季节性过敏性鼻炎的主要致敏抗原

过敏性鼻炎分为季节性和常年性两类,前者主要由花粉过敏所致。本文探讨新疆地区季节性过敏性鼻炎除花粉外其他主要致敏抗原。关于霉菌与季节性过敏性鼻炎的关系已有专文论述(中华耳鼻咽喉科杂志16:79,1981)不再重复。螨属节肢动物门蜘蛛纲,主要有屋尘螨、粉尘螨和宇尘螨等,应用10~(-4)和10~(-5)mg/ml粉尘螨抗原浸液作皮内试验,阳性率为40％。屋内尘土为常年性吸入物抗原,曾报道与季节性过敏性鼻炎关系密切,花粉为原发的致     

尘螨与过敏性疾病的研究进展

随着人们居住环境的现代化,与尘螨有关的过敏性疾病发病率迅速增加.在变态反应学中,最值得注意的螨主要有尘螨和仓储螨,尘螨包括粉尘螨、户尘螨和欧宇尘螨;仓储螨中主要为热带无爪螨[1,2].居室内最优势的螨类是尘螨(粉尘螨和户尘螨).本综述中的尘螨专指粉尘螨和户尘螨.     

过敏性鼻炎儿童过敏原致敏性的相关因素研究

目的探讨过敏性鼻炎儿童过敏原致敏性的相关因素。方法了解陕西榆林地区儿童过敏性鼻炎患者主要的过敏原,采用病例对照研究的方法初步分析具有过敏性鼻炎症状儿童过敏原致敏性的相关因素。结果陕西榆林地区儿童过敏性鼻炎患者最主要的5项过敏原分别为沙蒿(59.8%)、粉尘螨(39.1%)、屋尘螨(24.9%)、交链孢菌属(19.8%)和蟑螂(17.9%)。多因素Logistic分析结果显示:家族史、过敏史、患有哮喘病、近邻沙蒿、空调、食用鱼虾、饲养动物等因素可增加过敏性鼻炎儿童的致病风险。结论沙蒿、粉尘螨、屋尘螨、交链孢菌属及蟑螂为陕西榆林地区儿童过敏性鼻炎的主要过敏原,家族史、过敏史、患有哮喘病、近邻沙蒿、空调、食用鱼虾、饲养动物等因素是具有过敏性鼻炎症状儿童过敏原致敏性的相关因素。     

皮肤点刺在过敏性鼻炎与哮喘变应原检测中的应用

目的了解过敏性鼻炎与哮喘的发病与变压原相关件。方法对我院2006年收治的过敏性鼻炎与哮喘伴发过敏性鼻炎病人的变应原进行统计分析。结果过敏性鼻炎与哮喘最常见的变应原是粉尘螨和屋尘螨。过敏性鼻炎:粉尘螨75.34%,屋尘螨73.97%,哮喘:粉尘螨63.41%,屋尘螨65.85%。两者相比,变应原无差异。52.90%过敏性鼻炎可发展成哮喘。结论发现和明确变应原是治疗和预防过敏性鼻炎与哮喘的关键。     

京津冀地区自报过敏性鼻炎病人吸入过敏原检测临床相关性分析

目的调查京津冀地区自报过敏性鼻炎(allergic rhinitis,AR)病人吸入过敏原的致敏率,分析阳性过敏原的年龄及性别差异,阐明过敏原与过敏性鼻炎症状、合并症的临床相关性。方法采用20种标准化过敏原,对2011年1月至2013年7月就诊于首都医科大学附属北京同仁医院的6 236例京津冀地区自报过敏性鼻炎病人进行皮肤点刺试验(skin prick test,SPT)。记录病人鼻部症状视觉模拟评分和哮喘、过敏性结膜炎病史。应用χ2检验比较不同年龄、性别病人的阳性过敏原及其致敏率,应用Spearman相关分析评价过敏原的临床相关性。结果 5 530例病人(88.7%)至少1种过敏原阳性。京津冀地区自报过敏性鼻炎病人最常见的过敏原是粉尘螨和屋尘螨,致敏率分别为47.3%和41.7%,其在自报过敏性鼻炎成年病人中的致敏率随年龄增长而下降,男性高于女性。尘螨致敏与过敏性鼻炎的持续性、严重程度均无关,但户外过敏原的致敏率在中重度过敏性鼻炎病人显著高于轻度过敏性鼻炎病人,在持续性过敏性鼻炎病人显著高于间歇性过敏性鼻炎病人。SPT中尘螨的皮肤指数与过敏性鼻炎症状无关,艾蒿、禾本花粉的皮肤指数与过敏性鼻炎症状正相关。≥54%的AR合并哮喘或过敏性结膜炎病人呈现4种以上过敏原阳性。尘螨、德国小蠊阳性与AR合并哮喘或过敏性结膜炎无相关性,户外过敏原(艾蒿、蒲公英、大豚草)的致敏率在AR合并哮喘或过敏性结膜炎病人中显著高于无合并症AR病人。结论尘螨是京津冀地区自报过敏性鼻炎病人中最常见的吸入过敏原。吸入过敏原致敏率在不同的年龄、性别差异有统计学意义。过敏性鼻炎伴合并症病人多重致敏率高。户外过敏原致敏率与过敏性鼻炎症状严重程度正相关,其在过敏性鼻炎合并症病人中的致敏率升高。     

