1050例过敏原皮肤点刺实验观察与护理

目的明确肇庆地区1050例过敏性鼻炎患者过敏原分布情况。方法对肇庆地区1050例过敏性鼻炎患者进行过敏原皮肤点刺试验。结果 1050例患者皮肤点刺试验阳性率为90.01%(947例)。其中主要致敏原为屋尘螨(907例)、粉尘螨(885例)。结论肇庆地区过敏性鼻炎主要由尘螨引起,这对该地区过敏性鼻炎的防治及有针对性的健康知识宣教有重要的指导意义。     

广州地区579例儿童过敏性鼻炎患者吸入过敏原的临床分析

目的通过皮肤点刺试验,考察广州地区过敏性鼻炎患儿吸入过敏原的种类及其分布,为诊断、预防和治疗儿童过敏性鼻炎提供参考。方法采用常见的11种吸入过敏原,对579例诊断为过敏性鼻炎患儿进行皮肤点刺试验,计算各种过敏原阳性率反应,并结合过敏原的种类、数量及患者年龄等临床资料进行分析。结果过敏原皮肤点刺试验阳性率为77.72%,以户尘螨、粉尘螨阳性率最高,分别为73.58%和74.78%。其次依次为狗毛>猫毛>德国小蠊>多支>霉菌Ⅱ>树Ⅰ>交链>杂草>葡萄球菌。只对单一类别的变应原呈阳性反应的有121例,占所有阳性例数的26.9%,其中主要为螨类,占107例。对两类变应原呈阳性反应的有261例,对三类或三类以上变应原呈阳性反应的有68例。此外,皮肤点刺阳性率与患者年龄相关(P<0.001),11岁~14岁儿童(86.5%)>7岁~10岁儿童(75.0%)>5岁~6岁儿童(64.1%)。结论分析结果提示户尘螨和粉尘螨阳性率显著高于其他过敏原,是广州地区儿童过敏性鼻炎最主要的吸入过敏原。过敏患者多数具有敏感体质,往往同时对多种过敏原产生过敏反应。值得注意的是皮肤点刺试验阳性率与患者年龄具有一定关系。     

抗过敏药物的作用及应用原则

过敏反应是一种变态反应性疾病,是当人体接触某些特殊的过敏原后所发生的异常反应,可由多种物质引起。其发作急促,多在1～10分钟后出现,但也有在几日后出现的。过敏反应常见的症状之一是荨麻疹,俗称风疹块,是皮肤粘膜的过敏性疾病,以皮肤或粘膜的局限性、暂时性或瘙痒性的潮红斑和风团为特征。抗过敏药物的作用 (1)异丙嗪(非那根、抗胺荨):口服吸     

尘螨过敏的分子诊断策略及管理

尘螨是主要的过敏原之一, 广泛分布于全球各地, 尤其是在家庭环境中, 屋尘螨、粉尘螨和热带无爪螨是最常见的种类。已知的尘螨致敏组分超过35种, 其中Der p 1、Der p 2和Der p 23是主要组分。目前, 临床主要采用粗提物进行皮肤点刺试验和血清特异性免疫球蛋白E(specific immunoglobulin E, sIgE)检测进行尘螨过敏的初步诊断, 不能精确识别具体的致敏组分。考虑到不同地区和人群对尘螨的致敏蛋白存在显著差异, 尘螨过敏原组分诊断在精确确定致敏组分方面显得尤为重要。这不仅对于过敏原的回避有指导意义, 也对确定尘螨免疫治疗方案至关重要。为加强对尘螨分子诊断的认识并促进我国变态反应学科与国际接轨, 本文对近期欧洲过敏与临床免疫学会发布的《过敏原组分诊断指导建议2.0》进行内容解读与阐释。     

