过敏原皮肤点刺试验和串联法在儿童哮喘诊断中的作用

过敏原皮肤点刺试验是一种体内特异性免疫学检测方法,可用于测定哮喘患儿的特应性（对一种或多种过敏原敏感）。鉴于特应性与哮喘的发生、发展及严重程度有一定的关联,我们自１９９８年以来采用国际间儿童哮喘和过敏性疾病的对比研究（ＩＳＡＡＣ）第二阶段的方案,对过敏原皮肤点刺试验和问卷与之结合的方法（简称串联法）在儿童哮喘诊断中的作用进行了探讨,报告如下。对象：（１）１９９８年４月～１９９８年５月在北京朝阳区小学用整群抽样的方法选择９７０名１０～１２岁近１年内无哮鸣症状者（简称非哮喘儿童）,男５２０名,女５２…     

气道过敏性疾病患儿气传过敏原致敏分布特征及临床意义

目的:了解气道过敏性疾病患儿气传过敏原致敏分布特征及临床意义。方法:收集北京儿童医院2019年1月至12月诊断为气道过敏性疾病并进行气传过敏原皮肤点刺试验(skin prick test,SPT)的2557例患儿资料进行回顾性分析。按年龄分为≤5岁组、6~11岁组、≥12岁组;按疾病分为过敏性鼻炎组、哮喘组、过敏性鼻炎...     

3085例儿童过敏性疾病吸入性过敏原皮肤点刺试验及临床意义

目的：探讨西安及其周边地区儿童过敏性疾病吸入性过敏原状况及分布,为该地区儿童过敏性疾病的防治提供理论依据。方法：采用丹麦ALK-ABELL公司提供的13种标准化变应原皮肤点刺液,对2006年7月至2011年7月因各种过敏性疾病等原因就诊的来自西安及其周边地区的3085例儿童进行吸入性过敏原皮肤点刺试验（skin prick test, SPT）。结果：3085例患儿中,吸入性SPT阳性1368例,阳性率为44-34%。过敏原阳性率较高的前5位依次为屋尘螨804例（26.06%）、粉尘螨793例（25.71%）、热带螨440例（14.26%）、艾蒿282例（9.14%）、猫毛204例（6.61%）。<4岁组、4岁～组、7～15岁组SPT阳性率依次为28.66%、41.85%、58.61%,组间比较差异有统计学意义（P<0.01）,表现为随年龄增长SPT阳性率增加。男性SPT阳性率较女性高（47.78% vs 38.50%,P<0.05）。在各种不同的过敏性疾病中,以过敏性鼻炎患儿的SPT阳性率最高,达72.41%,其次依次为支气管哮喘（62-25%）、变态反应性皮肤病（45-83%）、过敏性紫癜（36.28%）。结论：西安及其周边地区儿童过敏性疾病吸入性过敏原以屋尘螨、粉尘螨、热带螨、艾蒿、猫毛等为主;SPT阳性率随年龄增长而增加;男性儿童SPT阳性率较女性高;在常见过敏性疾病中,以过敏性鼻炎患儿SPT阳性率最高。     

昆明市哮喘儿童过敏原皮肤试验、血清IgE检测分析

支气管哮喘是由嗜酸性粒细胞、肥大细胞和T淋巴细胞等多种炎性细胞参与的气道慢性炎症,主要与外界环境中的过敏原有关。我们于1997年8月至1999年1月选择过敏原皮肤点刺试验对哮喘儿童作过敏原检测分析,对其中部分儿童作血清总IgE(tIgE)、尘螨特异性IgE(sIgE)测定,并与健康儿童作对照,旨在了解昆明市儿童哮喘最常见的过敏原,为预防和治疗哮喘提供依据。     