河南地区2018年常见吸入性过敏原皮肤点刺试验结果分析

目的通过分析河南省2018年常见吸入性过敏原皮肤点刺试验结果,了解该地区常见吸入性过敏原的种类、致病情况及流行特点。方法选取2018年1—12月郑州大学第一附属医院收治的1 233例过敏性疾病患者,包括鼻炎78例,哮喘914例,其他过敏性疾病(皮炎、结膜炎等)241例。应用20种吸入性过敏原点刺液进行皮肤点刺试验,以生理盐水和组胺分别作为阴性对照和阳性对照,观察皮肤点刺结果。结果吸入性过敏原皮肤点刺试验阳性率为45.90%(566/1 233)。在1 233例过敏性疾病患者中,20种吸入性过敏原的阳性率排名前5位的依次为粉尘螨、屋尘螨、蟑螂、夏秋花粉1、柳树花粉,分别占24.41%、24.17%、17.36%、17.11%、15.98%。在78例鼻炎患者中,吸入性过敏原阳性率排列前5位的依次为粉尘螨、屋尘螨、夏秋花粉1、室内尘土、蟑螂,分别占42.31%、38.46%、24.36%、23.08%、17.95%。鼻炎患者对屋尘螨和粉尘螨同时过敏的阳性率为35.90%。在914例哮喘患者中,吸入性过敏原阳性率排列前5位的依次为粉尘螨、屋尘螨、夏秋花粉1、蟑螂、室内尘土,分别占24.62%、24.51%、17.40%、17.29%、11.60%。哮喘患者对屋尘螨和粉尘螨同时过敏的阳性率为20.90%。在241例其他过敏性疾病(皮炎、结膜炎等)患者中,吸入性过敏原阳性率排列前5位的依次为屋尘螨、粉尘螨、蟑螂、室内尘土、夏秋花粉1,分别占21.16%、20.75%、16.18%、14.52%、14.11%。夏秋季时,患者对屋尘螨和粉尘螨的过敏阳性率均高于冬春季时,差异有统计学意义(均P<0.05)。结论河南地区常见吸入性过敏原为尘螨、蟑螂、夏秋花粉1、柳树花粉,尘螨为主要吸入性过敏原且患者对尘螨过敏存在季节差异。     

天津地区过敏性疾病常见吸入过敏原调查分析

目的了解天津地区支气管哮喘和过敏性鼻炎患者变应原分布情况及主要致敏原状况，为天津地区过敏性疾病的流行病学研究和临床诊断治疗预防提供重要的依据。方法收集从2003年8月～2004年7月于我院呼吸科和耳鼻喉科就诊的支气管哮喘和过敏性鼻炎患者185例，分别进行常见吸入性过敏原皮肤过敏试验。结果皮肤试验阳性174例(94％)；其中室内尘土皮试阳性113例(61％)，粉尘螨阳性108例(58％)，多价霉菌Ⅰ阳性103例(56％)，多价垫料阳性98例(53％)，早春花粉Ⅰ阳性93例(50％)，夏秋花粉阳性92例(50％)，多价兽毛阳性81例(44％)，香烟阳性71例(38％)。结论室内尘土，粉尘螨和多价霉菌Ⅰ是天津地区导致外源性支气管哮喘、过敏性鼻炎发病最主要的致敏原。     

螨虫与支气管哮喘

目的对螨虫引起的支气管哮喘进行探讨。方法对屋尘螨、床螨、粉尘螨进行取样调查，采用螨的浸液对支气管哮喘患者做脱敏治疗。结果过敏性哮喘的致敏原以螨为最高；在临床上以擒螨、纳氏皱皮螨、粉尘螨三种浸液对皮试阳性的支气管哮喘患者进行免疫治疗，效果明显。结论螨在引起过敏性支气管哮喘病的过敏原中占很大比例，在治疗过程中应予以重视，尤其是做好预防工作。     

