儿童血清过敏原与哮喘发生关系的探讨

Association between serum allergens and asthma in children

摘要:

目的 探讨儿童血清特异性IgE(sIgE)过敏原与哮喘发生的关系。方法 采用免疫印迹法对2004年12月至2013年4月就诊的2 239例1~14岁单纯哮喘患儿(n=1 415)和非过敏性疾病患儿(n=824)的血清sIgE过敏原进行检测,分别建立所有样本、不同年龄及不同性别单纯哮喘与非过敏性疾病的病例对照模型,采用多因素logistic回归分析探讨过敏原与哮喘发生的关系。结果 2 239例患儿中,血清sIgE阳性者1 028例(45.91%),过敏原阳性率居于前三位的为户尘螨(15.68%)、屋尘(14.29%)和霉菌类(13.40%)。病例对照研究结果显示,户尘螨、霉菌类、屋尘、腰果/花生/黄豆是哮喘发病的危险因素(P< 0.05);不同年龄组与哮喘发生相关的过敏原有所不同,1岁~ 组儿童仅屋尘与哮喘的发生有关,户尘螨和屋尘是3~14岁儿童哮喘发生的危险因素,而霉菌类是6~14岁儿童哮喘发生的危险因素(P< 0.05);户尘螨和屋尘是男、女儿童哮喘发生的危险因素(P< 0.05),而腰果/花生/黄豆和霉菌类仅是男性儿童哮喘发生的危险因素(P< 0.05)。结论 户尘螨、屋尘、霉菌类为哮喘患儿最常见过敏原,且与哮喘发生关系极为密切。

Abstract:

Objective To study the association between serum-specific immunoglobulin E (sIgE) allergens and asthma in children. Methods The serum sIgE allergens were determined using Western blot in 2 239 children aged 1-14 years, consisting of 1 415 children with asthma alone and 824 children with non-allergic diseases between December 2004 and April 2013. The case-control models of asthma alone and non-allergic diseases were established. The association between allergens and asthma was investigated using multivariate logistic regression analysis. Results In the 2 239 children, 1 028 children (45.91%) were serum sIgE-positive, and the allergen with the highest positive rate was house-dust mite (15.68%), followed by house dust (14.29%) and moulds (13.40%). The results of the case-control analysis showed that house-dust mite, moulds, house dust, and cashew nut/peanut/soybean were significantly associated with the development of asthma. House dust was associated with the development of asthma in the 1-2 years old group (P< 0.05). House dust and house-dust mite as allergens were identified as the risk factors for the development of asthma in the 3-14 years old group (P< 0.05). In the 6-14 years old group, moulds as allergens were identified as the risk factors for the development of asthma (P< 0.05). House dust and house-dust mite as allergens increased the risk of asthma in boys and girls, while moulds and cashew nuts/peanuts/soybeans as allergens increased the risk of asthma in boys. Conclusions House-dust mite, house dust, and moulds are the most common allergens in children with asthma, and they are closely associated with the development of asthma.