上海嘉定地区儿童过敏原调查及过敏原与支气管哮喘的相关性

目的：分析上海嘉定地区过敏原及其与支气管哮喘发生的相关性。方法：上海嘉定南翔医院382 例4~12岁缓解期支气管哮喘患儿作为病例组（哮喘组）,采用整群随机法抽取上海嘉定地区2所学校和2所幼儿园402例4~10岁儿童（普查组）作为对照,对儿童家庭生活状况及过敏性疾病患病情况进行问卷调查,并进行18种常见过敏原皮肤点刺试验（SPT）。普查组按出生地分为移居组（219例）和常住组（183例）,分析家庭生活环境与SPT阳性率的相关性。结果：嘉定地区儿童过敏原主要为：粉尘螨、户尘螨、海虾、蟑螂、狗毛。哮喘组SPT阳性率为67.9%,显著高于普查组（31.8%）,二者差异有统计学意义（P＜0.01）。移居组家庭生活环境与常住组有明显差异（P＜0.01）,移居组SPT阳性率明显低于常住组,差异有统计学意义（P＜0.01）。结论：上海嘉定地区儿童主要过敏原为粉尘螨、户尘螨、海虾、蟑螂、狗毛;哮喘儿童对过敏原更具易感性;儿童生活环境与SPT阳性率存在一定相关性。     

儿童不同过敏性疾病的过敏原构成分析

目的 研究不同过敏性疾病患儿的常见过敏原,为儿童过敏性疾病的临床诊断、治疗和预防提供依据。方法 采用皮肤点刺试验对1 179 例患各种过敏性疾病的患儿进行过敏原检测,根据临床诊断分为6 组:特应性皮炎组(n=140)、过敏性胃肠炎组(n=37)、过敏性结膜炎组(n=77)、过敏性鼻炎组(n=301)、哮喘组(n=285)、混合过敏性疾病组(n=329)。结果 1 179 例患儿过敏原阳性总检出率为82.0%,阳性率最高的吸入过敏原是粉尘螨(68.1%)和屋尘螨(53.5%),阳性率最高的食物过敏原是牛奶(5.0%)和鸡蛋(4.8%)。特应性皮炎组和过敏性胃肠炎组中≤3岁患病的人数分别占84.3% 和83.8%,过敏性结膜炎组、过敏性鼻炎组、哮喘组和混合过敏性疾病组均以4 岁以上儿童占多数。特应性皮炎组以食物过敏原阳性为主,最常见的过敏原是鸡蛋和粉尘螨;过敏性胃肠炎组以食物过敏原阳性为主,最常见的过敏原是鸡蛋和牛奶;过敏性结膜炎组、过敏性鼻炎组、哮喘组和混合过敏性疾病组均以吸入性过敏原阳性为主,最常见的过敏原均是粉尘螨和屋尘螨。结论 不同过敏性疾病患儿的年龄分布和过敏原种类不同:特应性皮炎和过敏性胃肠炎多见于婴幼儿,以食物过敏原为主;过敏性结膜炎、鼻炎、哮喘和混合过敏症多见于年长儿,以吸入性过敏原为主。     

儿童哮喘皮肤点刺试验108例分析

目的：探讨皮肤点刺试验(SPT)在儿童哮喘诊断及防治中的意义。方法：采用德国默克集团——Allergopharma公司生产的变应原试液,其中吸入性变应原有螨虫、蟑螂、羽毛、狗上皮、猫上皮、霉菌、花粉、杂草;食入性变应原有牛奶、鸡蛋、猪肉、鸭肉、淡水鱼、虾、豌豆、小麦等共16种,以生理盐水作阴性对照,组胺作阳性对照。部位选在双手臂屈侧皮肤。结果：108例儿童哮喘中,SPT阳性67例,占62%。≤3岁组6/27例阳性(22.2%)、4～7岁组43/58例阳性(74.1%)、8～14岁组18/23例阳性(78.2%),婴幼儿组与学龄前和学龄期对比,其阳性率经χ2检验差异有非常显著性,P＜0.01。所有变应中,以螨虫阳性率最高,达59.3%,其次为蟑螂、狗上皮、猫上皮,分别为 33.3%、28.7%、25.9%,再其次为霉菌、羽毛和花粉,而食入性变应原阳性极少。结论：SPT检查在儿童哮喘诊断与防治中有重要参考价值,由于婴幼儿免疫机制欠完善,SPT阳性率较低,主张在3岁以后进行。     