热带无爪螨致敏与儿童哮喘

热带无爪螨是常见的变应原,尤其是在热带和亚热带地区。儿童过敏性哮喘与热带无爪螨的暴露和流行关系密切,本文综述了热带无爪螨致敏对儿童哮喘的影响。     

成都市部分公共场所尘螨污染情况调查及其浸出液蛋白电泳分析

目的:调查成都市2002年～2004年部分公共场所尘螨的污染情况及其浸出液蛋白组成分析。方法:采自压面机、学生宿舍、饭店内样本,过筛后生理盐水涂片检查,将培养后粉尘螨用PBS液浸泡,取其浸出液进行蛋白电泳分析。结果:共收集标本112份,检出尘螨92例,阳性率为82%:其中压面机阳性率为88%,学生宿舍阳性检出率为81%,饭店阳性检出率为78%,三地尘螨的阳性检出率无显著性差异(P<0.05)。尘螨滋生密度最高是55个/克尘土,最低是12个/克尘土,平均为32.12±8.66个/克尘土。粉尘螨浸出液的蛋白电泳显示出三条带,其中一条带深染,另两条带浅染。结论:尘螨普遍存在于人类居住和工作的环境中。     

Indoor Allergen Levels and Household Distributions in Nine Cities Across China

Objective Chinese allergic subjects have high levels of sensitization to house dust mite (HDM) and other indoor allergens. This study quantifies common indoor allergen levels in Chinese households.
Methods Dust samples were collected from nine cities. Major allergens Der p 1 and Der f 1 from Dermatophagoides pteronyssinus and D. farinae, and specific antigens of Blomia tropicalis, Tyrophagus putrescentiae, Acarus siro, and cockroach species Blattella germanica and Periplaneta americana were measured by ELISA.
Results HDM allergens were found in dust samples from bedding in 95% of the Chinese households. The median levels varied from <0.006 to 9.2 μg/g of dust, depending on the city. The percentages of households having HDM allergen levels associated with the risk of developing allergy sensitization and asthma were 65% and 25%, respectively. Specific antigens of the storage mite and cockroach were only found in samples from the southern and tropical regions of China. Levels of mite allergens were generally higher in samples from bedding compared to samples from the living room, even for storage mites, whereas levels of cockroach antigens were higher in the living room samples.
Conclusion HDM allergens are present in bedding dust samples from most Chinese households. Cities in southern and central China have relatively high levels of HDM major allergens compared to cities in northern and western China. Antigens of storage mites and cockroaches are not as common as HDM allergens.     

1491例变态反应性疾病患者过敏原检测结果分析

目的调查分析常州地区变态反应性疾病患者常见过敏原的分布情况,比较不同年龄阶段、不同季节的过敏原有无差异。方法选取本院2016年1月～2018年1月收治的1491例变态反应性皮肤病患者,采用16种过敏原对患者进行皮肤点刺试验,生理盐水作阴性对照,以组胺作阳性对照。结果 1491例变态反应性皮肤病患者常见过敏原阳性率从高到低依次为:粉尘螨89.67%、户尘螨86.38%、油菜花7.11%、葎草花粉6.37%蟑螂4.76%、猫毛3.76%。过敏原的季节性来分析:粉尘螨、户尘螨、夏季最高;春天比其他三个季节低;各种花粉在夏季最低,蟑螂夏季最高。粉尘螨、户尘螨、猫毛、狗上皮、狗毛季节性变化不是太明显。粉尘螨、户尘螨、猫毛、牛奶、鸡蛋黄未成年组高于成年组(P0.05)。葎草花粉、油菜花粉、蟑螂成年组高于未成年组(P0.05)。过敏原在同年龄阶段的男女中间的差异不明显(P0.05)。结论在常州地区,最主要的过敏原为粉尘螨、户尘螨、油菜花,过敏原在不同季节、不同年龄阶段分布不同,为本地区常见变态反应性疾病的防治提供科学依据,皮肤点刺试验用于明确变态反应性疾病致敏原因安全有效。     

Mites and house dust mite allergy in bronchial asthma in Northern Zambia

Of 100 asthmatic patients prick tested for allergy to Dermatophagoides pteronyssinus, 88% were positive compared with only 14% of controls. A significantly greater proportion of dust samples from the houses of the asthmatics contained Dermatophagoides mites. The house-dust mite D. pteronyssinus, constituted 90% of the mites identified, other pyroglyphid mites, Cheyletus and Glycophagus making up most of the remainder. This study confirms that allergy to D. pteronyssinus is an important factor in the aetiology of asthma in Ndola. It is suggested that prevention of asthmatic attacks could be directed towards mite control and hyposensitization.     

