真菌与慢性鼻-鼻窦炎关系的探讨

目的探讨真菌变应原在慢性鼻-鼻窦炎发病中的作用。方法实验组为慢性鼻-鼻窦炎患者30例，对照组为同期鼻中隔偏曲患者30例，检测患者血清TIgE、血清SIgE、嗜酸粒细胞阳离子蛋白（ECP）及吸入物过筛试验。结果实验组血清TIgE、SIgE、ECP均高于对照组，有统计学差异。结论在慢性鼻-鼻窦炎中嗜酸粒细胞处于活化状态，嗜酸粒细胞活化促进了病变的迁延与发展；慢性鼻-鼻窦炎变应原以户尘螨、粉尘螨、北艾、蓓草为主，真菌变应原检出较少。     

关于粉尘螨和屋尘螨变应原的交叉反应的研究

目的研究粉尘螨和屋尘螨之间是否存在交叉反应。方法应用Uni CAP System对480例粉尘螨皮肤点刺试验阳性的过敏性鼻炎患者血清进行屋尘螨、粉尘螨SIgE检测。结果粉尘螨SIgE等于或大于2级的患者,100%同时屋尘螨SIgE等于1级或以上,且大部分阳性等级相当。粉尘螨SIgE 1级患者,有90%患者屋尘螨SIgE等于1级或以上,只有10%患者屋尘螨SIgE 0级,但其荧光值较高,均接近1级的荧光值水平。把其中100例屋尘螨和粉尘螨同时过敏的患者血清进行热带无爪螨变应原检测,只有26%的阳性率,且阳性级别均在3级以下。应用粉尘满舌下含服制剂对102例患者进行免疫治疗2年,症状完全缓解有45例,44.12%,其中有效86.27%,显效83.91%,良效2.36%,微效13.73%。结论绝大部分对粉尘螨变应原过敏的患者同时对屋尘螨变应原过敏,粉尘螨和屋尘螨变应原存在高度的交叉反应,用粉尘螨变应原免疫制剂治疗可达到较好的疗效,而粉尘螨和屋尘螨变应原与热带无爪螨变应原关系不密切。     

福建泉州地区儿童变应性鼻炎变应原检测分析

目的：了解泉州地区儿童变应性鼻炎（AR）的变应原分布情况,为诊断、预防和治疗提供依据。方法：采用20种标准化变应原对泉州地区850例4～12岁拟诊为AR患儿进行皮肤点刺试验（SPT）,分析不同年龄、不同性别和病情轻重程度的患儿在变应原阳性率分布上的差异。结果：SPT阳性率前5位的变应原分别为屋尘螨（占66.7%）、粉尘螨（占65.5%）、蟑螂（占32.8%）、海蟹（占18.2%）及海虾（占16.8%）。学龄前儿童SPT阳性率与学龄期儿童比较差异无统计学意义（x2=0.92, P＞0.05）;不同性别之间SPT阳性率差异无统计学意义（x2=0.86,P＞0.05）;有家族史和哮喘史的患儿的阳性率与无家族史和哮喘史的阳性率相比差异有统计学意义（x2=18.36,P＜0.05）。结论：屋尘螨、粉尘螨、蟑螂、海蟹及海虾是泉州地区儿童AR的主要变应原,不同年龄阶段的患儿SPT阳性率相似,有家族史、哮喘史的患儿阳性率比无家族史、哮喘史的阳性率高。     

天津变应性鼻炎患者变应原调查

目的 探讨天津地区变应性鼻炎患者主要吸入性及食人性变应原分布情况.方法 采用38种标准化变应原(吸人性18种、食入性20种)对天津地区664例变应性鼻炎患者进行皮肤点刺试验(SPT),并将患者按性别和年龄分组,比较其在变应原阳性率分布上的差异.结果 SPT阳性率前6位的变应原分别为粉尘螨(53.92%)、屋尘螨(47...     