广东省龙川县支气管哮喘儿童常见吸入性过敏原检测分析

目的：探讨儿童哮喘吸入性过敏原分布特点,为防治儿童哮喘提供指导。方法2013年1月至12月广东省龙川县妇幼保健院确诊为支气管哮喘的105例患儿作为哮喘组,同年龄同性别98例健康儿童为对照组,对两组儿童进行皮肤点刺试验( SPT)及总IgE抗体及特异性IgE抗体浓度测定。结果哮喘组 SPT、总 IgE 抗体、特异性 IgE 抗体的阳性率均显著高于对照组(76．2% vs．32．7%、78．1% vs．34．7%、73．3% vs．31．2%)( P均<0．05)。哮喘组儿童 SPT 过敏原前5位分别是屋尘螨(60．9%)、粉尘螨(48．6%)、狗毛(27．6%)、豚草(20．9%)和棉绒(16．2%)。对照组儿童分别是屋尘螨(25．5%)、粉尘螨(21．4%)、狗毛(13．3%)、豚草(10．2%)和棉绒(7．1%)。哮喘组过敏原阳性率均显著高于对照组(P均<0．05)。结论屋尘螨、粉尘螨、狗毛、豚草和棉绒是本地区儿童最常见的过敏原,要及时避免接触以上5种过敏原,减少哮喘发病风险。     

Multi-Test Ⅱ点刺器在儿童过敏原皮肤点刺试验中的应用评价

目的 初步评价Multi-Test Ⅱ点刺器在儿童过敏原皮肤点刺试验（SPT）中的适用性。方法 选取2017年3~9月就诊的87例过敏性疾病患儿为研究对象,均进行6种吸入性过敏原的SPT和血清特异性IgE（sIgE）测定。分别应用单点刺针及Multi-Test Ⅱ点刺器于患儿左、右前臂进行SPT的测定,应用荧光酶联免疫法进行血清sIgE浓度的测定。用视觉模拟评分（VAS）标尺评估患儿接受SPT的疼痛程度。比较3种方法6种过敏原的阳性检出率分布差异及Multi-Test Ⅱ点刺器的灵敏度和特异度。结果 Multi-Test Ⅱ法、单点刺针法、荧光酶联免疫法3种方法检出6种过敏原的阳性率比较差异无统计学意义（P > 0.05）。与单点刺针法比较,Multi-Test Ⅱ法灵敏度为72.7%,特异度为78.2%;与荧光酶联免疫法比较,Multi-Test Ⅱ法灵敏度为73.4%、特异度为77.5%。Multi-Test Ⅱ法较单点刺针法疼痛程度低,差异有统计学意义（P < 0.05）。结论 Multi-Test Ⅱ法灵敏度及特异度较高且易被患儿接受,但测定结果需同时与患儿的临床病史相结合,必要时结合血清特异性IgE测定结果。     

尘螨点刺试验在儿童支气管哮喘中的应用

尘螨是小儿支气管哮喘的主要过敏原之一,我们用尘螨皮肤点刺试验对114例支气管哮喘患儿及100名健康儿童做过敏原测定,现将结果报道如下。 资料与方法 哮喘患儿来源于我院门诊及住院部。男85例,女29例;<3岁28例,>3岁86例。按第三届全国呼吸道疾病会议通过的儿童哮喘诊断标准确诊。正常体检     

海南儿童哮喘常见吸入性变应原的调查

目的 了解海南地区儿童哮喘常见吸入性变应原,探讨有效实施变应原避免的措施,为成功开展特异性免疫治疗提供依据.方法 对2 361例哮喘儿童进行13种常见过敏原皮肤点刺试验,对其中450例患儿进行10种过敏原体外特异性IgE检测.结果 2 361例哮喘患儿皮肤点刺阳性率为86.0%,其中,屋尘螨及粉尘螨阳性率分别为91.2%及89.3%,热带螨为86.3%,且阳性级别高.对三种螨呈三级以上皮肤点刺阳性反应的患者分别占65.7%、65.4%和58.2%.动物皮毛中,狗毛阳性率为22.4%,猫毛14.4%;德国小蠊及美洲大蠊分别为28.7%及21.9%,但其阳性级别通常很低.450例体外过敏原检测阳性率为72.4%,其中仍以螨虫阳性率最高,屋尘螨66.2%,粉尘螨59.6%.结论 屋尘螨、粉尘螨和热带螨是海南地区最重要的过敏原,其阳性率和阳性级别均比国内其他地区高.狗毛、猫毛、蟑螂等过敏原在海南也占一定比例.     

