全国多中心支气管哮喘与过敏性鼻炎门诊患者对蟑螂变应原皮肤反应性的调查

目的 探讨支气管哮喘(简称哮喘)和过敏性鼻炎患者对常见蟑螂(美洲大蠊和德国小蠊)的过敏水平及一些流行病学的特点,同时比较对不同品种蟑螂间的研究,为深入研究昆虫过敏症奠定基础.方法 在全国范围内挑选了25家主要从事变应性疾病防治研究的三级甲等医院,对就诊于呼吸科、儿科或变态反应科门诊的哮喘和(或)过敏性鼻炎患者6081例,采用统一的调查问卷和蟑螂抗原皮肤点刺试验.结果 哮喘和过敏性鼻炎患者对两种蟑螂抗原的反应性是显著相关的,其阳性程度也显著相关(P<0.001);对美洲大蠊抗原的阳性率26.34%高于德国小蠊19.37%,南方地区阳性率高于北方与东部地区,对蜂螂过敏的患者大多在2级水平,强阳性患者极少;男性患者对美洲大蠊和德国小蠊的阳性率分别是28%与19%,均高于女性的25%与15%;成人对美洲大蠊和德国小蠊的阳性率30%与24%也显著高于儿童的23%与14%,对于蜂螂过敏的患者,约有90%同时对屋尘螨抗原阳性.结论 蟑螂是哮喘和过敏性鼻炎患者的主要变应原之一、对美洲大蠊的阳性率高于德国小蠊,成人的阳性率高于儿童,男性高于女性,蟑螂和屋尘螨之间可能存在着抗原交叉的现象.     

蟑螂过敏患者对蚕蛾与尘螨过敏原体外检测研究

目的探讨对蟑螂变态反应性疾病患者血清中蚕蛾与尘螨过敏原特异性免疫球蛋白E（SIgE）的情况以及它们的相互关系。方法采用荧光酶联免疫吸附试验,对本院呼吸科和变态反应科门诊,经变应原皮试和体外血清SIgE检测,德国小蠊（Blatella germanica）变应原结果均为阳性的33例患者,继续给予检测美洲大蠊（Periplaneta Americana）、蚕蛾（Bombyx）和屋尘螨（Dermatophagoides pteronyssinus）3种常见昆虫变应原SIgE的测定。结果在变态反应性疾病的患者中,对这4种昆虫变应原同时过敏的患者,对蟑螂和蚕蛾的过敏程度均为弱阳性（4级以下）,其SIgE值显著低于屋尘螨（P〈0．001）;通过线性回归分析,显示两种蟑螂与蚕蛾两两之间存在显著的正相关关系（P〈0．001）,而蟑螂、蚕蛾与屋尘螨之间均不存在相关关系。结论对于蟑螂、蚕蛾和屋尘螨同时过敏的患者,屋尘螨的过敏程度最高;德国小蠊、美洲大蠊与蚕蛾之间可能具有共同的IgE结合成分。     

支气管哮喘患者对三种蟑螂变应原的特异性血清学反应

目的探讨支气管哮喘患者对常见蟑螂的过敏水平及不同品种蟑螂间可能存在的交叉抗原性及其程度。方法分别提取美洲大蠊、黑胸大蠊和德国小蠊抗原,用ELISA法测支气管哮喘患者血清中三种蟑螂抗原的特异性IgE抗体（sIgE）。结果美洲大蠊、黑胸大蠊和德国小蠊sIgE阳性率分别为23．5％、16．0％和14．0％。美洲大蠊与黑胸大蠊、德国小蠊间血清学反应符合率分别为74．0％和73．5％,黑胸大蠊与德国小蠊间血清学反应符合率为85．0％。美洲大蠊头、体部抗原sIgE阳性率分别为17．5％和14．5％,头体部抗原间血清学反应符合率为86．0％;黑胸大蠊头、体部抗原sIgE阳性率分别为12．5％和10．5％,头体部抗原间血清学反应符合率为88．0％;ELISA交叉抑制实验显示,三种蟑螂相互之间均存在较明显的交叉抑制现象。结论蟑螂是诱发支气管哮喘的主要变应原之一。三种蟑螂之间及美洲大蠊、黑胸大蠊不同部位之间均存在一定程度的交叉抗原性成分,即具有共同的IgE结合组分。     

