Dai Wei-li, Zhang Jie, Pan Yue-song, Chen Min, Zhang Ya-mei
Department of Otorhinolaryngologyl, Beijing Children's Hospital Affiliated to Capital University of Medical Sciences, Beijing 100045, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Nov;46(11):921-7.
To study the atopy spectrum and its related factors in 1 to 3 years old children with allergic rhinitis.
Ninety-six children with allergic rhinitis, aged between 1 and 3 years old, referred to ENT department of Beijing Children's Hospital between August 2009 and November 2010 were retrospectively reviewed. Data were recorded for patients' age, age stratification, sex, the age of first symptom, the duration of history, and the allergic history of children, the allergic history of parents. The screening tests on inhalant and food allergens were conducted by immunoblot assay using the Allergy Screen system. The total serum IgE level was also measured. The distribution of the inhalant and food allergens was summarized. The influence of the clinical characteristics was analyzed according to the age subgroup determined by month, allergen category and positiveness of eczema or asthma. Logistic regression was used to analyze the relationship of clinical characteristics and allergen spectrum.
The total positive rates of allergic screening test rate were 81.3%. The inhalant and food allergens were 62.5% and 53.1% respectively. The commonest allergy was mixed fungal (50.0%), followed by milk (34.4%), lamb (31.3%), beef (26.0%), dust mite (21.0%), wheat (18.8%), mugwort (12.5%), egg white or egg yolk (11.5%).62.5% of patients could be diagnosed as AR, the remaining could be diagnosed temporarily as non-allergic rhinitis temporarily. Single factor analysis of clinical characteristics in different subgroup determined by month showed that: inhalant allergen (positive/negative) (χ2=13.699, P=0.001), father suffered from AR (χ2=14.060, P=0.001), and father or mother suffered from AR (χ2=7.396, P=0.025) were statistically significant at three monthly age groups. The personal history of eczema (OR=3.143, P=0.034) might increase the possibility of sensitization to allergens. The personal history of eczema (OR=3.125, P=0.015) and the total serum IgE level>200 IU/ml (OR=3.119, P=0.030) might increase the possibility of sensitization to inhalant allergens. No clinical features for food allergen sensitization was statistically significant. There was no significant difference in positive rates between inhalant and food allergens groups. The presence of inhalant allergens (OR=3.594, P=0.046), insect bites dermatitis (OR=11.941, P=0.002) were the risk factors for positiveness of eczema or asthma, and the father with AR (OR=0.251, P=0.040) as protective factors.
Inhalant and food allergens all can be sensitized in the children with AR symptoms between 1 to 3 years old, and the positive rate of inhalant group is slightly higher. The differences of the inhalant allergen (positive/negative) and father suffered from AR are statistically significant at three monthly age groups. The history of eczema is the risk factor for allergen screening positive. Serum total IgE>200 IU/ml and eczema history are risk factors for inhalant allergen screening positive. The factors of inhalant allergens, insect bites dermatitis and father suffered from AR relate to any positive of eczema or asthma.
研究1至3岁过敏性鼻炎患儿的特应性谱及其相关因素。
回顾性分析2009年8月至2010年11月在北京儿童医院耳鼻喉科就诊的96例1至3岁过敏性鼻炎患儿。记录患儿的年龄、年龄分层、性别、首发症状年龄、病程、患儿过敏史、父母过敏史。采用Allergy Screen系统免疫印迹法进行吸入性和食物过敏原筛查试验。同时检测血清总IgE水平。总结吸入性和食物过敏原的分布情况。根据月龄、过敏原类别以及湿疹或哮喘的阳性情况确定年龄亚组,分析临床特征的影响。采用Logistic回归分析临床特征与过敏原谱的关系。
过敏筛查试验总阳性率为81.3%。吸入性和食物过敏原阳性率分别为62.5%和53.1%。最常见的过敏是混合真菌(50.0%),其次是牛奶(34.4%)、羊肉(31.3%)、牛肉(26.0%)、尘螨(21.0%)、小麦(18.8%)、艾蒿(12.5%)、蛋清或蛋黄(11.5%)。62.5%的患者可诊断为变应性鼻炎(AR),其余患者可暂时诊断为非过敏性鼻炎。按月龄对不同亚组临床特征进行单因素分析显示:吸入性过敏原(阳性/阴性)(χ2=13.699,P=0.001)、父亲患AR(χ2=14.060,P=0.001)、父亲或母亲患AR(χ2=7.396,P=0.025)在三个月龄组有统计学意义。个人湿疹史(OR=3.143,P=0.034)可能增加对过敏原致敏的可能性。个人湿疹史(OR=3.125,P=0.015)和血清总IgE水平>200 IU/ml(OR=3.119,P=0.030)可能增加对吸入性过敏原致敏的可能性。食物过敏原致敏的临床特征无统计学意义。吸入性和食物过敏原组阳性率无显著差异。吸入性过敏原的存在(OR=3.594,P=0.046)、虫咬性皮炎(OR=11.941,P=0.002)是湿疹或哮喘阳性的危险因素,父亲患AR(OR=0.251,P=0.040)为保护因素。
1至3岁有AR症状的患儿吸入性和食物过敏原均可致敏,吸入性组阳性率略高。吸入性过敏原(阳性/阴性)及父亲患AR在三个月龄组有统计学差异。湿疹病史是过敏原筛查阳性的危险因素。血清总IgE>200 IU/ml和湿疹病史是吸入性过敏原筛查阳性的危险因素。吸入性过敏原、虫咬性皮炎及父亲患AR的因素与湿疹或哮喘的任何一项阳性有关。