Skin test reactivity to molds in pre-school children with newly diagnosed asthma

BACKGROUND: The aim of the present study was to evaluate the prevalence of sensitization to molds and to house dust mites (HDM) in pre-school children with newly-diagnosed asthma. METHODS: From 1996 to 2000, 122 children 1 to 6 years of age with fresh asthma treated in the Kuopio University Hospital, Kuopio, Finland, were recruited in the study; 94% attended. Skin prick tests were performed to common inhalant allergens and to 10 molds. The homes were surveyed for moisture damage. RESULTS: A majority of the houses had signs of dampness and moisture. One-third of the children reacted to inhalant allergens. There were 11 positive reactions to molds in five children who all reacted to at least one animal dander or seasonal pollen. Aspergillus fumigatus, Botrytis cinerea, and Cladosporium herbarum were the most common mold allergens. There were only two children with positive reactions to HDM, and none of them reacted to molds. No associations were found between the presence or degree of moisture problems at home and mold or HDM allergy. CONCLUSION: Sensitization to molds seems to play only a minor role in pre-school children with newly-diagnosed asthma in a northern climate where the incidences of mold and HDM allergies are rather low.     

温州地区402例哮喘患儿特应质现象分析

目的 对温州地区15岁以下哮喘患儿特应质现象进行分析,探讨其临床及理论价值.方法 回顾性分析402例哮喘患儿皮肤过敏原诊断试验、血清特异性IgE、总IgE、个人过敏史、家族史、过敏原检出率、类型及与年龄关系.结果 哮喘发病有家族聚集倾向,家族过敏史总阳性率为52.74%.个人过敏史总阳性率为61.69%.过敏原皮肤诊断试验和过敏原血清特异IgE阳性率达83.58%,吸人性过敏原阳性人数占检测患儿的74.13%,其中以粉尘螨(61.44%)、屋尘螨(58.96%)为主;食人性过敏原阳性占24.38%,以小虾(16.67%)、牛奶(8.46%)为主.血清总IgE阳性率87.9%,总IgE阳性组和阴性组的哮喘患儿血清嗜酸性细胞阳离子蛋白(ECP)、户尘螨sIgE(D1)、粉尘螨sIgE(D2),皮肤过敏原诊断试验(pt)、家族过敏史、个人过敏史差异有统计学意义(P均≤0.05).哮喘患儿3岁前、后过敏原分布不同,3岁以后吸人性过敏原阳性为主.发病诱因中以上呼吸道感染为最多,哮喘症状发作的时间主要集中在临睡、夜晚、清晨.结论 儿童哮喘存在明显特应质现象,对其的正确认识和诊断对哮喘免疫机制的深入研究、综合治疗如在糖皮质激素吸入治疗的基础上,增加患儿教育、过敏原避免、特异性的免疫治疗等具有实用和理论指导意义.     