135例成人过敏原皮肤点刺试验的过敏原初步分析

目的了解成人哮喘及慢性咳嗽患者过敏原分布情况。方法选取112例患者（ig括46例哮喘患者及66例慢性咳嗽患者）及23名正常对照者过敏原皮肤点刺试验（SPT）结果分为哮喘组、慢性咳嗽组及正常对照组进行分析。结果哮喘组中,最常见的变应原依次为粉尘螨、屋尘螨、热带螨、狗毛、猫毛、德国小蠊,其中粉尘螨、屋尘螨的阳性率均在60％以上;慢性咳嗽组中,最常见的变应原依次为屋尘螨、粉尘螨、热带螨、猫毛、德国小蠊、美洲大蠊等;哮喘组SPT阳性率高于慢性咳嗽组,慢性咳嗽组SPT阳性率高于正常对照组,差异均具有统计学意义。典型哮喘与咳嗽变异性哮喘SPT阳性率无明显差别。结论引起哮喘与慢性咳嗽的主要变应原因素为屋尘螨、粉尘螨、热带螨,SPT在变应性疾病的变应原因素诊断中具有一定意义。     

蟑螂过敏患者对蚕蛾与尘螨过敏原体外检测研究

目的 探讨对蟑螂变态反应性疾病患者血清中蚕蛾与尘螨过敏原特异性免疫球蛋白E(SIgE)的情况以及它们的相互关系.方法 采用荧光酶联免疫吸附试验,对本院呼吸科和变态反应科门诊,经变应原皮试和体外血清SIgE检测,德国小蠊(Blatella germanica)变应原结果均为阳性的33例患者,继续给予检测美洲大蠊(Periplaneta Americana)、蚕蛾(Bombyx)和屋尘螨(Dermatophagoides pteronyssinus)3种常见昆虫变应原SIgE的测定.结果 在变态反应性疾病的患者中,对这4种昆虫变应原同时过敏的患者,对蟑螂和蚕蛾的过敏程度均为弱阳性(4级以下),其SIgE值显著低于屋尘螨(P＜0.001);通过线性回归分析,显示两种蟑螂与蚕蛾两两之间存在显著的正相关关系(P＜0.001),而蟑螂、蚕蛾与屋尘螨之间均不存在相关关系.结论 对于蟑螂、蚕蛾和屋尘螨同时过敏的患者,屋尘螨的过敏程度最高;德国小蠊、美洲大蠊与蚕蛾之间可能具有共同的IgE结合成分.     

135例成人过敏原皮肤点刺试验的过敏原初步分析

目的 了解成人哮喘及慢性咳嗽患者过敏原分布情况.方法 选取112例患者(包括46例哮喘患者及66例慢性咳嗽患者)及23名正常对照者过敏原皮肤点刺试验(SPT)结果分为哮喘组、慢性咳嗽组及正常对照组进行分析.结果 哮喘组中,最常见的变应原依次为粉尘螨、屋尘螨、热带螨、狗毛、猫毛、德国小蠊,其中粉尘螨、屋尘螨的阳性率均在60％以上;慢性咳嗽组中,最常见的变应原依次为屋尘螨、粉尘螨、热带螨、猫毛、德国小蠊、美洲大蠊等;哮喘组SPT阳性率高于慢性咳嗽组,慢性咳嗽组SPT阳性率高于正常对照组,差异均具有统计学意义.典型哮喘与咳嗽变异性哮喘SPT阳性率无明显差别.结论 引起哮喘与慢性咳嗽的主要变应原因素为屋尘螨、粉尘螨、热带螨,SPT在变应性疾病的变应原因素诊断中具有一定意义.     