科普新知

阻止过敏反应新方法 日本科学家也许已经发现了一种可以阻止哮喘、瘙痒和肿胀等病症的新方法。日本物理化学研究所免疫、过敏科学综合研究中心的黑崎知博负责的研究小组找到了对人体产生过敏反应至关重要的STIM1分子。研究人员发现，如果没有这种分子，人体就再也不会受到过敏原的影响。此前研究表明，人们会产生皮疹、打喷嚏、瘙痒和肿胀等过敏反应，主要因为灰尘和花粉等过敏原会导致钙在皮肤附近的肥大细胞当中聚集。     

环境因素致皮肤过敏与支气管哮喘发病之间关系的分析

目的　为了评价常见环境因素致皮肤过敏对支气管哮喘的影响 ,探讨哮喘的病因。方法　在收集某地区 5 91例支气管哮喘病例的基础上 ,对哮喘患者家系的共 2 4 83位成员逐一询问调查并进行皮肤过敏试验。用EPI5 0 1和SAS6 12程序软件进行资料的处理分析 ,主要计算优势比 (OR值 )等指标。结果　哮喘患者家系亲属的患病率为 14 6 % ,并且有随年龄增加而增加的趋势。皮试阳性率为 30 0 % ,其中 ,皮肤红疹阳性为 4 1 5 % ,而皮肤红斑阳性率为 9 6 %。皮试阳性、皮肤红疹和皮肤红斑均增加患哮喘的危险性 ,其优势比 (OR值 )分别为 1 4 6、1 83和 2 0 5 ,且均有高度显著性意义 (P <0 0 1)。结论　对环境中过敏原产生皮肤过敏者患哮喘的危险性增加 ,环境中过敏原是哮喘重要的危险因素之一。     

首饰引起的皮肤病

<正>接触性皮炎是由于对佩戴首饰中某种成分(如镍、铬、铜、色素等)发生过敏反应引起的皮肤病,表现为接触部位红斑、丘疹、瘙痒,严重者还可出现水疱、糜烂、渗出。一般来说,纯金纯银和珠宝首饰稳定性较好,发生过敏的几率较低。劣质重金属制品、镀金饰品引起皮炎的几率较高。对接触部位皮肤反复出现皮炎而原因不明者,应到医院皮肤科做金属斑贴试验,查找过敏原,避免敏感物质再接触。购买金属     

宜昌地区支气管哮喘患儿主要过敏原检测分析

目的 探讨宜昌地区支气管哮喘患儿主要过敏原分布特点及意义,为儿童变应性呼吸道疾病的防治提供理论依据.方法 采用变应原皮肤点刺诊断试剂盒对2011年3月～2012年2月在宜昌市中心人民医院儿童哮喘专家门诊诊治的218例哮喘患儿进行皮肤点刺试验.结果 (1)对218例哮喘患儿检测发现,总阳性率为74.31％(162例);(2)一种过敏原阳性率27.52％ (60例),两种或两种以上种过敏原阳性率72.48％(158例);(3)最常见过敏原的前四位为户尘螨(71.10％)、粉尘螨(70.64％)、狗毛(4.13％)、猫毛(3.67％); (4)户尘螨及粉尘螨过敏原皮肤点刺试验结果与哮喘急性发作严重程度有关.结论 全面检测并避免接触过敏原是有效控制儿童哮喘的重要环节,由于儿童过敏性哮喘急性发作严重程度与尘螨过敏原有关,避免接触户尘螨及粉尘螨可能成为预防中、重度哮喘急性发作的重要措施.     

