变应性鼻炎患者10030例吸人性变应原谱分析

目的 调查不同年龄和性别的10 030例变应性鼻炎(allergic rhinitis,AR)患者的吸入性变应原谱分布情况.方法 采用21组共43种标准化变应原对54 813例慢性鼻炎患者进行皮肤点刺试验,诊断AR 10 030例,男性和女性均按年龄(以周岁记)分为4组,分别是:3～17岁、18～39岁、40 ～59岁以及≥60岁组(共8组),分析各组患者变应原分布状况.结果 ①不同年龄组患者对不同变应原反应呈阳性的例数分析显示,男性占前4位的变应原依次为粉尘螨、屋尘螨、艾蒿、德国小蠊,女性依次为粉尘螨、屋尘螨、艾蒿和藜.②患者阳性变应原个数的分布显示,不同年龄男性和女性患者,双重变应原阳性均位列首位,其次是三重变应原阳性或单一变应原阳性.③单一阳性变应原分析显示,男性3 ～17岁患者前4位是粉尘螨、屋尘螨、交链孢霉菌、艾蒿,其余年龄组男性患者阳性变应原前4位均是粉尘螨、屋尘螨、艾蒿和德国小蠊;女性3～17岁患者阳性变应原前4位是粉尘螨、屋尘螨、艾蒿和交链孢霉菌,18 ～39岁组是粉尘螨、屋尘螨、艾蒿和蒲公英,40～59岁组是粉尘螨、屋尘螨、艾蒿和混合树1,≥60岁患者前4位变应原是粉尘螨、屋尘螨、混合动物毛和艾蒿.④不同年龄和性别患者双重阳性变应原占首位的均是粉尘螨+屋尘螨.在3 ～17岁的患者中,对交链孢霉菌的双重阳性患者例数排在粉尘螨+屋尘螨之后,高于其他变应原组合.18岁以上的患者,交链孢霉菌双重阳性患者比例下降,而花粉类变应原、德国小蠊、粉尘螨或屋尘螨的双重阳性率上升.⑤不同性别患者三重阳性变应原居首位的是粉尘螨+屋尘螨+德国小蠊,其次是粉尘螨+屋尘螨+混合动物毛和粉尘螨+屋尘螨+艾蒿,其余组合少见.结论 尘螨、夏秋花粉及杂草花粉、交链孢霉菌和德国小蠊是导致我国北方地区AR的主要变应原,不同性别和年龄阶段的患者,致病变应原有所不同.

Prevalence of sensitization to aeroallergens in 10 030 patients with allergic rhinitis

Objective To investigate the main inhaled allergens in patients with allergic rhinitis.Methods Forty-three standardization allergens were used to perform skin prick test in 54 813 patients with chronic rhinitis.According to different gender and age groups,10 030 patients with allergic rhinitis were divided into eight groups.The distributions of different allergens in the eight groups were analyzed.Results ①The most common four allergens in male patients with allergic rhinitis were Dermatophagoides farina (Der f),Dermatophagoides pteronyssinus (Der p ),Mugwort and Blaterlia Germanica.Der f,Der p,Mugwort and Chenopodium album were the most common in female patients.②In all groups,patients with dual positive allergens were the most common,followed by triple positive allergens and single positive allergen.③ In single positive allergen group,the top four allergen in male 3 - 17 year group were Derf,Der p,Alternaria tenuis and Mugwort.In other male groups,the most common positive allergen were Derf,Der p,Mugwort and Blaterlia Germanica.Meanwhile,the top four positive allergens in female 3 - 17 year group were Derf,Der p,Mugwort and Alternaria tenuis,in 18 -39 year group were Der f,Der P,Mugwort and Dandelion,in 40 -59 year group were Der f,Der p Mugwort and mixed tree 1,in ≥ 60 year group were Derf,Der P,mixed animal hair and Mugwort.④ In dual positive allergens group,the most common allergen combination was Derf + Der p,followed by Alternaria tenuis in patient of 3 - 17 year group.⑤ In triple positive allergens group,the most common allergen combination was Derf + Der p + Blaterlia Germanica,followed by Derf + Derp + mixed animal hair.Conclusions Dust mites,flowers pollen,herbs,Alternaria tenuis and Blaterlia Germanica were the most common allergens in patients with allergic rhinitis.However,the frequencies of the allergens were different in different age groups.