Zhumambayeva Saule, Rozenson Rafail, Tawfik Ali, Awadalla Nabil Joseph, Zhumambayeva Roza
the third year PhD student in «Medicine» specialty, department of children diseases N1, Medical University Astana, Astana, Kazakhstan.
Professor of the department of children diseases N1, Medical University Astana, Astana, Kazakhstan.
Int J Pediatr Otorhinolaryngol. 2014 Feb;78(2):214-7. doi: 10.1016/j.ijporl.2013.10.056. Epub 2013 Nov 25.
Introduction the first months of life are the most vulnerable period in allergic disease development and it is not clear enough whether inhalant pollen allergen exposure predisposes the risk of consequent allergic reactions.
To study the clinical and epidemiological criteria of hay fever with special emphasis on investigation of the relationship between the date of birth and seasonal allergic rhinitis development in children and adolescents in Kazakhstan.
The prospective hospital based study was conducted during pollen season from the beginning of May to the end of October in two consequent years 2010 and 2011. 184 children and adolescents at the age of 1--17 years underwent consultations and skin prick tests in the allergological center "Umit" (Astana, Kazakhstan). Special allergological questionnaires were developed and adapted for local residents. The assessment of symptoms severity was performed using a scoring system. Skin prick tests were performed in 112 patients. The number of patients was explained by the age limitations. Correlation analysis between skin prick test results and the month of birth were performed.
It was found that in summer months there were the highest number of patients with seasonal allergic rhinitis 68 (36.9%), followed by spring 44 (23.9%), then autumn 37 (20.1%) and the lowest percent of patients 35 (19.1%) was born in winter. Rhinoconjunctival syndrome was diagnosed in 180 (97.8%) patients, pollen induced bronchial asthma in 76 (41.3%) and pollen induced urticaria in 35 (19.0%) patients. Mono sensitization among Kazakhstan children and adolescents was determined only to several species of the plants, mainly to Artemisia Absinthium (68.2%) and Sunflower (25.7%), whereas multiple sensitization to the mix of weeds was determined in 75 (66.9%) patients, to the mix of meadow grass in 33 (29.4%), mix of meadow grass+mix of weeds in 25 (22.3%) and mix of trees in 9 (7.1%) patients. The mean of symptoms severity of total scoring (24) was 15.5. The mean of IgE level in blood tests was 323.2IU/ml.
Our results proved that first months of life are the crucial period and inhalant pollen allergen exposure, particularly to the weeds pollen, predisposes the risk of consequent allergic reactions development in children and adolescents in Kazakhstan. This fact may predetermine the risk of consequent allergic reactions development and the awareness of patients about it helps to prevent following severe clinical manifestations.
在生命的最初几个月是过敏性疾病发展中最脆弱的时期，吸入性花粉过敏原暴露是否会增加随后发生过敏反应的风险尚不清楚。
研究花粉症的临床和流行病学标准，特别强调调查哈萨克斯坦儿童和青少年的出生日期与季节性过敏性鼻炎发展之间的关系。
在2010年和2011年连续两年的花粉季节（从5月初到10月底）进行了一项基于医院的前瞻性研究。184名1至17岁的儿童和青少年在哈萨克斯坦阿斯塔纳的“Umit”过敏中心接受了咨询和皮肤点刺试验。专门为当地居民开发并改编了过敏问卷。使用评分系统对症状严重程度进行评估。对112名患者进行了皮肤点刺试验。由于年龄限制，患者数量有限。对皮肤点刺试验结果与出生月份进行了相关性分析。
发现夏季季节性过敏性鼻炎患者数量最多，为68例（36.9%），其次是春季44例（23.9%）,秋季37例（20.1%），冬季出生的患者比例最低，为35例（19.）。180例（97.8%）患者被诊断为鼻结膜炎综合征，76例（41.3%）患者被诊断为花粉诱发的支气管哮喘，35例（19.0%）患者被诊断为花粉诱发的荨麻疹。哈萨克斯坦儿童和青少年中仅对几种植物有单一致敏，主要是对苦艾（68.2%）和向日葵（25.7%），而75例（66.9%）患者对杂草混合物有多重致敏，33例（29.4%）患者对草地草混合物有多重致敏，25例（22.3%）患者对草地草混合物+杂草混合物有多重致敏，9例（7.1%）患者对树木混合物有多重致敏。总评分（24分）的症状严重程度平均值为15.5。血液检测中IgE水平的平均值为323.2IU/ml。
我们的结果证明，生命的最初几个月是关键时期，吸入性花粉过敏原暴露，特别是对杂草花粉的暴露，会增加哈萨克斯坦儿童和青少年随后发生过敏反应的风险。这一事实可能预先决定随后发生过敏反应的风险，患者对此的认识有助于预防随后的严重临床表现。
