室内空调机滤尘网及空气中浮动尘螨变应原的测定

目的 检测开空调机前后室内空气中及空调机滤网灰尘中尘螨主要变应原的浓度，探讨空调机滤网中的尘螨变应原与哮喘发病的关系。 方法 采集开空调机前后哮喘患者和健康者家庭卧室空气中的灰尘及空调滤网灰尘，分别用ELISA检测其粉尘螨1组变应原（Der f 1）、屋尘螨1组变应原（Der p 1）和尘螨2组变应原（Der 2）的浓度。 结果 哮喘患者家庭空调开机前空气中Der p 1、Der f 1和Der 2的浓度分别为（0.23 ± 0.13）、（2.62 ± 1.08）和（0.93 ± 0.41） ng/m³，开机后依次为（0.56 ± 0.25）、（4.74 ± 1.22）和（2.33 ± 0.64） ng/m³，开机前后相比，三者浓度差异均有统计学意义（P<0.05）；健康者家庭空调开机前空气中Der p 1、Der f 1和Der 2的浓度分别为（0.33 ± 0.11）、 （11.5 ± 3.08）和（2.1 ± 0.8） ng/m³， 开机后分别为（0.63 ± 0.23）、 （19.8 ± 4.3）和（3.6 ± 1.0） ng/m³，开机前后相比，三者浓度差异均有统计学意义（P<0.05）。空调滤网灰尘中Der p 1、Der f 1和Der 2的浓度，哮喘患者家庭分别为（0.52 ± 0.19）、 （3.34 ± 0.63）和（2.53 ± 0.65） μg/g灰尘，健康者家庭分别为（1.30 ± 0.35）、 （5.16 ± 0.92）和（3.47 ± 1.13） μg/g灰尘。空调滤网灰尘中尘螨主要变应原浓度，健康者家庭和哮喘患者家庭的Der f 1和Der 2浓度均大于使过敏人群致敏的尘螨主要变应原浓度阈值2 μg/g 灰尘。 结论 空调滤网灰尘中存在尘螨抗原，是室内尘螨变应原的重要来源之一，是引起过敏性哮喘的诱因之一。     

3 种常见尘螨分子进化关系的初步探讨

为探讨粉尘螨（Dermatophagoides farinae）、屋尘螨（Dermatophagoides pteronyssinus）和梅氏嗜霉螨（Euroglyphus maynei）的分类，采用PCR扩增获得粉尘螨1类(Der f 1)和2类变应原(Der f 2)的cDNA片段，经测序后推导氨基酸序列, 与GenBank中的屋尘螨Der p 1、Der p 2和梅氏嗜霉螨Eur m 1、Eur m 2氨基酸序列进行比对，分别构建1类和2类变应原分子进化树。结果显示变应原之间相似度，Der p 1与Eur m 1为86%，Der p 1与Der f 1为83%；Der p 2与Eur m 2为87%，Der p 2与Der f 2为67%。用变应原氨基酸序列构建分子进化树，1类变应原Der p 1与Eur m 1聚成一簇，2类变应原Der p 2与Eur m 2聚成一簇。结果表明屋尘螨和梅氏嗜霉螨亲缘关系较近，而与粉尘螨较远。     

尘螨变应原的分子生物学研究进展

自Kern（1921）首次报道屋尘浸液可诱导哮喘病患者皮肤速发型变态反应以来，屋尘被认为是重要的哮喘诱发因素之一。此后，Tuft（1949）报道了许多例特应性皮炎患者均对屋尘浸液产生速发型皮肤变态反应，证实屋尘含有某种特应性变应原，但其具体来源尚不清楚^［1］_。直至1964年，Voorhorst等报道了屋尘变应原主要来自尘螨（Dermatophagoides），螨体及螨的代谢物均是变应原，且屋尘变应原活性与其尘螨数量呈正相关^［2］_。 尘螨隶属于节肢动物门（arthropoda）、 蛛形纲（arachnida）、蜱螨亚纲（Acari）、真螨目（acariformes）、 粉螨亚目（acaridida），是现代屋宇生态系统中的重要成员，日本约有3%的人患有螨原性变态反应病，我国也有1%~4%的人受其困扰^{［3-5］_。}尘螨变应原主要存在于螨体及其代谢产物中，其组成成分相当复杂，约有30余种，目前已从尘螨中提取至少20种变应原^［6］_。这些变应原均可引起螨性哮喘、过敏性鼻炎、螨性皮炎等变态反应性疾病，尘螨作为吸入性变应原逐渐被重视，人们对尘螨变应原的研究也逐步深入^{［3，7-11］_。}现对尘螨变应原的分子生物学研究进展综述如下。     