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??Objective To understand the trend of inhaled allergen positive rate among 0-12-year-old children from 2006 to 2013 in Chongqing Children’s Hospital??and to provide evidence for preventing allergic rhinitis in children. Methods??All cases were collected from Otorhinolaryngological Department of the Children’s Hospital of Chongqing Medical University from 1st January??2006 to 29th October??2013. Totally 10983 children with allergic rhinitis aged 0-12 years old in Chongqing urban districts were enrolled. All the patients underwent skin prick test??SPT?? with 13 standardized common inhalant allergens. Then the children were divided into the infants group??aged??3 years????preschool children??3 years≤aged??7 years?? and school-age children??7 years≤aged??12 years?? according to age. The trend of inhaled allergen positive rate over 8 years was observed. Results From 2006 to 2013??the SPT positive rate increased sharply??then tended to be stable??and then decreased slowly??Curve Estimation??R 2??0.836??adjustment R 2??0.770. ANOVA test??F??12.727??P??0.011??. It may be related to meteorological factors. With the growth of age??the positive rates of Dermatophagoides pteronyssinus??Dermatophagus farinae??Blomia tropicalis??Cockroaches??cat fur??dog fur and mugwort increased??which were 121.200??123.060??103.237??104.784??17.042??8.515 and 11.256??respectively????P was 0.000??0.000??0.000??0.000??0.000??0.014 and 0.004??respectively??. Conclusion ??Meteorological factors and age may have effects on allergic rhinitis??AR?? in children??with the growth of age??the positive rates of inhaled allergens have tendency variation.     

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??Abstract??Objective??To investigate the characteristics of respiratory impedance in children and adults with asthma and explore the clinical significance. Methods??From Jul. 2005 to Jun. 2006 in Tianjin Children's Hospital?? IOS ??Impulse Oscillometry?? was performed in 80 children and 62 adults with asthma and 112 healthy children to obtain respiratory impedance data?? at the same time?? the conventional pulmonary function test was also performed in some of the patients. Data coming from different groups were analyzed statistically. Results??Based on IOS data?? total resistance R5 increased??142.19±36.40??% and central resistance R20 was normal???88.53±17.83??%??in child asthma group. Both R5 and R20 increased in adult asthma group???190.03±49.97??%????152.53±39.11??%??. In two groups?? reactance X5 and Fres decreased or backed off in various degrees?? more obviously for Fres. The conventional pulmonary test data also implied that the percentages of FVC and FEV1/FVC were ??81.19±15.42??% and ??55.57±12.93??% respectively in adult group??and ??79.12±18.65??% and ??64.81±9.78??% respectively in child group. Conclusion??The characteristics of respiratory impedance between children and adults are different. The pathological changes of child asthma are mainly in the small airway where inhaled medicine should reach as far as possible.     

支气管哮喘儿童皮肤点刺试验结果分析

目的 分析支气管哮喘(bronchial asthma,BA)儿童皮肤点刺试验(skin prick test,SPT)结果,并提出预防策略.方法 对2007年3月至2010年10月在我院哮喘门诊就诊的200例BA患儿进行SPT结果分析,采用SPSS 17.0软件分析过敏原分布情况及其与年龄、性别的相关性.结果 (1) 200例BA患儿SPT阳性率为72.5%(145/200例),吸入性变应原阳性率62.5%(125/200例),食入变应原阳性率14.0%(28/200例),其中粉尘螨73例(36.5%)、屋尘螨81例(40.5%)、室外霉菌38例(19.0%)、艾蒿34例(17.0%)、猫上皮34例(17.0%)、树木花粉(树Ⅰ)26例(13.0%)、鸡蛋16例(8.0%)、牛奶11例(5.5%);(2) 18种变应原中猫上皮、艾蒿、室外霉菌及树Ⅰ随年龄增加其过敏频率升高,鸡蛋、牛奶随年龄的增加其过敏频率降低,而变应原过敏频率与性别无显著相关性;(3) 18种变应原中粉尘螨、屋尘螨、豚草、藜随年龄增加其过敏严重程度增加,而变应原过敏严重程度与性别无显著相关性.结论 粉尘螨、屋尘螨、猫上皮、室外霉菌、艾蒿、树Ⅰ、鸡蛋、牛奶等是BA儿童的主要变应原.BA儿童应避免接触这些过敏因素.

