苏南地区儿童变应性鼻结膜炎临床研究

目的 分析苏南地区1~14岁患儿同时出现变应性鼻炎(AR)和变应性结膜炎(AC)的特应性分布状态、临床特征,以及变应性鼻结膜炎与其他变应性疾病之间的关系。 方法 采集2015年6月~2015年9月114例1~14岁具有变应性鼻结膜炎症状的苏南地区(苏州、无锡、常州)患儿病史资料,包括就诊年龄、性别、出现症状年龄、病史月数、个人过敏史、父母过敏史。采用敏筛定量过敏原检测系统( Allergy Screen)筛查共计19类吸入组和食物组变应原特异性lgE(specific IgE, sIgE)及血清总IgE水平。归纳该组患儿吸入性变应原和食物变应原致敏的分布状态, 按变应原类别及湿疹(EC)、荨麻疹或哮喘(AT)任一阳性分组分析各临床特征因子的影响作用,Logistic回归方法分析各临床特征与变应原致敏的相互关系。 结果 变应原筛查总阳性率为89.47%(102∕114);吸入组变应原、食物组变应原阳性率分别为89.47%(102∕114)、57.9%(66∕114);排名前四的过敏原分别为户尘螨、混合真菌、牛奶、狗毛皮屑。其中户尘螨阳性率最高(60.5%),其次为混合真菌(46.49%)、牛奶(27.19%)、狗毛皮屑(22.81%)。88.6%(101∕114)可确诊为变应性鼻结膜炎,其余可暂视为非变应性鼻结膜炎。变应原阳性102例,其中27例(26.5%)为单一阳性;75例(73.5%)伴发其他变应原阳性。114例中,仅7例(6.1%)表现为单一变应性疾病,107例(93.9%)伴有其他变应性疾病。联合变应性疾病排序情况为(AR+AC+AT+EC)>(AR+AC+EC)>(AR+AC)>(AR+AC+AT)。 结论 苏南地区1~14岁变应性鼻结膜炎患儿致敏变应原以吸入性变应原为主,其中户尘螨阳性率最高,其次为混合真菌 。变应性鼻结膜炎变应原致敏多为早发、复合致敏,联合发生多种变应性疾病的可能性大。

Clinical analysis of pediatric allergic rhinoconjunctivitis in the southern region of Jiangsu Province

Objective To study the atopy spectrum and related factors in 1-to 14-year-old children with allergic rhino-conjunctivitis from the southern region of Jiangsu Province,and to explore the relationship of allergic rhinoconjunctivitis with other allergic diseases.Methods Data from 114 children with allergic rhinoconjunctivitis from the southern region of Jiangsu Province (Suzhou,Wuxi,and Changzhou),aged between 1 and 14 years old and admitted to the Third Peo-ple's Hospital of Changzhou between June 2015 and September 2015,were retrospectively reviewed.The data included patients'age,sex,age at first symptom,duration of symptoms,allergic history of children,and allergic history of par-ents.Screening tests for inhalant and food allergens were conducted using an immunoblot assay with the Allergy Screen system.The total serum IgE level was also measured.The distribution of inhalant and food allergens was summarized. The influence of clinical characteristics was analyzed according to the allergen category and positivity for eczema,urti-caria,or asthma.Logistic regression was used to analyze the relationships between clinical characteristics and the aller-gen spectrum.Results The total positive rate of the allergic screening tests was 89.47% (102/114).The inhalant and food allergens accounted for 89.47% (102/114)and 57.9% (66 /114),respectively,of the positive rates. The top four allergens were Dermatophagoides pteronyssinus (60.5%),mixed fungi (46.49%),milk (27.19%), and dog dander (22.81%).Among the patients,88.6% (101 /114)were diagnosed with allergic rhinoconjunctivi-tis,and the remaining patients were temporarily diagnosed with non-allergic rhinoconjunctivitis.Among the 102 patients with positive allergic screening tests,27 (26.5%)showed positivity for a single allergen and 75 (73.5%)showed positivity for multiple allergens.Among 114 patients with allergic rhinoconjunctivitis,only 7 (6.1%)showed a single allergic disease,and 107 (93.9%)showed other accompanying allergic diseases.The sequence of the combinations of allergic diseases was as follows:(AR+AC +AT +EC)>(AR +AC +EC)>(AR +AC)>(AR +AC +AT). Conclusion Inhalant allergens were the main causes of pediatric allergic rhinoconjunctivitis in the southern region of Jiangsu Province,wherein the positive rate was highest for Dermatophagoides pteronyssinus,followed by mixed fungi. Allergic sensitization in allergic rhinoconjunctivitis is the early and compound sensitization that results in the possibility of multiple allergic diseases.