广西地区儿童过敏原分析及防治对策

目的 探讨广西地区儿童过敏性疾病过敏原的种类、分布特点、与过敏性疾病的相关性和防治对策。方法 选取在2019年1月至2019年12月从广西各地到广西壮族自治区妇幼保健院厢竹院区就诊的4 329例0～14岁临床考虑患过敏性疾病的儿童入组,进行回顾性研究。采用过敏原皮肤点刺测试(SPT)的方法,用22种常见的过敏原测试。结果 4 329例临床考虑过敏性疾病儿童的过敏原阳性率为93.85%。食物过敏原前3位：鸡蛋(1 729例,39.94%)、牛奶(1 319例,30.47%)、小虾(1 216例,28.09%);吸入类过敏原前3位：尘螨(2 080例,48.05%)、蟑螂(1 282例,29.61%)、杂草(834例,19.27%)。儿童常见的食物类过敏原反应程度以1级为主,占80.52%,3、4级过敏反应主要由鸡蛋引起。吸入类过敏原反应程度以1级为主,占72.48%,3、4级过敏反应主要由尘螨引起。鸡蛋、牛奶、酵母、小麦、牛肉、黄豆、鳕鱼、小虾、蟹肉、花生、芒果、蟑螂、树、杂草、尘螨15种过敏原阳性率在各年龄组间分布差异有统计学意义(χ²=8.668～439.655...     

复方地黄消痔软膏对豚鼠皮肤过敏试验

目的观察复方地黄消痔软膏对皮肤有无过敏反应；方法取复方地黄消痔软膏0.2g涂抹白色豚鼠皮肤致敏接触6小时，共计三次，末次接触后14天取0．2g受试药进行激发接触，6小时后，去除药品，即刻观察，并于24、48、72小时连续观察动物有无异常反应；结果豚鼠皮肤用药后未见红斑和水肿，表明复方地黄消痔软膏对豚鼠皮肤无过敏反应；结论复方地黄消痔软膏外用治疗痔疮是安全的。     

西南地区家长自述婴幼儿食物过敏及其相关因素研究

目的 研究西南地区家长自述婴幼儿食物过敏现状及相关因素。 方法 采用分层整群随机抽样的方法抽取云贵川三省城乡6~24月龄婴幼儿3 344名作为对象,通过对婴幼儿看护人进行问卷调查收集婴幼儿食物过敏、致敏食物、婴幼儿及其家庭基本信息,初步探讨家长自述婴幼儿食物过敏流行趋势及特征,应用Logistic回归方法分析其相关因素。结果 家长自述婴幼儿食物过敏发生率为9.54%,城市(13.62%)高于农村(5.69%),差异有统计学意义(χ²=61.51,P＜0.05);性别及月龄组间无显著差异。主要致敏食物为鱼虾类(城市34.65%,农村30.63%)和蛋类(城市29.53%,农村27.03%),第3位致敏食物城乡有差异,城市是水果类(9.45%),农村是奶类(18.02%)。剖宫产儿食物过敏风险高于自然分娩儿(OR=1.53,P＜0.05)、4个月内非纯母乳喂养儿食物过敏风险高于纯母乳喂养儿(OR=2.17,P＜0.05)、断乳月龄早于4个月儿食物过敏风险高于4月龄后断乳儿(OR=1.55,P＜0.05)。 结论西南地区家长自述婴幼儿食物过敏发生率较高,值得进一步关注。自然分娩和母乳喂养可能有助于预防婴幼儿食物过敏。     

Human exposure to allergenic pollens: a comparison between urban and rural areas

Background

Pollinosis is found more frequently in urban areas than in rural environments. This could be partly related to the different types of pollen exposure in these dissimilar areas. The objective of this study was to compare the distribution of pollen in these environments across an urbanization gradient.

Methods

Daily pollen abundances were obtained in France using Hirst-type sensors. Sampling was conducted from January to June in 2003 and 2006 in a rural area, a semi-rural area and in two urban areas, which were characterized by several urbanization criteria.

Results

Total allergenic pollen abundance was higher in rural and semi-rural areas than in urban areas irrespective of the sampling year. Multivariate analyses showed that pollen exposures differed according to the type of area and were strongly explained by the urbanization gradient. Grass, ash, birch, alder, hornbeam, hazel and plantain pollen quantities exceeded the allergy threshold more often in rural settings than in urban areas. In urban areas, only plane pollen quantities exceeded the allergy threshold more often than in rural areas.