Abstract：

Objective To investigate the outcome of allergen skin prick test in children with bronchial asthma,and propose prevention strategy.Methods Sensitinogen prick test on the skin was applied on 200 children who were in asthma clinic of our hospital between Mar 2007 and Oct 2010.Then,the distribution of sensitinogen and their correlation with age and sex were analysed by SPSS 17.0.Results (1) The positive rate of sensitinogen prick test in 200 children with asthma was 72.5%(145/200).The positive rate of inhalant allergen and ingestion allergen were 62.5%(125/200),14.0%(28/200),respectively,of which dermatophagoides farinae,dermatophagoides pteronyssinus,outdoor mould,mugwort,cat epidermis,tree Ⅰ,egg,milk were 36.5%,40.5%,19.0%,17.0%,17.0%,13.0%,8.0%,5.5% respectively.(2) The frequency of sensitivity to cat epidermis,mugwort,outdoor mold and tree Ⅰ increased with age and the frequency of sensitivity to egg and milk decreases with age.The sensitivity rate to all other allergens had no relation with sex.(3) The severity of sensitivity to dermatophagoides farinae,dermatophagoides,ragweed and pigweed increased with age,while severity of sensitivity had no significant relation with sex among the 18 kinds of allergens.Conclusion Dermatophagoides farinae,dermatophagoides pteronyssinus,outside mould,mugwort,tree Ⅰ,cat epidermis,egg and milk are the major allergens in children with bronchial asthma,who should avoid contact with these facters.     

Low frequency of positive skin tests in asthmatic patients infected with Schistosoma mansoni exposed to high levels of mite allergens

Helminthic infections and allergic diseases are highly prevalent in many parts of the world. Although skin reactivity to indoor allergens is decreased in subjects from helminthic endemic areas, the degree of exposure to mite allergens has not yet been investigated in these areas. This study evaluated the association between exposure to dust mites and skin reactivity to mite allergens in subjects with a history of wheezing in the last 12 months selected from a rural endemic area for schistosomiasis (group I, n = 21), and two non- Schistosoma mansoni endemic locale, a rural area (group II, n = 21) and a urban slum area (group III, n = 21). All subjects were evaluated by skin prick tests with mite allergens, and for total and specific immunoglobulin E (IgE) against dust mites, antibodies for S. mansoni , and for intestinal parasites. Dust samples from each subjects' home were quantified for mite allergen and species of the mite identification. Except for S. mansoni infection which was more prevalent in group I than in groups II and III (p < 0.0001), the prevalence of intestinal parasites, and total and specific IgE levels were similar for all groups. Despite the levels of mite allergens and specifically to Der p 1 detected in dust samples of subjects home from all three areas, the frequency of positive skin reactivity to mite antigens was significantly lower (19.0%) in subjects from group I relative to group II (76.2%) and group III (57.1%; p < 0.001). This result suggests that S. mansoni infection could modulate the immediate hypersensitivity skin response to mite allergens in highly exposed subjects.     

苏州大学附属儿童医院支气管哮喘及过敏性鼻炎患儿皮肤点刺试验结果分析

目的　应用皮肤点刺试验了解支气管哮喘及过敏性鼻炎患儿的主要过敏原, 为其预防、 诊断、 治疗提供依据。方法　选取于2015年8月至2017年7月在苏州大学附属儿童医院门诊诊断为支气管哮喘及过敏性鼻炎的2252例患儿进行皮肤点刺试验检测过敏原,并对其性别、 疾病种类数据采用SPSS 21.0软件进行分析。结果　2252例患儿进行皮肤点刺试验, 1390例阳性, 阳性率61.7%。男女比例1.75∶1, 男性阳性率（925/1433, 64.5%）高于女性阳性率（465/819, 56.8%）, 差异有统计学意义（P＜0.05）。支气管哮喘患儿阳性率为65.3%（607/929）, 过敏性鼻炎患儿阳性率为58.8%（664/1129）, 支气管哮喘合并过敏性鼻炎患儿阳性率61.3%（119/194）。支气管哮喘阳性率高于过敏性鼻炎, 差异有统计学意义（P＜0.05）。过敏原以粉尘螨（60.3%）、 屋尘螨（43.4%）最常见, 其次是草花粉、 猫毛。结论　苏州大学附属儿童医院的支气管哮喘、 过敏性鼻炎患儿最常见过敏原为螨类; 皮肤点刺试验可为过敏性疾病的诊断提供依据。