武汉地区儿童变应性鼻炎变应原分布特征

目的:探讨武汉市城区儿童变应性鼻炎变应原的分布情况。方法:对2～13岁641例临床诊断为变应性鼻炎的患儿,应用该地区常见的标准化变应原试剂行皮肤点刺试验,对变应原的分布按学龄前及学龄期进行分析。结果:在该地区AR的患儿中,粉尘螨和屋尘螨依然是主要的变应原,其次为艾蒿和霉菌、豚草。变应原总体阳性率排序为粉尘螨(67.13%)、屋尘螨(65.42%)、艾蒿(27.17%)、霉菌Ⅰ(24.96%)、豚草(18.43%)。学龄期儿童较学龄前期儿童变应原的阳性率有增高趋势,以屋尘螨、粉尘螨、豚草阳性率增高显著。结论:尘螨是该地区儿童的最重要的变应原,学龄期儿童较学龄前期儿童的各种变应原的阳性率有增高趋势。     

顺德地区变应性鼻炎患者皮肤点刺结果分析

目的调查顺德地区变应性鼻炎患者主要变应原的分布特点。方法采用标准化变应原对519例变应性鼻炎患者分成青少年组和成年人组进行皮肤点刺试验。青少年组175例,成年人组344例,比较两组变应原阳性率的差异。结果皮肤点刺试验阳性率89.4%,前3位的吸入性变应原分别为粉尘螨(79.0%)、户尘螨(74.1%)、蟑螂(46.8%);多数变应性鼻炎患者对多个变应原皮试反应阳性。青少年组对粉尘螨的敏感程度明显高于成人组(p<0.005)。结论顺德地区尘螨是最重要的变应原,应重视对尘螨的特异性免疫治疗。     

576例变态反应性鼻炎患者变应原点刺试验结果分析

目的 了解武汉地区变态反应性鼻炎患者变应原种类,探讨不同地区变应原分布的差异和产生的原因,及其在疾病防治方面的价值.方法 将576例变态反应性鼻炎患者分为季节性变应性鼻炎组(258例)及常年性变应性鼻炎组(318例),并应用阿罗格(NHD)变应原点刺试验对患者进行变应原测试.结果 在所有病例中屋尘螨和粉尘螨阳性率最高,其后依次为艾蒿、霉菌、豚草、早春花粉、梧桐花粉、羽毛.季节性变应性鼻炎组中早春花粉阳性率(22.9%,59/258)和豚草阳性率(34.5%,89/258)高于常年性变应性鼻炎组[11.3%(36/318)、22.3%(71/318)].而常年性变应性鼻炎组中霉菌阳性率和粉尘螨阳性率高于季节性变应性鼻炎组,差异有统计学意义(P＜0.01).结论 武汉地区变应原分布与我国其他地区变应原分布不同,为武汉地区变态反应性鼻炎的防治工作提供了依据.     

变应性鼻炎变应原体内、体外检测结果相关性分析

目的探讨变应原体内、体外检测方法在变应性鼻炎诊断中的应用。方法采用体内法-变应原皮肤点刺试验(SPT)和体外法-血清检测法(使用瑞典Pharmacia的Uni CAP100)两种方法检测两种主要常见变应原。选取变应性鼻炎患者171例,105例用粉尘螨(D2)变应原,66例用蟑螂(I6)变应原进行SPT,同时抽取患者静脉血检测上述两种变应原的特异性Ig E(sIgE),将两种方法检测的结果进行比较。结果 105例变应性鼻炎患者中粉尘螨血清sIgE检测阳性率85.71%,皮肤点刺试验阳性率91.43%,总阳性率94.29%,灵敏性为96.67%,皮试与血清sIgE检测的总符合率为88.57%。66例变应性鼻炎患者中蟑螂血清sIgE检测阳性率86.36%,皮肤点刺试验阳性率89.39%,总阳性率93.94%,灵敏性为94.74%,皮试与血清sIgE检测的总符合率为87.88%。两种变应原采用两种检测方法差异均无统计学意义(P>0.05)。结论变应原体内、体外检测结果相关性好,在变应性鼻炎的诊断上可以互补,有较大的临床应用价值。     

支气管哮喘儿童青少年过敏原特点分析

目的了解温州市1 025例支气管哮喘(哮喘)儿童青少年过敏原分布特点及影响因素,为儿童青少年哮喘防治提供依据。方法选择2008—2015年在温州医科大学附属育英儿童医院就诊的1 025例2~16岁哮喘患者,对皮肤点刺试验(SPT)结果进行分析,尘螨SPT阳性的影响因素采用Logistic回归分析。结果 1 025例哮喘患者的过敏原总阳性率为91.80%,过敏原前6位是屋尘螨(89.46%)、粉尘螨(88.09%)、热带螨(41.36%)、猫毛(31.02%)、狗毛(26.53%)和蟑螂(22.14%)。尘螨SPT阳性影响因素Logistic回归分析结果显示,5~16岁年龄组哮喘患者的尘螨SPT阳性风险相对高于0岁~组(屋尘螨:OR=2.189,95%CI:1.409~3.398;粉尘螨:OR=2.569,95%CI:1.689~3.907);哮喘合并过敏性鼻炎患者的尘螨SPT阳性风险高于单纯哮喘患者(屋尘螨:OR=4.083,95%CI:2.484~6.710;粉尘螨:OR=4.904,95%CI:2.999~8.022);性别、居住环境与哮喘患者尘螨SPT阳性均未见统计关联(P0.05)。结论屋尘螨、粉尘螨是温州市哮喘儿童青少年最常见的吸入性过敏原,年龄大、哮喘伴过敏性鼻炎患儿的尘螨SPT阳性率更高。     

