. We also selectively review data for the effectiveness of allergen reduction in reducing asthma symptoms and present a potential research agenda regarding these two broad areas of environmental exposure and their relationship to childhood asthma.     

从化地区哮喘患儿变应原皮肤点刺试验的临床研究

【目的】 了解从化地区支气管哮喘发病相关的主要致敏变应原及其特点,指导选择特异性免疫治疗对象。 【方法】 对382 例支气管哮喘缓解期患儿,用德国默克公司生产的阿罗格食入组及吸入组点刺试剂进行皮肤点刺试验,组胺液为阳性对照,生理盐水为阴性对照。 【结果】 哮喘患儿皮肤点刺试验阳性率为 88.5%。吸入变应原总阳性率为81.2%,吸入变应原中以粉尘螨和屋尘螨阳性率居高,分别为77.2%和71.2%;食入变应原总阳性率为32.7%,居前两位的为小虾19.9%,花生6.3%。在吸入变应原中高龄组与低龄组比较差异有统计学意义(P<0.05),食入变应原中高龄组与低龄组比较差异无统计学意义(P>0.05)。哮喘或哮喘并鼻炎患儿均以螨类过敏最常见,两组间螨类、霉菌类、动物皮毛类、蟑螂及杂草变应原阳性率差异均无统计学意义。 【结论】 从化地区支气管哮喘患儿发病相关的吸入变应原主要是粉尘螨、屋尘螨,食入变应原主要是小虾、花生。3~14岁儿童哮喘患儿随着年龄增长,对吸入性变应原更为敏感。哮喘与哮喘并鼻炎患者共同的变应原主要是螨类,其次为霉菌类、动物皮毛类,为哮喘的防治提供了指导作用。     

Inactivation of Dust Mites,Dust Mite Allergen,and Mold from Carpet

Carpet is known to be a reservoir for biological contaminants, such as dust mites, dust mite allergen, and mold, if it is not kept clean. The accumulation of these contaminants in carpet might trigger allergies or asthma symptoms in both children and adults. The purpose of this study is to compare methods for removal of dust mites, dust mite allergens, and mold from carpet. Carpets were artificially worn to simulate 1 to 2 years of wear in a four-person household. The worn carpets were inoculated together with a common indoor mold (Cladosporium species) and house dust mites and incubated for 6 weeks to allow time for dust mite growth on the carpet. The carpets were randomly assigned to one of the four treatment groups. Available treatment regimens for controlling carpet contaminants were evaluated through a literature review and experimentation. Four moderately low-hazard, nondestructive methods were selected as treatments: vacuuming, steam-vapor, Neem oil (a natural tree extract), and benzalkonium chloride (a quaternary ammonium compound). Steam vapor treatment demonstrated the greatest dust mite population reduction (p < 0.05) when compared to other methods. The two physical methods, steam vapor and vacuuming, have no statistically significant efficacy in inactivating dust mite allergens (p = 0.084), but have higher efficacy when compared to the chemical method on dust mite allergens (p = 0.002). There is no statistically significant difference in the efficacy for reducing mold in carpet (p > 0.05) for both physical and chemical methods. The steam-vapor treatment effectively killed dust mites and denatured dust mite allergen in the laboratory environment.