郑州地区成人自报过敏性鼻炎患者吸入过敏原分析

  目的  了解郑州地区成人自报过敏性鼻炎(allergic rhinitis, AR)患者吸入过敏原致敏谱,分析不同年龄、性别及年份间阳性致敏原的差异,为AR的临床诊治提供参考。  方法  采用17种吸入过敏原试剂对2019年1月—2021年12月就诊于河南省人民医院过敏反应科门诊且自报为AR的成人患者2 305例进行皮肤点刺试验(skin prick test, SPT),比较不同性别、年龄、年份致敏原分布情况,并对阳性率进行分析。  结果  2 305例AR患者SPT阳性率为77.09%,常合并多种过敏原致敏,对4种及以上过敏原阳性者1 137例(49.33%);过敏原阳性率前5位依次为粉尘螨(42.78%)、户尘螨(38.61%)、梧桐花粉(35.27%)、蒿属花粉(34.27%)、葎草花粉(31.63%);18~30岁年龄组过敏原SPT阳性检出率达峰值(91.84%),阳性率随年龄增长而下降;不同性别间粉尘螨、户尘螨、油菜花、葎草花粉SPT阳性率比较差异有统计学意义(均P＜0.05);2019—2021年室内吸入过敏原粉尘螨、户尘螨阳性率呈逐年升高趋势,季节性吸入过敏原梧桐花粉、蒿属花粉、葎草花粉阳性率呈逐年下降趋势。  结论  AR患者常合并4种及以上吸入过敏原致敏;18~30岁SPT检出率达峰值;粉尘螨、户尘螨、梧桐花粉、蒿属花粉、葎草花粉是郑州地区成人自报AR患者最常见的致敏原。      

Mite populations in sydney household bedding with particular reference to nursery sheepskins.

Samples of dust were collected from three articles of household bedding in twenty-two Sydney homes during a six-week period beginning in mid December, 1973. Mites, sometimes in large numbers, were found in all homes. The mean number of mites recovered from nursery sheepskins (all woollen) was thirteen times as high as the mean number from other forms of adult or infant bedding sampled. The high mean number in sheepskins is the result of massively high populations in seven of the eighteen skins sampled. Hospital sheepskins were almost almost uniformly mite free. Far fewer mites were collected from cot mattresses which were either vinyl topped or covered with a plastic coverslip than were collected from a cot mattress with a cotton top alone.     

Indoor mite allergen levels, specific IgE prevalence and IgE cross-inhibition pattern among asthmatic children in Haikou, southern China

Background  Haikou locates in tropical island with unique mite propagation. The aim of this stuy is to determine mite allergens levels in Haikou, and to investigate the prevalence of mite specific IgE-sensitization and IgE cross-reactivity between house dust mites. 

Methods  Allergen and antigen concentrations against six mite species were tested by enzyme-linked immunosorbent assay (ELISA). Specific IgE concentrations and cross-inhibitions were measured with ADVIA Centaur^®.

Results  Allergen or antigen Dermatophagoides pteronyssinus (Der p 1), Blomia tropicalis (Blo t ) and Tyrophagus putrescentia (Tyr p) were detected in dust samples. Dermatophagoides farinae (Der f 1), Lepidoglyphus destructor (Lep d 2), and Acarus siro (Aca s ) were found in very few samples. Specific IgE tests showed high prevalence of sensitizations against all tested mites with high IgE levels to Der p, Der f, and Blo t. Storage mites, Blo t, Tyr p, Lep d, and Aca s, could inhibit Der p from 0 to 50%. Storage mites could inhibit Der f between 30% and 100%. Der p IgE could be inhibited by Der f with up to 90%, and vice versa. Der p could inhibit Blo t from 40% to 80%. Blo t was able to fully inhibit IgE binding to Lep d, Tyr p, and Aca s compared to partial inhibition by Der p.

Conclusions  Der p is the dominating mite and has the highest specific IgE prevalence among asthmatic children. Blo t represents an important source of storage mite sensitization and some patients may be independently sensitized to both Der p and Blo t. High prevalence of sensitization to Der f may be due to IgE-mediated cross-reactivity with Der p and Blo t.

