4岁以下哮喘患儿特应性状态及其与临床特征关系

Atopy spectrum and its relationship with clinical characteristics in asthmatic children under 4 years of age

摘要:

目的：分析4岁以下哮喘患儿特应性分布状态及其与临床特征关系。方法：采集62例经临床诊断的4岁以下哮喘患儿病史资料,包括年龄、性别、初次喘息年龄,已发作喘息次数,病史月数,父母过敏史(主要为经临床诊断的哮喘和过敏性鼻炎),个人过敏史(主要为经临床诊断的湿疹和过敏性鼻炎)。UniCAP100系统荧光酶联免疫法筛查混合食物变应原(fx5E)、混合霉菌(mx2)、混合吸入性变应原(Phadiatop)以及测定血清总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,Logistic回归方法分析各临床特征对变应原致敏的影响作用。结果：fx5E,mx2,Phadiatop阳性率分别为40.3%,14.5%,14.5%,三类混合变应原筛查总阳性率为46.8%,总吸入性变应原致敏率24.2%。结论：4岁以下临床诊断哮喘的患儿经体外检测显示约四分之一存在吸入变应原致敏;父母哮喘史、患儿食物变应原致敏、初次喘息年龄在2岁以后和高IgE水平提示对吸入性变应原致敏的影响有显著性意义。

Abstract:

OBJECTIVE: To study the atopy spectrum and the influence of clinical characteristics upon it in asthmatic children under 4 years of age. METHODS: Clinical data of 62 asthmatic children under 4 years of age, including age, sex, the age of first wheezing attack, the total times of wheezing attack, the duration of history of wheezing, and the allergic history of both children and parents, were collected. The screening tests on allergens (fx5E,mx2 and Phadiatop)were conducted by fluoroenzyme-immunometric assay using the UniCAP100 system. The total serum IgE level was also measured. Logistic regression was used to analyze the effect of clininal characteristics on allergic sensitization. RESULTS: The positive rates of fx5E, mx2 and Phadiatop were 40.3%, 14.5% and 14.5% respectively, and the total allergic sensitization screening test rate was 46.8%. The sensitization rate to inhalant allergens was 24.2%. The allergic history of parent )s), the sensitization to food allergens, the age of first wheezing attack and total serum IgE level were main factors influencing the sensitization to inhalant allergens. CONCLUSIONS: About a quarter of asthmatic children under 4 years of age showed sensitization to inhalant allergens. The asthmatic history of parent (s), the sensitization to food allergens, the age of first wheezing attack greater than 2 years and the significantly higher total serum IgE level may increase the possibility of sensitization to inhalant allergens in asthmatic children under 4 years of age.