江西地区AR患者变应原分布情况及血清尘螨sIgE与IgG4水平的关系

目的探讨江西地区变应性鼻炎（AR）患者常见变应原分布情况及血清尘螨特异性IgE（sIgE）和IgG4水平的关系。方法对164例AR患者进行11种常见变应原皮肤点刺试验（SPT）,采用ELISA法检测血清尘螨sIgE和sIgG4。结果变应原SPT阳性率为100%（164/164例）,变应原主要为屋尘螨（65.3%）、粉尘螨（58.2%）、热带螨（36.6%）和为德国小蠊（15.5%）;引起AR的单种变应原阳性76例,2种阳性者38例,≥3种阳性者50例;AR组血清尘螨sIgE和sIgG4水平高于对照组（P均〈0.01）;尘螨变应原阳性强度与血清尘螨sIgE水平呈正相关（r=0.221 7,P〈0.05）,血清尘螨sIgE与IgG4水平呈正相关（r=0.184 3,P〈0.05）。结论屋尘螨、粉尘螨、热带螨、德国小蠊是江西地区AR患者主要的变应原。AR患者血清尘螨sIgE和IgG4水平明显升高,监测血清sIgE和IgG4水平对AR的治疗有指导意义。     

荨麻疹与螨性过敏的关系及粉尘螨注射液免疫治疗

目的 检测荨麻疹和其他皮疹患者对螨的敏感性,并观察粉尘螨注射液特异性免疫治疗（SIT）荨麻疹螨敏阳性者的临床疗效。 方法 1998-2005年对皮肤科门诊的皮疹患者采用粉尘螨（Df）变应原皮肤点刺试验（SPT）检测螨敏情况。将荨麻疹螨敏反应SPT≥++患者分成3组：A组粉尘螨注射液常规特异性免疫治疗,皮下注射1 ∶ 100 000（w/v）0.3、0.6和1.0 ml,各剂量1次/周×3周,1 ∶ 10 000和1 ∶ 5 000（w/v）的 剂量、疗程同上,即剂量递增期共9周;1 ∶ 5 000 （w/v）1.0 ml/(次·周)×6周,即维持剂量期。B组粉尘螨注射液冲击特异性免疫治疗,3个浓度各治疗1 d,各浓度的3个剂量间隔30 min,即剂量递增期共3 d;1 ∶ 5 000 （w/v）1.0 ml/(次·d)×6 d,即维持剂量期。A组和B组各1疗程后改用维持量1 ∶ 5 000（w/v）1.0 ml每2周1次,维持1年。C组为对照组,用抗组胺药物治疗,依巴斯汀10 mg/d+盐酸西替利嗪10 mg/d,7 d为1个疗程（以后需要时用）。观察各组的治疗效果。用ELISA测定20患者粉尘螨注射液特异性免疫治疗前后血清总IgE（tIgE）和粉尘螨特异性IgE（sIgE）水平的变化。 结果 2 685例皮疹患者中,荨麻疹患者螨敏阳性率为70.3%（1754/2 496）,高于湿疹患者的63.5%（54/85）和过敏性紫癜患者的60.6%（63/104）（P＜0.05）。248例荨麻疹螨敏SPT≥++患者接受粉尘螨注射液特异性免疫治疗,1年后临床总有效率为91.1%（226/248）,其中基本控制和显效者占66.1%（164/248）,高于抗组胺药物治疗组[12.7%（20/158）]（P＜0.01）;冲击特异性免疫治疗起效快,其最终疗效也优于常规特异性免疫治疗（基本控制+显效为76.7%>55.0%）（P＜0.05）。20例荨麻疹螨敏患者tIgE水平特异性免疫治疗1年后比免疫治疗前下降,粉尘螨sIgE水平显著上升（P＜0.01）。 结论 尘螨变应原皮肤点刺试验对荨麻疹螨敏具有病因诊断价值,粉尘螨注射液特异性免疫治疗对荨麻疹螨敏者有较好的疗效。此外,冲击免疫治疗起效快且优于常规免疫治疗。     