无锡地区成人过敏性鼻炎患者吸入性过敏原分析

目的 分析无锡地区成人过敏性鼻炎患者吸入性过敏原分布情况.方法 采用德国MEDIWISS公司生产的AllergyScreen试剂盒检测356例过敏性鼻炎患者血清中的吸入性过敏原.结果 户尘螨阳性率79.5％、屋尘阳性率57.3％、猫毛发皮屑阳性率7.0％、狗毛发皮屑阳性率13.2％、矮豚草阳性率11.5％、桑树阳性率4.8％、蟑螂阳性率3.9％、霉菌(点青霉、分枝孢霉、烟曲霉、交链孢霉)阳性率26.4％,栎榆、梧桐柳、三角叶杨阳性率9.0％.结论 无锡地区成人过敏性鼻炎患者最常见的吸入性过敏原是户尘螨和屋尘,减少户尘螨和屋尘对疾病的控制具有积极作用.     

广州地区儿童呼吸道变态反应性疾病常见变应原的流行病学分析

目的了解广州地区呼吸道变态反应性疾病儿童常见变应原,为预防和治疗儿童变应性疾病提供科学依据。方法选择2006年2月至2007年3月在广州医学院第一附属医院儿科门诊符合支气管哮喘（简称哮喘）和（或）变应性鼻炎（简称鼻炎）的广州地区5岁以上患儿183例,其中男132例,年龄（8．2±0．2）岁;女51例,年龄（7．8±0．4）岁;哮喘并鼻炎者105例,哮喘患儿58例,仅鼻炎患儿20例。所有对象均进行皮肤变应原点刺试验（SPT）及血清总IgE、特异性IgE和嗜酸粒细胞计数。结果在入选的183例患儿中．SPT阳性（≥1个变应原阳性）157例（85．8％）,各变应原阳性率为5．5％～75．4％,变应原中以屋尘螨致敏的阳性率最高,达79．8％,其次为粉尘螨与热带螨,分别为72．7％与65．0％,其余变应原阳性率依次为：狗毛48．6％,美洲大蠊47．0％,猫毛34．4％．德国小蠊29．5％,霉菌类19．7％,花粉类15．9％,艾蒿7．7％,豚草5．5％。螨过敏阳性患儿有146例,常合并其他一种或多种变应原阳性（115例,78．8％）,而螨过敏阴性患儿（37例,20．2％）中仅有11例（29．7％）合并其他一种或多种变应原阳性（X2=33．099,P〈0．001）,差异有统计学意义。各年龄组发病率特点：高龄组（〉7岁）SPT阳性率为82．3％,高于低龄组（≤7岁）（79．3％）,两组间SPT阳性率的差异有统计学意义（P〈O．05）。在吸入变应原种类的比较中,高龄组在螨类过敏阳性率、猫毛与狗毛阳性率、蟑螂阳性率均高于低龄组,差异有统计学意义（P〈0．05）;两组在霉菌类及花草类阳性率的差异无统计学意义。哮喘并鼻炎、哮喘、鼻炎3组患儿均以螨类过敏最为常见,3组间除蟑螂SPT阳性率差异有统计学意义外（P〈0．05）,螨类、动物皮毛类、霉菌及花草类的变应原阳性率差异均无?     

