未成年人与成年人变应性鼻炎变应原致敏特点

目的 分析江苏省常州市变应性鼻炎(AR)患者16种标准化变应原皮肤点刺试验(SPT)结果，比较本地区未成年人与成年人变应性鼻炎变应原致敏的特点。方法 4383例(3~75岁)临床疑似AR的患者被分为未成年人组(3~17岁)及成年人组(18~75岁)，其中未成年人组又细分为三组(3~5岁组，6~14岁组，15~17岁组)后进行SPT结果分析。结果 未成年人组SPT阳性1063例(78.9%)，其中男717例(67.5%)，女346例(32.5%)；成年人组SPT阳性1687例(55.6%)，其中男715例(42.4%)，女972例(57.6%)。未成年人组与成年人组均以粉尘螨、户尘螨为最主要变应原，阳性率分别为92.9%、90.8%及81.0%、78.9%。主要变应原第3~5位者，未成年人组为猫毛(7.2%)、蟑螂(6.9%)、葎草花粉(5.8%)，成年人组为蟑螂(14.2%)、葎草花粉(13.0%)、海虾(6.4%)。经χ2检验，未成年人组与成年人组的SPT阳性率，SPT阳性男女比例，粉尘螨、户尘螨、蟑螂、葎草花粉及猫毛变应原阳性率，单一尘螨阳性率，单一尘螨阳性男女比例，粉尘螨及户尘螨阳性等级中+++及++++构成比与++构成比差异均有统计学意义(P<0.05)。经细分的未成年人三组间，除6~14岁组SPT阳性率与3～5岁组和15～17岁组比较差异有统计学意义(P<0.05)外，其余上述各项两两相比差异均无统计学意义(P>0.05)。结论 本地区未成年人与成年人AR患者的主要变应原存在显著差别。未成年人组中，男性SPT阳性率及单一尘螨阳性率明显高于女性。未成年人更适合特异性免疫治疗(SIT)。

Analysis on characteristics of allergic sensitization in childhood and adult patients with allergic rhinitis

Objective To investigate positive allergens and sex distribution in childhood and adult patients with allergic rhinitis(AR) in Changzhou City, Jiangsu Province. Methods A total of 4383 cases (aged between 3-75 years) with allergic symptoms and signs underwent skin prick test (SPT)with 16 kinds of standardized allergens. The samples were stratified on childhood and adult groups to analysis the distributive characteristics of allergens responsible for each group. The childhood subjects were further stratified on 3 groups (3-5-year-old, 6-14-year-old, 15-17-year-old) for analysis. Results 1063 cases (78.9%) had the positive reaction in the childhood group, including 717 (67.5%) cases of males and 346 (32.5%) cases of females. 1687 cases (55.6%) had the positive reaction in the adult group, including 715 (42.4%) cases of males and 972 (57.6%) cases of females. Dermatophagoides farinae and Dermatophagodies pteronyssinus had the highest positive ratio (92.9%, 90.8% and 81.0%, 78.9%) in both groups, the 3rd to 5th followed were cat hair (7.2%), cockroach (6.9%) and Humulus L.(5.8%) in the childhood group, cockroach (14.2%), Humulus L.(13.0%), and shrimp (6.4%) in the adult group. There were significantly higher sensitivities to positive ratio of SPT, male and female positive ratio of SPT, positive ratio of Dermatophagoides farinae, Dermatophagodies pteronyssinus, cockroach, Humulus L. and cat hair, positive ratio of single dust mite, male and female positive ratio of single dust mite, and the ratio of class +++, ++++ and ++ in the dust mite position between the childhood group and the adult group (P<0.05). And there were no significantly high sensitivities to the three groups in childhood according to the items above expect positive ratio of SPT between the 6-14-year-old group and the 3-5-year-old group (P<0.05), and the 6-14-year-old and 15-17-year-old groups (P<0.05). Conclusion There are significantly high sensitivity to the main allergens between childhood and adult AR patients in the region. In childhood group, the number of male is higher than that of female in the positive ratio of SPT and the single Dust mite. It suggests that the minors would be more suitable for specific immunotherapy.