Conclusions

Allergenic pollen exposure is higher in rural areas than in urban areas, and the most abundant pollen in each area did not originated from the same taxa. This result should be taken into account in epidemiological studies comparing allergies in rural and urban areas to adapt the panel of pollen extracts for human environmental exposure. In addition, this study highlights that some ornamental trees produce a large number of allergenic pollens and provide new sources of aeroallergens.     

Nut Allergy: Clinical and Allergological Features in Italian Children

Background: Nut allergies are an increasingly frequent health issue in the pediatric population. Tree nuts (TN) and peanuts are the second cause of food anaphylaxis in Italy. Unfortunately, knowledge of the clinical characteristics of a TN allergy in Italian children is limited. Our study aimed to identify the clinical and allergological characteristics of Italian children with a nut allergy (TN and peanut). Methods: A retrospective observational analysis was performed on the clinical charts of children with a history of nut reaction referred to the allergy unit of the hospital from 2015 to 2019. The studied population was represented by children with a confirmed nut allergy based on positive prick by prick and/or serum-specific IgE to nut plus a positive nut oral food challenge. Demographic, clinical, and allergological features were studied and compared among different nuts. Results: In total, 318 clinical charts were reviewed. Nut allergy was confirmed in 113 patients. Most patients (85/113, 75%) had a familial history of allergy and/or a concomitant allergic disorder (77/113, 68%). Hazelnut and walnut were the more common culprit nuts observed in allergic children. Anaphylaxis was the first clinical manifestation of nut allergy in a high percentage of children (54/113, 48%). The mean age of the first nut reaction was statistically higher with pine nuts. Over 75% of children reported a single nut reaction. During the OFCs, the signs and symptoms involved mainly the gastrointestinal system (82/113, 73%) and resolved spontaneously in most cases. Severe reactions were not frequent (22/113, 19%). Conclusion: To our knowledge, this is the first Italian study that provided a comprehensive characterization of children with a nut allergy. These results are important for clinicians treating children with a nut allergy.     

A retrospective evaluation of heparin product reactions in patients with alpha-gal allergies

BackgroundAlpha-gal allergy, also known as red meat allergy or alpha-gal syndrome, can present after bites of certain tick species that contain galactose-alpha-1,3-galactose (alpha-gal) carbohydrate. Following this exposure, patients may develop an allergic reaction after mammalian meat consumption. Some heparin products are derived from porcine intestinal tissue, and it is therefore possible that administering these medications to a patient with an alpha-gal allergy may trigger a reaction.ObjectiveThe purpose of this study was to evaluate the incidence of reactions to porcine heparin products in patients with an alpha-gal allergy.MethodsA retrospective case series was conducted by review of electronic medical record data. Patients included were between the ages of 18 and 89 years, with a documented alpha-gal or red meat allergy and an admission to a hospital in the Sentara Healthcare system. The primary outcome was the incidence of allergic reactions upon exposure to heparin products in patients with a documented alpha-gal allergy.ResultsPatients with a documented alpha-gal allergy received a heparin product in 57 of 158 hospital visits (36.1%). Heparin products were tolerated in 56 of the 57 visits (98.3%). The incidence of an alpha-gal reaction to unfractionated heparin was 2.6% (1/39) while the incidence of an alpha-gal reaction to enoxaparin was 0% (0/22).Conclusion and RelevanceHeparin products were associated with a low incidence of alpha-gal reactions among patients with documented alpha-gal allergy. It is possible that enoxaparin poses less of a risk for reaction in these patients compared to unfractionated heparin.     

Iodine allergy--adverse reactions to contrast media

Essential of iodine allergy is not well-known in clinical practice and it might be combined with the adverse reactions of intravascular contrast media which contain iodine. Definition of iodine allergy should be cleared up because serum also contains iodine. One should make a difference between iodine allergy and adverse reactions of contrast media. Physiological role and occurrence of iodine in the organism was reviewed, moreover, allergic reactions caused by iodine-containing chemicals (iodine and tropomyosine allergy). The contrast medium types and their immediate and late reactions were considered together with the mechanism. According to the published data and author's own experience the iodine allergy should be considered as an iodine-protein complex allergy. The cause of adverse reactions of contrast media is the whole molecule and not the iodine content of it. No cross reaction can be observed between iodine and contrast media. Iodine allergy and contrast media reactions are entirely different phenomenons. It was referred to prevention and therapy, as well.     