北京地区成人过敏性鼻炎吸入过敏原谱分析

目的确定适合北京地区成人过敏性鼻炎的主要吸入过敏原,以作为流行病学过敏原筛查及诊断时应用。方法选择北京居民中明确诊断为过敏性鼻炎的成人患者265例,对其吸入常年性、季节性两组共16种标准化过敏原进行检测,分析主要过敏原排序。结果常见过敏原阳性率排序分别为屋尘螨40.38%、粉尘螨37.36%、艾蒿23.02%、树Ⅰ21.89%、猫18.49%、葎草18.11%、树Ⅱ17.36%、蟑螂16.60%、矮豚草15.85%、霉菌Ⅰ13.58%、狗12.45%。屋尘螨和粉尘螨阳性率高度相关（r=0.737,P〈0.01）。结论尘螨、夏秋花粉、春季花粉、宠物皮屑、蟑螂、霉菌是北京地区成人过敏性鼻炎常见过敏原,蟑螂及宠物过敏应引起重视。在本地区进行成人过敏性鼻炎吸入过敏原流行病学调查时,组合可包括屋尘螨、艾蒿、葎草、树Ⅰ、树Ⅱ、蟑螂、猫、霉菌Ⅰ。     

广州地区儿童呼吸道变态反应性疾病常见变应原的流行病学分析

目的 了解广州地区呼吸道变态反应性疾病儿童常见变应原,为预防和治疗儿童变应性疾病提供科学依据.方法 选择2006年2月至2007年3月在广州医学院第一附属医院儿科门诊符合支气管哮喘(简称哮喘)和(或)变应性鼻炎(简称鼻炎)的广州地区5岁以上患儿183例,其中男132例,年龄(8.2-4-0.2)岁;女51例,年龄(7.8士0.4)岁;哮喘并鼻炎者105例,哮喘患儿58例,仅鼻炎患儿20例.所有对象均进行皮肤变应原点刺试验(SPT)及血清总IgE、特异性IgE和嗜酸粒细胞计数.结果 在人选的183例患儿中,SPT阳性(≥1个变应原阳性)157例(85.8%),各变应原阳性率为5.5%～75.4%,变应原中以屋尘螨致敏的阳性率最高,达79.8%,其次为粉尘螨与热带螨,分别为72.7%与65.0%,其余变应原阳性率依次为:狗毛48.6%,美洲大蠊47.0%,猫毛34.4%,德国小蠊29.5%,霉菌类19.7%,花粉类15.9%,艾蒿7.7%,豚草5.5%.螨过敏阳性患儿有146例,常合并其他一种或多种变应原阳性(115例,78.8%),而螨过敏阴性患儿(37例,20.2%)中仅有11例(29.7%)合并其他一种或多种变应原阳性(x2=33.099,P<0.001),差异有统计学意义.各年龄组发病率特点:高龄组(>7岁)SPT阳性率为82.3%,高于低龄组(≤7岁)(79.3%),两组间SPT阳性率的差异有统计学意义(P<0.05).在吸入变应原种类的比较中,高龄组在螨类过敏阳性率、猫毛与狗毛阳性率、蟑螂阳性率均高于低龄组,差异有统计学意义(P<0.05);两组在霉菌类及花草类阳性率的差异无统计学意义.哮喘并鼻炎、哮喘、鼻炎3组患儿均以螨类过敏最为常见,3组间除蟑螂SPT阳性率差异有统计学意义外(P<0.05),螨类、动物皮毛类、霉菌及花草类的变应原阳性率差异均无统计学意义.结论 过敏性因素是儿童呼吸系统变态反应性疾病发病的重要诱发因素,在广州地区哮喘和(或)鼻炎儿童可以通过SPT检查明确过敏原,最常见的变应原是屋尘螨、粉尘螨及热带螨.随着年龄增长,呼吸道变态反应性疾病患儿对吸入性变应原更为敏感.鼻炎、哮喘、哮喘并鼻炎患儿有共同的变应原.研究不同年龄段变态反应性疾病患者的变应原特征,有助于对疾病的早期诊断和早期干预.     

