过敏反应：亚洲一家三级保健医院的十年回顾性研究。
Anaphylaxis: Ten-year retrospective study from a tertiary-care hospital in Asia.
机构信息
Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
出版信息
Asian Pac J Allergy Immunol. 2020 Mar;38(1):31-39. doi: 10.12932/AP-210318-0284.
BACKGROUND
The study of anaphylaxis in different geographic areas raises the awareness to improve prevention and medical care.
OBJECTIVE
To investigate the incidence, causes, characteristics, and management of anaphylaxis in Chiang Mai, Thailand.
METHODS
We performed a retrospective review, based on ICD-10 electronic medical records of patients who attended the Out-Patient and Emergency Departments at Chiang Mai University Hospital from January 2007 to December 2016.
RESULTS
A total of 441 episodes of anaphylaxis in 433 patients were analyzed. Three-hundred and sixty-two (84%) were adults and 71 (16%) were children. Anaphylaxis was common in the second and third decades of life. The incidence rate for all causes of anaphylaxis was 3.9 episodes per 100,000 out-patient and emergency visits per year. The rate in children was more frequent than in adults. Foods were the most common culprit (47%), followed by insect stings (23%) and drugs (18%). Severe anaphylaxis, defined as the loss of consciousness, hypotension, respiratory failure, or cyanosis were found in 163 events (37%). The time lapses between exposure with an allergen and the onset of symptom less than 30 minutes and triggered by insect stings were significantly associated with severe anaphylaxis. Biphasic reactions occurred in 6 patients (1.4%). Adrenaline injections were prescribed in most of patients (90%). There were no fatality cases in the past 10 years.
CONCLUSIONS
The incidence of anaphylaxis in our hospital appears more often in children than in adults. The frequency in adults trends to be increasing. Food and insect stings are the common causative agents.
背景
不同地理区域的过敏反应研究提高了人们对预防和医疗的认识。
目的
调查泰国清迈过敏反应的发生率、原因、特征和管理。
方法
我们对 2007 年 1 月至 2016 年 12 月期间在清迈大学医院门诊和急诊就诊的患者的 ICD-10 电子病历进行了回顾性分析。
结果
共分析了 433 例患者的 441 例过敏反应。其中 362 例（84%）为成年人，71 例（16%）为儿童。过敏反应在 20 至 30 岁的人群中较为常见。所有过敏反应的发生率为每 100000 次门诊和急诊就诊 3.9 例。儿童的发生率高于成年人。食物是最常见的罪魁祸首（47%），其次是昆虫叮咬（23%）和药物（18%）。严重过敏反应，定义为意识丧失、低血压、呼吸衰竭或发绀，发生在 163 例（37%）中。暴露于过敏原与症状发作之间的时间间隔小于 30 分钟，且由昆虫叮咬引起的过敏反应与严重过敏反应显著相关。6 例（1.4%）发生双相反应。大多数患者（90%）都开了肾上腺素注射剂。在过去的 10 年中没有死亡病例。
结论
我们医院的过敏反应发生率在儿童中比在成人中更为常见。成人的发病率呈上升趋势。食物和昆虫叮咬是常见的致病因素。
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