五岁以下哮喘儿童变应原的检测及临床意义

目的了解年幼儿哮喘常见变应原,为有效避免变应原及早期干预治疗提供依据。方法选择在海南省人民医院儿童哮喘防治中心治疗的5岁以下哮喘儿童468例,使用丹麦爱尔开-阿贝优公司的吸入组点刺试剂进行皮肤点刺试验,对其中251例哮喘患儿定量检测血清中变应原特异性IgE抗体水平。结果 468例哮喘患儿体内过敏原（皮肤点刺试验）阳性率为66%,尘螨皮试阳性率最高且强阳性率（＋＋＋—＋＋＋＋）也最高,其中屋尘螨及粉尘螨分别为87.4%及86.3%,热带螨为66.3%,德国小蠊及美洲大蠊分别为26.7%及19.9%。动物皮毛中,以狗毛为主（20.1%）,猫毛次之（12.4%）。251例体外变应原检测阳性率为57.8%,其中仍以屋尘螨阳性率（63.25%）最高,粉尘螨（58.6%）次之,狗上皮为15.9%。食物组中蛋清为9.3%、花生为4.3%、苹果为3.1%,分居前3。结论哮喘儿童皮肤点刺试验有较高的变应原检出率,屋尘螨、粉尘螨、热带螨是海南儿童哮喘最常见的吸入变应原,蟑螂、狗毛、猫毛等变应原也不容忽视。食入性过敏原检出率低,其对儿童哮喘的影响远低于吸入变应原。

Detecting allergen for asthma in children under5 years old

Objective To explore the common allergens for asthma in young children,and then avoid allergens and provide a basis for early intervention of immunotherapy.Methods 468 patients were performed skin prick testing by a panel of inhaled allergen extracts and 251 patients were carried out specific IgE testing for against allergens.Results Skin prick tests showed that 66% patients sensitized to allergen extract from 468 patients.There is high percentage and strong positive against dust mites.Among the SPT positive patients,there are 87.4%,86.3% and 66.3% patients allergic to Der p,Der f and Blo t.German cockroach and America cockroach 26.7% and 19.9% respectively.SPT positive rate for dog 20.1%,cat 12.4%.Specific IgE tests showed positive rates 57.8%,Der p 66.2% and Der f 59.6%,dog 15.9%,egg yolk 9.3%,peanut 4.3%,apple 3.1% of food allergens.Conclusion There is a higher detection rate of allergens of SPT in asthmatic children than sIgE.There is a high percentage of SPT positive and a very high prevalence of sensitization against Der p and Der f,Blo t in childhood asthma of Hainan.Sensitization against cockroach,dog and cat could not be disregard.There is a lower detection rate of ingested allergen and less important for childhood asthma compare to inhaled allergen.