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儿童过敏反应在三级医疗中心的特征。

Characteristics of anaphylaxis in children referred to a tertiary care center.

机构信息

Department of Pediatric Allergy and Clinic Immunology, Ankara Children's Hematology Oncology Education and Research Hospital, Ankara, Turkey.

出版信息

Allergy Asthma Proc. 2013 May-Jun;34(3):239-46. doi: 10.2500/aap.2013.34.3654.

DOI:10.2500/aap.2013.34.3654
PMID:23676573
Abstract

Anaphylaxis is a potentially life-threatening condition. There are limited data about the etiology and the clinical characteristics in developing countries. This study aimed to investigate the clinical characteristics of anaphylaxis patients attending our pediatric allergy clinic. We conducted a prospective analysis of patients who were admitted to our allergy clinic for anaphylaxis from 2010 to 2012. Ninety-six patients were evaluated during the study period. The mean age was 7.4 ± 5.2 years. Venom, food, and drugs were the most common causative agents responsible for 31 (32.3%), 30 (31.3%), and 26 (27.1%) of the cases, respectively. Foods implicated most frequently were peanuts and nuts (n = 9; 30.0%), cow's milk (n = 7; 23.3%), and egg white (n = 6; 20.0%). The clinical manifestations during anaphylaxis in order of frequency were cutaneous (97.9%), respiratory (86.5%), gastrointestinal (42.7%), neurological (37.5%), and cardiovascular symptoms (30.2%). A biphasic course was noticed in five cases (5.2%). Of the 91 patients, 79 (86.8%) received H1-antihistamines, 73 (80.2%) received corticosteroids, 40 (44.4%) received adrenaline, 38 (41.8%) received fluid replacement therapy, 18 (19.8%) received β2-mimetics, and 8 (8.8%) received H2-antihistamines. According to severity, 7.3% of patients had mild, 59.4% had moderate, and 33.3% had severe anaphylaxis. Food and bee venom allergy were the most common etiologies. Adrenaline, the first-line treatment of anaphylaxis, was administered in only 44.4% of our cases.

摘要

过敏反应是一种潜在的危及生命的情况。发展中国家有关病因和临床特征的资料有限。本研究旨在调查我院儿科过敏门诊就诊的过敏反应患者的临床特征。我们对 2010 年至 2012 年期间因过敏反应而入住我院过敏门诊的患者进行了前瞻性分析。研究期间共评估了 96 例患者。平均年龄为 7.4±5.2 岁。毒液、食物和药物是引起 31 例(32.3%)、30 例(31.3%)和 26 例(27.1%)过敏反应的最常见病因。最常涉及的食物是花生和坚果(n=9;30.0%)、牛奶(n=7;23.3%)和蛋清(n=6;20.0%)。过敏反应的临床表现按频率排列为皮肤(97.9%)、呼吸(86.5%)、胃肠道(42.7%)、神经(37.5%)和心血管症状(30.2%)。5 例(5.2%)患者出现双相病程。在 91 例患者中,79 例(86.8%)接受了 H1 抗组胺药,73 例(80.2%)接受了皮质类固醇,40 例(44.4%)接受了肾上腺素,38 例(41.8%)接受了液体替代治疗,18 例(19.8%)接受了β2-激动剂,8 例(8.8%)接受了 H2 抗组胺药。根据严重程度,7.3%的患者为轻度,59.4%为中度,33.3%为重度过敏反应。食物和蜂毒过敏是最常见的病因。肾上腺素是过敏反应的一线治疗药物,但在我们的病例中只有 44.4%的患者使用了肾上腺素。

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