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。     

"引江济淮"工程对钉螺扩散和血吸虫病蔓延的影响

目的 论证“引江济淮”工程能否造成钉螺扩散和血吸虫病蔓延。 方法 调查工程途经地区血吸虫病流行现状，包括常规方法调查钉螺分布情况，间接血凝试验（IHA）检测居民血清中血吸虫抗体，尼龙绢集卵孵化法检查耕牛血吸虫感染情况；现场螺笼放养，定期观察巢湖实验区钉螺的生存繁殖情况，为期1年，同时设立对照区。 结果 工程引水口附近江外滩钉螺密度最高达326只/框。工程途经的无为县、和县钉螺分布广，居民IHA血吸虫抗体阳性率分别为22.1%（168/760）和18.6%（37/199），耕牛血吸虫感染率分别为2.4%（9/371）和0.2%（2/997）。工程沿线巢湖市居巢区和芜湖市裕溪口地区居民血吸虫感染率分别为1.3%（46/3 598）和10.5%（310/2 960）。在巢湖2个实验区放养肋壳钉螺和光壳钉螺各100只，1年后回收活螺分别为6～189只和20～47只，放养期间查见幼螺；2个实验区和对照区肋壳钉螺的产卵季节存活率分别为11.3%（6/53）～16.7%（10/60）、 3.0%（1/33）～20.8%（11/53）和4.7%（2/43）～14.7%（10/68），差异无统计学意义（χ² =0.093，0.760，P＞0.05； χ² =0.647，0，P＞0.05）；光壳钉螺分别为24.1%（14/58）～44.4%（32/72）、 37.8%（17/45）～67.3%（37/55）和86.3%（44/51）～93.1%（54/58），差异有统计学意义（χ² =9.575，5.302，P＜0.05；χ² =56.863，36.218，P＜0.05）。产卵季节（放养1个月）的雌螺卵巢含卵量，2个实验区和对照区肋壳钉螺为5.90±1.64个、3.00±2.41个和4.44±2.65个（t=1.396，1.460，P＞0.05）；光壳钉螺同地卵巢含卵量为3.52±3.90个、2.92±3.36个和3.42±2.40个（t=0.656，0.201，P＞0.05），差异均无统计学意义。 结论 钉螺可在巢湖环境中存活、繁殖；“引江济淮”工程可引起钉螺扩散，相关地区开始具备血吸虫病传播条件。     

上海市流动人口对血吸虫病传播的潜在危险性研究

目的 掌握流动人口对上海市血吸虫病传播可能造成的潜在危险性。 方法 2004年在上海市城郊结合部流动人口较多的闵行区和浦东新区，根据整群随机抽样原则两区各抽取3乡（镇）、每乡（镇）各抽取1行政村作为调查点，居住满1个月以上、≥1周岁的外来流动人口为调查对象，进行问卷调查和间接红细胞凝集试验(IHA)。IHA阳性者再以尼龙绢集卵孵化法进行粪检。 结果 共调查流动人口2 931人，其中男性1 575人（占53.74%），女性1 356人（占46.26%）。血清学检测阳性率为4.71%（138/2 931）。来自血吸虫病流行省的流动人口共1 938人（占66.12%），其中血清学检测阳性率为5.99%，显著高于来自传播阻断省的2.60%（χ²=10.28， P＜0.01）和非流行省的1.68%（χ²=12.86， P＜0.01）。对138例血清学检测阳性者进行集卵法粪检，均为阴性。根据2004年全国未控制和控制血吸虫病的地区人群感染和发病情况，推算上海市来自未控制地区和控制地区的流动人口中血清学检测阳性数约为15 055例（分别为13 356和1 699例），发病人数约为2 423例（分别为2 168和255例），其中来自安徽省的流动人口的血清学检测阳性数及发病人数均占首位。 结论 流动人口为上海市血吸虫病潜在流行的主要隐患因素。     

