空气中优势真菌与儿童过敏性哮喘关系的研究

目的研究气传真菌与婴幼儿和儿童过敏性哮喘关系，及免疫治疗的疗效。方法采用空气中曝片调查法和曝皿调查法，观察气传真菌的品种和数量；对住院的３４５例哮喘患儿进行过敏原皮试；对真菌变应原皮试阳性病例进行免疫治疗。结果经１年的调查，曝片观察到的３５７４６个真菌孢子和曝皿观察到的１１８８个菌落，分属于４个亚门６０个种属，常见菌种有黑粉菌、交链孢菌、锈菌、枝孢芽枝菌、芽枝菌、皮思菌、大孢枝孢菌、黑曲菌、杂曲菌和烟曲菌。８５例婴幼儿哮喘患儿，３９例真菌变应原皮内试验阳性（４５．９％），２６０例儿童哮喘患儿，１０８例皮试阳性（４１．５％），总阳性率４２．６％。阳性率与真菌数量无关。真菌过敏性哮喘患儿的发病无明显季节特征。１０８例儿童哮喘中的８１例坚持免疫治疗，总有效率为８８．９％。结论气传真菌是小儿哮喘的重要致敏原；免疫治疗有一定疗效。

The relationship between airborne fungi and allergic asthma in children

Objective To study the relationship between the airborne fungi and allergic asthma in children. Methods Airborne fungi were isolated and identified by using gravitational precipitation method (sheet glass and culture plate of exposure) determination. Fungal allergen skin tests were performed on 345 children with bronchial asthma. Fungal immunotherapy was given to children who showed positive results on the skin tests. Results Observation of 35 746 grain of airborne fungi spores and 1 188 grain of fungi spores for one year revealed the following species of fungi: Ustilaginales, Aternaria, Uredinales, Clodoporium cladosporioides, Cladosporium, Pithomyces, Cladosporium macrocarpum, Aspergillus niger, Aspergillus versicolor and Aspergillus fumigatus. Thirth nine of 85 infants and young children with asthma (45.9%) showed positive skin test and 108 of 260 older children with asthma (41.5%) were positive for the skin tests; total positive rate was 42.61%. Eighty one in 108 cases of asthma completed fungal immunotherapy. Total effective rate was 88.9%. Conclusion The airborne fungi are important sensitization allergen for inducing asthma in children. Fungal immunotherapy is an effective method for treatment of asthma associated with fungi.