1000例临床诊断变应性鼻炎儿童皮肤点刺试验结果分析

目的研究长沙地区变应性鼻炎儿童的变应原分布及其随年龄增长的变化情况,为预防主要的变应原提供理论依据。方法以2013年7月至2015年2月就诊于我科门诊临床诊断为变应性鼻炎的患儿为调查对象,所有患儿均采用变应原皮肤点刺试验(SPT)检测过敏原,计算各变应原的阳性率,并分析其与年龄变化的关系。结果 1在1 000例诊断为变应性鼻炎的患儿中,皮肤点刺试验阳性者687例,阳性率为68.70%。其中包括吸入性变应原阳性患儿534例,阳性率为53.40%(534/1 000),单纯尘螨过敏占212例,阳性率21.20%(212/1 000),占吸入性变应原的39.70%(212/534),粉尘螨和户尘螨是最主要的两种吸入性过敏原;其次,蟑螂、霉菌、猫毛的阳性率分别为20.40%(204/1 000)、13.60%(136/1 000)及12.20%(122/1 000)。食入性过敏患儿178例,阳性率17.80%(178/1 000),单一食物过敏44例,阳性率4.40%(44/1 000),占食入性的24.72%(44/178),海虾(6.60%)、牛奶(6.60%)和鸡蛋(6.40%)是主要的食入性过敏原。2粉尘螨、户尘螨、猫毛及禾草的阳性率随年龄的增长显著升高,差异有统计学意义。3变应原检测阳性率与性别之间无显著统计学差异。结论 1尘螨是长沙地区主要的过敏原,7~13岁是变应性鼻炎高发年龄段。2SPT是变应性疾病常用的检测手段,但受其他因素的干扰,存在假阴性及假阳性,应谨慎判断。     

我院荨麻疹患儿体外过敏原分析

目的：对本院荨麻疹患儿过敏原情况进行分析探讨。方法：采用免疫球蛋白E测定试剂盒（化学发光法）检测血清总IgE （TIgE）和Phadia公司全自动体外变应原检测系统ImmunoCAP250荧光酶联免疫法检测血清吸入物过敏原过筛查试验（Phadiatop）、食物过敏原过筛查试验（Fx5E）和特异性IgE（SIgE）。结果：193例荨麻疹患儿中,TIgE阳性率为99.3%。Phadiatop、Fx5E总计阳性率为59.8%;Phadiatop、Fx5E阳性率分别为32.1%和49.7%。SIgE显示吸入物过敏原以屋尘、粉尘螨、屋尘螨为主（47.6%）,食物过敏原以牛奶、鸡蛋为主（56.3%,52.6%）。0-3岁年龄段患儿Fx5E阳性率为45.2%,明显高于Phadiatop的阳性率26.2%（P〈0.05）;〉3岁患儿中两者无明显差异（P〈0.05）。结论：荨麻疹患儿多属特应性体质,约60%与第I型变态反应有关;吸入物过敏原主要为屋尘、粉尘螨、屋尘螨,食物过敏原以牛奶、鸡蛋为主;0-3岁患儿食物过敏是其主要因素,而〉3岁患儿食物与吸入物过敏几乎均等存在。     

淮南地区校内人群尘螨过敏情况

目的　了解校内人群尘螨过敏情况 ,为更好地防治青少年变态反应性疾病提供依据。方法　采用定点随机抽样调查方法 ,对淮南地区部分学生和教职工进行皮肤挑刺试验 (SPT)。结果　SPT阳性率为 1 3 .86 % ,其中男女分别为 1 3 .75 %和 1 4 .0 0 % ,差异无显著性 (P>0 .0 5) ;幼儿、小学生、中学生、大学生、教职工SPT阳性率依次为 7.38% ,9.87% ,1 4 .74% ,1 7.75 % ,2 3 .52 % ,差异有显著性 (P <0 .0 0 1 )。SPT阳性 32 7人中 ,患鼻炎、哮喘、皮炎、荨麻疹、药物过敏症者共 1 88人 ,患病率为 57.49% ,明显高于SPT阴性人群 (P <0 .0 1 ) ;患有呼吸系统疾病和皮肤病的 474人中 ,SPT阳性 2 1 2人 ,占 44 .73 % ,明显高于无呼吸系统疾病和皮肤病人群 (P <0 .0 1 )。结论　校内人群尘螨过敏情况应引起重视。     

