Allergy Unit, Hospital Universitario Fundacion Alcorcón, Alcorcón, Madrid, Spain.
Medicine and Surgery Department, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Clin Exp Allergy. 2015 Jun;45(6):1027-39. doi: 10.1111/cea.12418.
Knowledge about the epidemiology of anaphylaxis is based on data from various sources: clinical practice, large secondary clinical and administrative databases of primary care or hospitalized patients, and recent surveys with representative samples of the general population. As several similar results are often reported in several publications and populations, such findings are highly like to be robust. One such finding is that the incidence and prevalence of anaphylaxis are higher than previously thought. Publications from the last 5 years reveal an incidence of between 50 and 112 episodes per 100 000 person-years; estimated prevalence is 0.3-5.1% depending on the rigour of the definitions used. Figures are higher in children, especially those aged 0-4 years. Publications from various geographical areas based on clinical and administrative data on hospitalized patients suggest that the frequency of admissions due to anaphylaxis has increased (5-7-fold in the last 10-15 years). Other publications point to a geographic gradient in the incidence of anaphylaxis, with higher frequencies recorded in areas with few hours of sunlight. However, these trends could be the result of factors other than a real change in the incidence of anaphylaxis, such as changes in disease coding and in the care provided. Based on data from the records of voluntary declarations of death by physicians and from large national databases, death from anaphylaxis remains very infrequent and stands at 0.35-1.06 deaths per million people per year, with no increases observed in the last 10-15 years. Although anaphylaxis can be fatal, recurrence of anaphylaxis--especially that associated with atopic diseases and hymenoptera stings--affects 26.5-54% of patients.
临床实践、大型初级保健或住院患者的二次临床和行政数据库、以及针对普通人群的具有代表性样本的最新调查。由于在若干出版物和人群中经常报告有若干类似结果,因此这些发现极有可能是可靠的。其中一个发现是过敏反应的发病率和患病率高于以往的认识。过去 5 年的出版物报告的发病率为每 100000 人年 50-112 例;根据所用定义的严格程度,估计的患病率为 0.3-5.1%。儿童中的发病率更高,尤其是 0-4 岁的儿童。基于住院患者的临床和行政数据的来自不同地理区域的出版物表明,由于过敏反应而入院的频率有所增加(在过去 10-15 年中增加了 5-7 倍)。其他出版物表明过敏反应的发病率存在地理梯度,在阳光照射时间较少的地区记录到的频率更高。然而,这些趋势可能是过敏反应发病率发生真实变化以外的其他因素造成的,例如疾病编码和所提供的护理的变化。根据医生自愿申报死亡记录的数据和来自大型国家数据库的数据,因过敏反应而死亡的情况仍然非常罕见,每年每百万人中有 0.35-1.06 人死亡,在过去 10-15 年中没有观察到增加。尽管过敏反应可能致命,但过敏反应的复发--特别是与特应性疾病和膜翅目昆虫螫伤相关的过敏反应--影响 26.5-54%的患者。