浙江宁海并殖吸虫中间宿主感染情况调查

2007年8月在宁海县深圳区俞山村现场捕捉溪蟹和川卷螺,镜检并殖吸虫囊蚴和尾蚴的感染情况。共捕获97只长江华溪蟹（Sinopotamon yangtsekiense）,阳性率为11.3%(11/97),平均感染度为1个囊蚴/只。其中, 体重＜5 g的20只, 阳性率为10%(2/20), 平均感染度为1个囊蚴/只; 体重>5 g的77只中,5～15 g的阳性率为10.2%（5/49）,平均感染度为1个囊蚴/只;15～25 g的阳性率为20.0%（4/20）, 平均感染度为1个囊蚴/只,25～35 g的阳性率为0（0/8）。体重>5 g的77只中,雄蟹与雌蟹比例为2.5 ∶ 1,阳性率分别为12.7%（7/55）和9.1%（2/22）,差异无统计学意义（χ²=1.20,P>0.05）。采集放逸短沟蜷（Semisulcospira libertina）200只,未发现阳性。     

感染弓形虫小鼠脾脏CD4+CD25+T细胞的变化

目的 观察小鼠感染刚地弓形虫后脾脏CD4⁺CD25⁺调节性T细胞的动态变化。 方法 将28只雌性C57BL/6小鼠随机分为4组，其中3组每鼠腹腔接种弓形虫速殖子悬液200 μl（含弓形虫速殖子5×10⁴个/ml），对照组腹腔接种灭菌PBS 200 μl。分别于弓形虫感染后第2、4和6天取脾，制成单个核细胞，用实时荧光定量PCR检测脾CD4⁺ T细胞Foxp3基因表达水平，流式细胞仪检测脾CD4⁺CD25⁺调节性T细胞占CD4⁺ T细胞的比例，并对CD4⁺CD25⁺调节性T细胞和CD4⁺ T细胞进行绝对计数。 结果 感染后第4和6天，小鼠脾脏CD4⁺ T细胞Foxp3 mRNA相对表达水平分别为 1.89±0.23和1.79±0.24， 均显著高于正常水平（1.00±0.12）（P＜0.01）；CD4⁺CD25⁺调节性T细胞占CD4⁺ T细胞的比例从感染后第2天（15.07%±2.73%）开始上调（P＜0.05），至感染后第4 和6天分别为24.29%±3.19%和19.80%±2.66%，均明显高于正常水平（11.58%±2.04%） （P＜0.01）；脾脏CD4⁺ T细胞占脾细胞的比例及其绝对数量均从感染后第2 天开始降低，至感染后第6 天分别降至5.49%±1.71%和（1.71±0.44）×10⁶ （P＜0.01）。 结论 弓形虫感染导致小鼠脾脏CD4⁺CD25⁺调节性T细胞占CD4⁺ T细胞的比例上调，而脾脏CD4⁺ T细胞的显著减少是促成比例上调的主要原因。     

热带螨与支气管哮喘

支气管哮喘(简称哮喘)是由多种细胞和细胞组分参与的气道慢性炎症性疾患.多数哮喘的发生、发展和症状的持续与尘螨过敏密切相关.螨引起的哮喘称为螨性哮喘.目前我国大陆地区主要致敏螨种为屋尘螨,而热带无爪螨是海南地区哮喘患者的主要致敏原,且在多方面具有致敏特异性.     

Mite allergen levels and acarologic analysis in house dust samples in Uberaba, Brazil.

Mite allergen exposure has been widely related to sensitization and development of allergic diseases. This study intended to evaluate the degree of allergen exposure in Uberaba, Brazil, through the measurements of Der f 1 and Der p 1 allergen levels associated with the acarologic analysis in house dust samples. A total of 240 dust samples were collected from 60 houses through vacuuming sofas and bedding, during the months of March and July 2000. Indoor temperature and relative humidity were also measured. Mites were counted and identified under light microscopy and allergen levels were measured by two-site monoclonal antibody ELISAs. The major mite family was Pyroglyphidae (39.4%), having D. pteronyssinus as the most frequent species (15.6%), followed by D. farinae (12.3%) and E. maynei (7.9%). The family Glycyphagidae was less commonly found (4.8%), with Blomia tropicalis (4.4%) as its majoritary member. The highest levels of Der f 1 and Der p 1 allergens were found in bedding samples in March (31.7 and 0.9 microg/g of dust, respectively), with Der f 1 levels significantly higher than Der p 1 (p < 0.0001). There was a significant positive correlation between the mite number and allergen levels. These results indicate that Dermatophagoides sp are the most frequent mites in our region followed by E. maynei. Therefore, the knowledge of the local mite fauna would improve the means of investigating the association between allergen exposure and sensitization, allowing the addition of new mite extracts in diagnostic tests.     