Occupational sensitization to storage mites in the personnel of a water-damaged grocery store

Objectives: To investigate the occupational exposure and sensitization to storage mites (SM) in sales staff working in a moisture-damaged and three healthy reference buildings. Methods: The study population consisted of the entire personnel (n=12) in the moisture-damaged grocery store. They all suffered from persistent upper respiratory tract symptoms. Twelve (in results 11) symptom-free controls working in three healthy reference groceries were matched with age, sex and occupation. Dust samples from each building were examined for mites. The clinical study consisted of otorhinolaryngological examination and determination of IgE reactivity. Specific serum IgE antibodies were measured against three SMs and two house dust mites (HDM). Skin prick tests (SPT) were made to the same five mites and to five common aeroallergens. If sensitization to any of the SMs was detected, a nasal provocation test (NPT) was performed. Results: SMs were found in all buildings. In all, seven cases and four control subjects showed IgE-mediated reactivity. Sensitization to mites was detected in six cases and in three controls and in 2/12 and 3/11 this was the only IgE antibody response observed. In addition, one case and one control subject were sensitized to common aeroallergens. NPT with SMs was positive in four cases and in one control. Conclusions: In grocery stores, the personnel are exposed to SMs. The risk of sensitization to mites is obvious and an IgE response can occur without any reactivity to common aeroallergens. SM allergy may in some cases explain the chronic rhinitis related to moisture-damaged buildings.     

江苏地区尘螨暴露、尘螨过敏在外源性哮喘中的作用

1992年7月至1993年4月于江苏地区用病例对照研究的方法着重对尘螨暴露、尘螨过敏与外源性哮喘的联系进行非条件Logistic回归分析。以对象床褥上鸟嘌呤含量为尘螨暴露水平的指标,血清中尘螨特异性IgE为尘螨过敏的指标。结果表明:尘螨暴露、尘螨过敏、双亲过敏史和出生于高螨密度月份均与外源性哮喘发生有显著联系。尘螨暴露的人群归因危险度百分比(PAR%)达70.29%。据此,对外源性哮喘的防治提出了建议。     

从化地区哮喘患儿变应原皮肤点刺试验的临床研究

【目的】 了解从化地区支气管哮喘发病相关的主要致敏变应原及其特点,指导选择特异性免疫治疗对象。 【方法】 对382 例支气管哮喘缓解期患儿,用德国默克公司生产的阿罗格食入组及吸入组点刺试剂进行皮肤点刺试验,组胺液为阳性对照,生理盐水为阴性对照。 【结果】 哮喘患儿皮肤点刺试验阳性率为 88.5%。吸入变应原总阳性率为81.2%,吸入变应原中以粉尘螨和屋尘螨阳性率居高,分别为77.2%和71.2%;食入变应原总阳性率为32.7%,居前两位的为小虾19.9%,花生6.3%。在吸入变应原中高龄组与低龄组比较差异有统计学意义(P<0.05),食入变应原中高龄组与低龄组比较差异无统计学意义(P>0.05)。哮喘或哮喘并鼻炎患儿均以螨类过敏最常见,两组间螨类、霉菌类、动物皮毛类、蟑螂及杂草变应原阳性率差异均无统计学意义。 【结论】 从化地区支气管哮喘患儿发病相关的吸入变应原主要是粉尘螨、屋尘螨,食入变应原主要是小虾、花生。3~14岁儿童哮喘患儿随着年龄增长,对吸入性变应原更为敏感。哮喘与哮喘并鼻炎患者共同的变应原主要是螨类,其次为霉菌类、动物皮毛类,为哮喘的防治提供了指导作用。     