The role of cockroach allergens in asthma

Cockroach allergy has been recognized as an important cause of asthma. Cockroach asthma has been described as a more severe disease, associated with perennial symptoms and high levels of total IgE. Cockroaches produce several allergens that induce sensitization, and exposure to high levels of cockroach allergens in the home is a major risk factor for symptoms in sensitized individuals. Previously identified allergens from Blattella germanica and Periplaneta americana, the most important domiciliary species, include Bla g 2 (inactive aspartic protease), Bla g 4 (calycin), Bla g 5 (glutathione-S-transferase), Bla g 6 (troponin), the Group 1 cross-reactive allergens Bla g 1 and Per a 1, Per a 3 (arylphorin), and Per a 7 (tropomyosin). Strategies for decreasing environmental exposure to cockroach have been recently investigated. The results suggest that a sustained decrease in cockroach allergen levels is difficult to accomplish, even after successful extermination of cockroach populations. Cockroach allergens have been cloned and produced as recombinant proteins in high-level expression vectors. The use of recombinant cockroach allergens should allow mechanisms of cockroach-induced asthma to be investigated and may lead to the development of new approaches to asthma treatment in the future.     

Survey of indoor cockroaches in some dwellings in Bangkok

This study aimed to investigate the species distribution of indoor cockroaches in dwellings in Bangkok. Commercial sticky traps were used to catch cockroaches in 128 private residences (40 single houses, 49 townhouses, 39 apartments), 34 offices, and 30 small groceries. The cockroaches were identified as Periplaneta americana, Supella longipalpa, Blattella germanica, Neostylopyga rhombifolia, P. brunnea, P. australasiae, Pycnoscelus surinamensis, and B. lituricallis; two were unidentified species. The most common species were P. americana, S. longipalpa and B. germanica--most of which were nymphal stages. P. americana and S. longipalpa infested all kinds of buildings, especially private residences (50.0% and 17.2%, respectively) and offices (61.8% and 58.8%, respectively); they were also found mostly (15.1%) in mixed infestation and with no predominant species. B. germanica (26.7%) were significantly predominant in groceries. Air conditioners have no influence on cockroach distribution.     

Isolation of bacteria with antibiotic resistance from household cockroaches (Periplaneta americana and Blattella germanica)

Cockroaches may harbor and disseminate microorganisms to the environment. In this study, Periplaneta americana and Blattella germanica were collected from 40 households in Kaohsiung City and Kaohsiung County, Taiwan. Cockroach infestation was found in 50% of the studied households and 226 cockroaches (123 P. americana and 103 B. germanica) collected by trapping. P. americana was more often found in the kitchen (70.7%) whereas B. germanica in the storage room (51.5%) and kitchen (36.9%). There was no significant difference between the percentages of P. americana (99.9%) and B. germanica (98.0%) carrying bacteria. A total of 25 species of bacteria was isolated from P. americana and only 21 from B. germanica. Antibiotic resistance was found in Staphylococcus aureus, Enterococcus species, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Serratia marcescens, and Proteus species isolated from the cockroaches. These findings suggest a potential role of cockroaches in the transmission of pathogenic bacteria with antibiotic resistance in households.     

Repellent activity of essential oils against cockroaches (Dictyoptera: Blattidae, Blattellidae, and Blaberidae) in Thailand

Seven commercial essential oils extracted from the plant species Boesenbergia rotunda (L.) Mansf., Citrus hystrix DC., Curcuma longa L., Litsea cubeba (Lour.) Pers., Piper nigrum L., Psidium guajava L. and Zingiber officinale Roscoe, and naphthalene as a control, were evaluated for repellent activity against the three cockroach species Periplaneta americana (L.), Blattella germanica (L.) and Neostylopyga rhombifolia (Stoll) under laboratory conditions. The essential oil derived from Citrus hystrix showed the best repellency over other candidate essential oils and naphthalene. The essential oil of Citrus hystrix exhibited complete repellency (100%) against P. americana and B. germanica, and also showed the highest repellency (among the essential oils tested) of about 87.5% against N. rhombifolia under laboratory conditions. In the field, Citrus hystrix essential oil formulated as a 20% active ingredient in ethanol and some additives provided satisfactory repellency of up to 86% reduction in cockroaches, mostly P. americana and N. rhombifolia with a residual effect lasting a week after treatment. Citrus hystrix essential oil has good potential for being used as a cockroach repellent. Further improvements in efficacy and residual activity may be realized with appropriate formulations.     