House dust mites in the city of Lima, Peru.

Since mites are the most common house dust allergens, knowledge about the species most prevalent in a region is important for diagnostic and specific immunotherapy purposes. In order to establish the prevalence of house dust mites in different city districts, 100 house dust samples were collected from different parts of Lima. Lima is a city of tropical climate located along the coast of the Pacific Ocean. The relative air humidity is 80-90% and the various districts studied are located at altitudes ranging from 37-355 meters. The mite Blomia tropicalis was the organism most frequently detected, being present in 59% of the house dust samples. Dermatophagoides pteronyssinus occupied second place (15.9%), followed by Chortoglyphus arcuatus and Tyrophagus putrescentiae. These four mites, taken together, represented more than 90% of the mites detected. No specimen of the species Dermatophagoides farinae was detected. We conclude that B. tropicalis and D. pteronyssinus are the most common house dust mites in Lima. Considering the high prevalence of B. tropicalis in Lima and the fact that its cross-reactivity with antigens of the mites of the family Pyroglyphidae is minimal, we conclude that sensitization to this mite should be investigated separately in allergic patients living in Lima.     

Mite allergen exposure, sensitisation and clinical symptoms in Valdivia, Chile.

One hundred consecutive asthmatic paediatric patients were evaluated and skin tested with a battery of skin prick test reagents, including 8 different standardized house dust mite extracts. Asthma severity was graded according to the Global Initiative for Asthma (GINA) document in mild persistent (52 patients), moderate persistent (39) and severe persistent (9). Sixty patients had asthma and allergic rhinitis, 12 asthma and eczema, and 8 asthma, allergic rhinitis and eczema. The patient population was divided into 2 different socioeconomic groups (50 patients per group) based on a standardized, validated questionnaire. A dust sample was collected with an adapted vacuum cleaner from the mattress of each patient and analysed for Der p 1, Der f 1 and Der p 2 allergen content using monoclonal antibodies. Eighty patients were skin test positive to at least one mite species. All positive skin test patients were positive to Dermatophagoides pteronyssinus, 99% to D. farinae, 92% to Euroglyphus maynei, 80% to Lepidoglyphus destructor, 73% to Tyrophagus putrescientae, 72% to Blomia tropicalis; 70% to Acarus siro and 68% to Chortoglyphus arcuatus. All patients with severe persistent asthma had a positive skin test to mites, 85% in the moderate group, and 73% in the mild group (p < 0.01). 95% of patients with asthma and allergic rhinitis had a positive skin test to mites, 92% of patients with asthma and eczema and 100% of patients with asthma, allergic rhinitis and eczema; (p < 0.01). Mean Der p 1, Der f 1 and Der p 2 allergen concentrations were 18.3, 0.6 and 5.6 microg/g of mattress dust, respectively. Mean Der p 1 allergen levels in the middle-low socioeconomic group were significantly higher than in the middle high group (p < 0.01). There is a high rate of allergic sensitisation among pediatric asthmatic patients in Chile. More than one species are implicated, although sensitisation and exposure to D. pteronyssinus predominates. Mite allergic patients are exposed to high mite allergen concentrations, exceeding previously established risk levels for sensitisation and symptoms.     

Sensitization to different mite species in German farmers: in vitro analyses.

Allergic airway diseases are often caused by house dust mites (HDM) and storage mites (SM), respectively, and we were recently able to demonstrate that symptomatic German farmers are frequently sensitized to different mite species. The present study aimed to obtain information on the protein and immunobiochemical characteristics of the extracts of the following mites: Dermatophagoides pteronyssinus, Dermatophagoides farinae, Acarus siro, Acarus farris, Lepidoglyphus destructor, Tyrophagus putrescentiae, Blomia tjibodas, Blomia topicalis, Blomia kulagini, Glycyphagus domesticus, Thyreophagus entomophagus, and Cheyletus eruditus. Specific IgE determinations were performed with EAST. The protein patterns of the mite extracts were studied by SDS-PAGE estimating the weighted-average molecular weights of the proteins. Using the Western blot technique, we determined the allergen pattern in several mite extracts. The allergens in each extract were classified in terms of the frequency of sensitization as major, intermediate, and minor allergens using allergograms. As already reported, a positive EAST to at least one mite was measured in 31/86 patients, and most sera were positive with several mite species. The majority of the mite extracts exhibited a very complex protein pattern according to SDS-PAGE. An allergen was found in Western blots of nearly all species equivalent to a molecular weight of 14 to 15 kD. This was, in our opinion, the first time that this particular allergen was detected in Blomia tjibodas and Glycyphagus domesticus. In conclusion, using EAST we were able to show that 36% of the German farmers tested were sensitized to SM. All mite extracts showed a complex protein pattern in the molecular weight range -95 kD to -10 kD. A common allergen band in the region of -14 to -15 kD was found in the majority of the mites studied, and it can be assumed that this corresponds with the group 2 allergen.     