Kawasaki syndrome: a controlled study of an outbreak in Wisconsin

The etiology of Kawasaki syndrome remains unestablished, although a possible role has been suggested for exposure to the application of carpet shampoo, house dust mites, and rickettsial infection. During an outbreak of 20 cases of Kawasaki syndrome that occurred in southeastern Wisconsin from November 1982 through March 1983, a case-control study was done of 15 cases and 30 matched controls. The study included questionnaire administration, dust collection from homes, and serum specimen collection. Only one patient had been exposed to a shampooed carpet within 30 days before onset of illness. No differences were noted between cases and controls in the degree of exposure to house dust mite-associated factors in the home, nor in the occurrence, density and species-specific prevalence of house dust mites in the home. Meadow voles exposed to house dust mites from the homes of patients did not develop serologic or pathologic evidence of infection due to rickettsiae in the spotted fever and typhus groups or Coxiella burnetii. Anti-mite-specific immunoglobulin E was not detected in serum specimens from cases or controls. Results from this study do not support hypotheses suggesting that the development of Kawasaki syndrome is associated with exposure to application of carpet shampoo, house dust mites, or rickettsial infection.     

Remission of chronic urticaria in the course of house dust mite immunotherapy—Mere coincidence or something more to it?

It has been hypothesised that house dust mite is as a causative and/or deteriorating factor in some cases of chronic urticaria. In this report we describe two patients with the history of respiratory house dust mite allergy and chronic urticaria, which resolved in the course of house dust mite immunotherapy. Basing on literature and our own experiences, we can only speculate that some patients suffering from mite-induced respiratory allergy and concomitant chronic urticaria may benefit additionally from allergen immunotherapy, manifesting as the withdrawal or alleviation of urticaria symptoms.     

乳胶过敏发病机制的研究

目的研究乳胶过敏的发病机制,探讨其在职业病防治中的意义。方法统计分析上海仁济医院过敏性疾病防治中心651例门诊患者常见过敏原皮肤点刺试验(SPT)结果;再按门诊号随机选择64例乳胶SPT阳性患者,并以30例无过敏性疾病及其家族史的正常人作为对照,采用纸片法ELISA和Western-blot测定血清中乳胶特异性IgE(sIgE)。结果门诊过敏性疾病患者乳胶SPT的阳性率(37.5%)较高;乳胶过敏高危人群乳胶sIgE的阳性率(39%)高于非高危人群(16%)和正常对照(0%),差异有统计学意义(P<0.05,P<0.01);过敏患者血清可与乳胶手套浸出液中的多种成分反应。结论乳胶是过敏性疾病患者常见致敏原之一,IgE介导的速发反应是乳胶过敏的常见形式之一,高危人群应进行乳胶过敏检查,以便适当进行职业防护和日常保护。     

Allergy to house dust mites and asthma

House dust mites have been shown to be important sources of indoor allergens associated with asthma and other allergic conditions. Asthma is a chronic respiratory disease that affects millions of people worldwide, and numerous scientific studies have shown that the prevalence of asthma is increasing. The most common dust mite species around the world include Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), Euroglyphus maynei (Em) and Blomia tropicalis (Bt). Over the past three decades, many important allergens from these species have been identified and characterized at the molecular level. The biological function of several house dust mite allergens has been elucidated, with many of them showing enzymatic activity. However, Bt allergens remain the least studied, even though this mite is very common in tropical and subtropical regions of the world, including Puerto Rico. Therefore, it is very important to include Bt in diagnostic and therapeutic strategies for house dust mite induced allergy and asthma, particularly in areas where Bt exposure and sensitization is high. Recombinant DNA technology, as well as other molecular biology and immunological techniques, have played a fundamental role in advances towards a better understanding of the biology of house dust mites and their role in allergic diseases. This kind of study also contributes to the understanding of the complex immunologic mechanisms involved in allergic reactions. The development of effective diagnostic and therapeutic approaches depends on the continuity of research of house dust mite allergens. The objectives of this review are to describe the most important aspects of house dust mite allergy and to acquaint the scientific community with the latest findings pertaining to house dust mite allergens, particularly those derived from Bt.     

The diagnosis of IgE-mediated allergy of the upper airways

A statistical analysis was made of data concerning diagnosis of IgE-mediated allergy in the upper respiratory tract in 292 patients. It appears that screening for an IgE-mediated allergy can be performed with a limited number of skin tests (rye grass, timothy, birch, house dust mite and cat). In this study a larger number of skin tests (15 instead of 5) and investigation of specific IgE (RAST) yielded little additional information (in 2% and 3% of the patients, respectively). When indicated, an extended series of skin tests, immuno-assay (total IgE and specific IgE) and eosinophil counts in the serum and nasal smear should be performed.