Maternal Intake of Cow’s Milk during Lactation Is Associated with Lower Prevalence of Food Allergy in Offspring

Maternal diet during pregnancy and lactation may affect the propensity of the child to develop an allergy. The aim was to assess and compare the dietary intake of pregnant and lactating women, validate it with biomarkers, and to relate these data to physician-diagnosed allergy in the offspring at 12 months of age. Maternal diet during pregnancy and lactation was assessed by repeated semi-quantitative food frequency questionnaires in a prospective Swedish birth cohort (n = 508). Fatty acid proportions were measured in maternal breast milk and erythrocytes. Allergy was diagnosed at 12 months of age by a pediatrician specialized in allergy. An increased maternal intake of cow’s milk during lactation, confirmed with biomarkers (fatty acids C15:0 and C17:0) in the maternal blood and breast milk, was associated with a lower prevalence of physician-diagnosed food allergy by 12 months of age. Intake of fruit and berries during lactation was associated with a higher prevalence of atopic eczema at 12 months of age. Our results suggest that maternal diet modulates the infant’s immune system, thereby influencing subsequent allergy development.     

哈尔滨市香坊区学龄儿童牛乳蛋白过敏状况调查

目的了解儿童牛乳蛋白过敏(cowmilk protein allergy,CMPA)现状,为CMPA的防治和致敏食物的监管提供科学依据。方法以自编问卷、皮肤点刺试验、德国敏筛试纸实验作为初步诊断依据,对哈尔滨市5840名6～10岁学龄儿童进行筛查,分析牛乳蛋白过敏的影响因素。结果在有效答卷5720份中,自诉牛乳蛋白过敏的学生196例,其中47例皮肤点刺实验、德国敏筛试纸均呈阳性,CMPA发生率为0.82%。牛乳蛋白过敏多为皮疹,其次为胃肠过敏。除对牛乳蛋白过敏外,同时也对其他食物过敏。喂养方式、其他食物过敏情况、父母过敏情况是CMPA发生的影响因素。结论应采取母乳喂养、推荐食用低致敏婴儿配方粉等综合措施预防和治疗CMPA。     

Self-Selection Bias in an Epidemiological Study of Respiratory Health of a Rural Population

ABSTRACT

A common source of bias in epidemiological studies is self-selection or volunteer bias. The self-selection into cohorts for further investigation or for participation in a substudy may be an important source of selection bias. The objectives of this paper were to identify differences in selected demographic characteristics, individual and contextual factors, and variables related to respiratory health between study participants who were willing to participate in subsequent clinical and allergy testing and those who were not willing to participate. One hundred and fourteen households (207 individuals) from a small town and 54 households (99 individuals) from a nearby rural municipality participated in this study. One key informant from each household provided information about each adult in that household. The question being studied was: “We wish to find out more about respiratory health of rural people. We would like to invite you to perform breathing and allergy tests. Would you be willing to be contacted for breathing and allergy tests in a nearby location?” One hundred and four participants said “Yes” they would participate in the clinical studies, 144 said “No” they would not participate in the clinical studies, and 52 said “Would like more information” about the clinical studies. More than one half (53.8%) of male participants and 46.2% of female participants indicated that they would like to participate in breathing and allergy tests. A higher proportion of study participants (26.1% males, 30.8% females) in the lowest income category requested more information compared to those answering either “Yes” (15.7% for males, 20.5% for females) or “No” (18.5% males, 23.3% females) to the question being studied. Study participants who were willing to participate in further breathing and allergy tests had a higher proportion of self-reported chronic phlegm and ever had allergic reaction to things eaten than those who either said “No” or “Would like more information.” Among male study participants who said “Yes” to further participation, a higher proportion was exposed to one of the occupational exposures of interest compared to those who said either “No” or “Would like more information.” This pattern was not observed for females.     