Sensitization to different mite species in German farmers: clinical aspects.

Various mite species referred to collectively as house dust and storage mites are recognized worldwide as a cause of allergic airway disease. Our study aimed to investigate the frequency of sensitization and potential importance of mite species in farmers using a broad mite spectrum. A total of 86 German farmers with rhinitis and/or asthma were studied by skin prick testing and/or enzyme allergosorbent test (EAST) with the following mites: Blomia tjibodas, Blomia tropicalis, Blomia kulagini, Glycyphagus domesticus, Thyreophagus entomophagus, Euroglyphus maynei, Chortoglyphus arcuatus, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae, Acarus farris and Cheyletus eruditus. Sensitization to at least one mite species was detected in 51 patients (59%) by skin prick testing, and in 31 patients (36%) by EAST. The most frequent sensitizations determined by skin tests were found for the three Blomia species, E. maynei and G. domesticus. Twelve patients (14%) gave a positive EAST with the predator mite C. eruditus. A total of 22 patients gave positive EAST results with the Dermatophagoides species. We were able to document sensitization to C. arcuatus, E. maynei and T. entomophagus for the first time in Germany. A considerable proportion of the German farmers tested were sensitized to storage mites. The allergological potential of various mite species has been recognized, some for the first time. It was concluded that B. tjibodas, G. domesticus, C. arcuatus and C. eruditus in particular should be included in an allergy diagnosis. Further investigations into the clinical relevance of the sensitizations and possible cross-reactivity between the mite species are necessary.     

Antigenic analysis of household dust samples

Household dust samples from the homes of 106 allergy clinic patients in Baltimore were analyzed for specific allergen content. Dust mite antigen content was determined by enzyme-linked immunosorbent assays (ELISA) specific for the major allergens of Dermatophagoides pteronyssinus, D. farinae, and D. microceras. Cat and dog antigen content were determined by ELISA using antisera for Fel d 1 (formerly cat allergen 1) and dog allergens 3 and 13, respectively. Mold content was assessed by culture with microscopic identification. Dust mite antigen was detected in 99% of homes (D. farinae, 95%; D. pteronyssinus, 88%; D. microceras, 31%), with total antigen content ranging from 50 ng/g dust (the lower limit of detection) to 30,170 ng/g (median, 1,123 ng/g). Animal allergens were found in 100% of samples (cat: range, 2 to 130,000 ng Fel d 1/g; median, 90 ng/g; dog: range, 112.5 to 585,000 IU/g; median, 2,719.5 IU/g). Although there were highly significant differences in antigen content (p less than 0.001) between homes with and without a particular pet in residence, many homes without pets contained pet allergens at high concentrations. Molds were also detected in 100% of homes (range, 4 to 761 colonies/30 mg dust; median, 72 colonies/30 mg). No correlation was demonstrated between antigen content and skin test results, a history of asthma, symptoms on allergen exposure, or the age of the home (except for molds) for any of the allergens detected. We conclude that dust mite allergens, cat and dog allergens, and molds are virtually ubiquitous in Baltimore homes and that our ability to predict the presence and relative quantities of these allergens on clinical grounds is very limited.     

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.     

热带无爪螨致敏蛋白组分及其临床研究

热带无爪螨是热带和亚热带地区的主要螨种,过敏性哮喘、过敏性鼻炎和湿疹均与之有关。与屋尘螨和粉尘螨不同,热带无爪螨第5组抗原是其主要过敏原。本文对热带无爪螨的孳生和暴露、流行病学、变应原及交叉反应等国内外研究进展进行综述。     

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.