     

186例哮喘儿童皮肤点刺实验结果分析及其意义

目的分析哮喘儿童皮肤点刺试验结果,了解儿童哮喘的过敏原种类及其在各年龄段的分布特点。方法选取2009年3月～2010年11月来本院哮喘门诊就诊的186例患儿临床资料进行回顾性分析。采用德国默克公司生产的变应原试液以生理盐水作阴性对照,组胺作阳性对照。结果186例患儿中SPT阳性150例,其中,i～3岁组56例,4～6岁组48例,7～14岁组46例,7～14岁组SPT阳性率最高,4～6岁组次之,1～3岁组最低,3组变应原阳性率比较,差异有统计学意义。在不同年龄组所有变应原中,以尘螨阳性率最高,屋尘螨达37．6％,粉尘螨36．6％;其次为室外霉菌34．4％。随着年龄的增长,患儿致敏的变应原阳性种类相对增多,10种以上变应原阳性者7～14岁组明显高于其他两组。结论所有变应原阳性率中以尘螨阳性率最高且受年龄影响,所以指导家长避免和减少与尘螨的接触是治疗和护理儿童哮喘的最基本措施。     

深圳儿童尘螨流行病学调查及致敏性分析

目的了解深圳地区儿童尘螨感染情况及其致敏性,为采取有力的控制措施及制定居室内空气微生物标准提供依据.方法随机抽取了部分专科门诊及两所幼儿园进行卫生学调查研究及分析.采用尘螨浸液皮试法,按标准判断.采用特殊滤过装置的吸尘器采集积尘,所采集的样本按常规滤过标准制作及进行光学显微镜镜下检查.结果61.3%过敏性疾病儿童对尘螨浸液皮试呈阳性反应,明显高于对照组(P＜0.01);患儿组居室环境尘螨检出率高于对照组(P＜0.01).对照组经采取干预措施后,尘螨检出率明显下降.结论尘螨是深圳儿童过敏性疾病的主要致敏原;尘螨普遍存在于深圳居民家庭环境中,主要生存于床垫、空调、被褥、沙发、空调滤网等地方.     

Effect of germicidal UV-C light(254 nm) on eggs and adult of house dustmites,Dermatophagoides pteronyssinus and Dermatophagoides farinae (Astigmata: Pyroglyhidae)

Objective

To examined the immediate and 24 hours post- irradiation germicidal effects of UV-C lamp on eggs and adults of house dust mites Dermatophagoides pteronyssinus (D. pteronyssinus) and Dermatophagoides farinae (D. farinae).

Methods

This study investigated the immediate and 24 hours post irradiation mortalities of adult mites exposed to UV-C at different exposure times (5 mins, 10 mins, 15 mins, 20 mins, 30 mins and 60 mins) and distances (10 cm, 25 cm, 35 cm, 45 cm and 55 cm). Fresh eggs of the 2 dust mites were also irradiated at 10, 35 and 55 cm for 0.5, 1, 2, 3, and 5 minutes, and observed daily post- irradiation for up to 7 days.

Results

Highest immediate mortality of 100% occurred with direct irradiation at 10 cm distance from UV-C lamp and for 60 mins, for both species of mites. The post 24 hours mean mortality rates were (58.4±17.4)% for D. pteronyssinus and (27.7±9.7)% for D. farinae when irradiated for 1 hour at 55 cm distance under UV-C lamp. When mites were irradiated in the presence of culture media, the highest mortality rates were lower compared to the direct irradiation; at 10 cm distance and 60 mins exposure, the mean mortality was (74.0±6.8)% for D. pteronyssinus and (70.3±6.7)% for D. farinae. Egg hatchability for both species of mites was also notably reduced by greater than 50% following irradiation.

Conclusions

Ultraviolet C irradiation is lethal to an array of organisms by damaging their nucleic acids (DNA and RNA). This study demonstrates the increasing mite mortalities with increasing exposure times and decreasing distances.     

变应性鼻炎舌下免疫与综合治疗的疗效观察

目的评价舌下尘疫苗螨疫苗治疗变应性鼻炎的疗效及安全性。方法采用单纯舌下尘螨含服(38例)与舌下尘螨疫苗含服配合药物治疗(38例)对比的方法,对76例尘螨过敏的变应性鼻炎患者进行了6个月的临床观察。结果治疗后两组患者的症状和体征评分与治疗前比较,差异有统计学意义(P<0.05)。单纯舌下含服组总有效率为63.16%,综合治疗组总有效率为86.84%,差异有统计学意义(P<0.05)。结论舌下含服尘螨疫苗治疗变应性鼻炎疗效好,且早期配合药物对症治疗能提高患者的依从性。