Self-selection bias in an epidemiological study of respiratory health of a rural population

A common source of bias in epidemiological studies is self-selection or volunteer bias. The self-selection into cohorts for further investigation or for participation in a substudy may be an important source of selection bias. The objectives of this paper were to identify differences in selected demographic characteristics, individual and contextual factors, and variables related to respiratory health between study participants who were willing to participate in subsequent clinical and allergy testing and those who were not willing to participate. One hundred and fourteen households (207 individuals) from a small town and 54 households (99 individuals) from a nearby rural municipality participated in this study. One key informant from each household provided information about each adult in that household. The question being studied was: "We wish to find out more about respiratory health of rural people. We would like to invite you to perform breathing and allergy tests. Would you be willing to be contacted for breathing and allergy tests in a nearby location?" One hundred and four participants said "Yes" they would participate in the clinical studies, 144 said "No" they would not participate in the clinical studies, and 52 said "Would like more information" about the clinical studies. More than one half (53.8%) of male participants and 46.2% of female participants indicated that they would like to participate in breathing and allergy tests. A higher proportion of study participants (26.1% males, 30.8% females) in the lowest income category requested more information compared to those answering either "Yes" (15.7% for males, 20.5% for females) or "No" (18.5% males, 23.3% females) to the question being studied. Study participants who were willing to participate in further breathing and allergy tests had a higher proportion of self-reported chronic phlegm and ever had allergic reaction to things eaten than those who either said "No" or "Would like more information." Among male study participants who said "Yes" to further participation, a higher proportion was exposed to one of the occupational exposures of interest compared to those who said either "No" or "Would like more information." This pattern was not observed for females.     

Asthma,eczema, and reports on pollen and cat allergy among pupils in Shanxi province,China

Objectives To study self-reported asthma, eczema, and pollen and furry pet allergy among pupils (9–20 years) in Shanxi province, China, in relation to dietary and environmental factors. Methods A standardised questionnaire was distributed to pupils in two primary and two secondary schools, one in Taiyuan city (3.0 milj. inhabitants), the others in Qingxu county, a rural area 30 km outside Taiyuan. Totally, 2,116 pupils (90%) participated. Results Fifty percent were girls, 61% had been growing up on the countryside, 18% lived in Taiyuan now, 1.7% had ever had asthma, 0.8% had doctor’s diagnosed asthma, 1.4% pollen allergy, 1.7% cat allergy, and 0% had dog allergy. Multiple logistic regression was applied, controlling for age, gender, diet, indoor exposures, rural childhood, and current urban residency. Girls had less eczema (OR = 0.51; 95%CI 0.28–0.92). Pupils in the city had more eczema (OR = 5.05; 95% CI 1.11–23.3). Those with a rural childhood had less asthma (OR = 0.17; 95% CI 0.05–0.60), eczema (OR = 0.15; 95% CI 0.13–0.66) and pollen/cat allergy (OR = 0.50; 95%CI 0.25–0.99). None of the indoor variables was related to asthma or allergy. Children with frequent fruit consumption had less asthma (OR = 0.40; 95% CI 0.19–0.82) and pollen/cat allergy (OR = 0.49; 95% CI 0.29–0.84). Those with frequent fish consumption had less asthma (OR = 0.32; 95% CI 0.11–0.97). Those with frequent hamburgers consumption had more asthma (OR = 2.05; 95% CI 1.09–3.87) and eczema (OR = 1.85; 95% CI 1.12–3.04). Conclusion Asthma, eczema, and pollen or pet allergy was uncommon, compared with western countries and other areas in China. Pupils with a rural childhood had less asthma and allergy, which is consistent with the “hygiene hypothesis”. Fruit and fish consumption may reduce, and fast food consumption may increase the risk for asthma. Finally, the higher prevalence of asthma and eczema among younger children, born in the 1990s, indicates a cohort effect similar to that observed in western countries.