Cockroach surveys in the Northern region of Thailand and Guangxi Province of China

Cockroach surveys were carried out in three provinces of the Northern region of Thailand: Chiang Mai, Chiang Rai, and Mae Hong Son, and three cities of Guangxi Province of the People's Republic of China: Nanning, Huangjiang, and Hechi. Sticky traps were used for cockroach sampling in these surveys. At least 30 houses in each province or city were randomly sampled. Traps were placed in kitchen areas for 2 nights. In Thailand, a total of 214 cockroaches was caught in 65 of 112 houses (59.4%) with an average of 1.9 cockroaches/ house. There were 5 species of cockroach caught: Periplaneta americana (32.7%), Pycnoscelis surinamensis (29%), Periplaneta australasiae (18.2%), Periplaneta brunnea (17.3%), and Periplaneta fuliginosa (2.8%). In China, a total of 198 cockroaches was caught in 67 of 99 houses (67.5%) with an average of 2 cockroaches/ house. There were 6 species of cockroaches caught: P. americana (53%), Py. surinamensis (12.6%), P. brunnea (12.1%), P. australasiae (12.1%), P. fuliginosa (9.6%), and Neostylopyga rhombifolia (0.6%). According to the surveys in this study, there were no significant differences among the number of cockroaches caught in the six locations of the two countries (p > 0.05). P. americana was the most abundant cockroach species in both countries.     

Cockroaches (Periplaneta americana and Blattella germanica) as potential mechanical disseminators of Entamoeba histolytica

Since cockroaches feed on feces, they may disseminate infective agents with the fecal-oral route. A field survey and experiments were conducted to determine the role of cockroaches in the dissemination of Entamoeba histolytica. Periplaneta americana (n=299) and Blattella germanica (n=29) were collected from 11 primary schools in an urban area of South Taiwan. E. histolytica/E. dispar cysts were found on the cuticle and/or in the digestive tract of P. americana (25.4%) whereas cysts were only isolated from the digestive tract of B. germanica (10.3%). E. histolytica cysts were found on the cuticle and/or in the digestive tract of both species after exposure to 1000 or 100 cysts/g feces for 24 h. These findings indicate that cockroaches may harbor the E. histolytica cysts and play a role as potential mechanical disseminators.     

辽宁地区过敏性支气管哮喘患者变应原分布特征

目的了解辽宁地区2003至2007年过敏性支气管哮喘（简称哮喘）患者变应原的种类、分布和反应强度。方法应用12种标准化变应原（Alutard⑧）对2003至2007年我院变态反应免疫治疗中心的辽宁地区哮喘初诊患者进行变应原皮肤点刺试验（skinpricktest,SPT）。结果5年哮喘患者SPT阳性率为25．24％（1817／7200）。每年SPT阳性率分别为16．52％（95／575）、18．07％（229／1267）、27．30％（519／1901）、28．87％（507／1756）和27．45％（467／1701）。SPT变应原阳性率分布前5位的依次为粉尘螨、屋尘螨、蒿草、豚草和动物毛变应原,其次为树木、蟑螂、霉菌、向日葵、蓰草和牧草。变应原SPT反应强度分布：＋504例（11．25％）、＋＋1895例（42．29％）、＋＋＋1665例（37．16％）、＋＋＋＋417例（9．31％）,以＋＋、＋＋＋等级为主。结论尘螨为辽宁地区过敏性哮喘的占绝对优势的变应原;蒿草、豚草花粉分别居第二位、第三位,亦为季节性哮喘伴鼻炎的主要变应原。SPT变应原反应强度以＋＋和＋＋＋为主。