儿童不同过敏性疾病的过敏原构成分析

Positive allergens in children with different allergic diseases

摘要:

目的 研究不同过敏性疾病患儿的常见过敏原,为儿童过敏性疾病的临床诊断、治疗和预防提供依据。方法 采用皮肤点刺试验对1 179 例患各种过敏性疾病的患儿进行过敏原检测,根据临床诊断分为6 组:特应性皮炎组(n=140)、过敏性胃肠炎组(n=37)、过敏性结膜炎组(n=77)、过敏性鼻炎组(n=301)、哮喘组(n=285)、混合过敏性疾病组(n=329)。结果 1 179 例患儿过敏原阳性总检出率为82.0%,阳性率最高的吸入过敏原是粉尘螨(68.1%)和屋尘螨(53.5%),阳性率最高的食物过敏原是牛奶(5.0%)和鸡蛋(4.8%)。特应性皮炎组和过敏性胃肠炎组中≤3岁患病的人数分别占84.3% 和83.8%,过敏性结膜炎组、过敏性鼻炎组、哮喘组和混合过敏性疾病组均以4 岁以上儿童占多数。特应性皮炎组以食物过敏原阳性为主,最常见的过敏原是鸡蛋和粉尘螨;过敏性胃肠炎组以食物过敏原阳性为主,最常见的过敏原是鸡蛋和牛奶;过敏性结膜炎组、过敏性鼻炎组、哮喘组和混合过敏性疾病组均以吸入性过敏原阳性为主,最常见的过敏原均是粉尘螨和屋尘螨。结论 不同过敏性疾病患儿的年龄分布和过敏原种类不同:特应性皮炎和过敏性胃肠炎多见于婴幼儿,以食物过敏原为主;过敏性结膜炎、鼻炎、哮喘和混合过敏症多见于年长儿,以吸入性过敏原为主。

Abstract:

Objective To investigate the major allergens in children with different allergic diseases, and to provide theoretical evidence for the clinical prevention, diagnosis, and treatment of allergic diseases in children.Methods Skin prick test (SPT) was conducted to detect allergens in 1 179 allergic children. According to clinical diagnoses, patients were categorized into six groups:atopic dermatitis (n=140), allergic gastroenteritis (n=37), allergic conjunctivitis (n=77), asthma (n=285), allergic rhinitis (n=301) and allergic co-morbidity (n=329) groups.Results Of the 1 179 patients, 82.0% had positive SPT results; the most prevalent inhalant allergens were Dermatophagoides farinae (68.1%) and Dermatophagoides pteronyssinus (53.5%), while the most common food allergens were milk (5.0%) and eggs (4.8%). The proportions were 84.3% and 83.8% for patients under or equal to 3 years of age in the atopic dermatitis and allergic gastroenteritis groups, respectively. Patients over 4 years of age accounted for the majority of the other four groups. Food as major allergens were found in both atopic dermatitis and allergic gastroenteritis groups; eggs and Dermatophagoides farinae were the most common allergens for the former group, while eggs and milk for the latter group. Inhalant allergens were the major allergens in the allergic conjunctivitis, allergic rhinitis, asthma, and allergic co-morbidity groups, and the most prevalent allergens were Dermatophagoides farinae and Dermatophagoides pteronyssinus.Conclusions There are differences in the distribution of age and allergen types in children with different allergic diseases. Atopic dermatitis and allergic gastroenteritis are prevalent in infants and young children, and food allergens are more common. Patients in allergic conjunctivitis, allergic rhinitis, asthma, and allergic co-morbidity groups are mostly children over 4 years of age, and inhalant allergens are more common.