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北京地区患有呼吸道过敏的儿童对气传变应原致敏的患病率

Prevalence of Sensitization to Aeroallergens in Greater Beijing Region Children With Respiratory Allergy.

作者信息

Guan Kai, Zhu Wenjing, Sha Li, Liu Chuanhe, Zhao Jing, Yin Jia, Chen Yuzhi

机构信息

Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China.

出版信息

Front Pediatr. 2022 May 19;10:848357. doi: 10.3389/fped.2022.848357. eCollection 2022.

Abstract

OBJECTIVE

To evaluate the prevalence and distribution of sensitization to aeroallergens in children with atopic diseases.

METHODS

We conducted skin prick test on 9,527 pediatric patients (aged 0-17 years) with atopic diseases in allergy department of Children's Hospital affiliated with the Capital Institute of Pediatrics. Positive rates of aeroallergens were compared among the different groups.

RESULTS

Boys (69.5%) had a higher positive rate in SPT results than girls (59.8%; χ = 91.7, < 0.01), and the prevalence of sensitization to aeroallergens increased from 56.1% in the 0-5 year group, to 73.0% in patients above 12 years. Japanese hop (36.2%) and (28.1%) were the most common outdoor and indoor aeroallergens, respectively. From low to high age groups, the positive detection rates of were 20.3, 30.6, and 33.5%, respectively, followed by D. pteronyssinus (15.7, 24.8, and 30.0%) and cat dander (8.6, 19.8, and 27.9%, respectively), while dog dander and cockroach showed the same trend. The top three positive detection rates of outdoor aeroallergens were Alternaria (30.9%), Japanese Hop (26.7%), and Artemisia (23.7%) in the preschool age group. With regard to patients aged 6 to 11 years, the three most common were Japanese hop (39.2%), Alternaria (36.4%), and Fraxinus pollen (34.4%). Japanese hop (43.8%), Sabina (41.1%), and birch pollen (39.6%) became increasingly common allergens among adolescents. There were more patients with strongly positive reactions to Alternaria in AS (χ = 10.2, < 0.01) and AS with AR groups (χ =9.7, < 0.01) than those in the AR group. Asthmatic patients had significantly higher multiple positive reactions than those with AR ( < 0.01). Asthmatic patients had a much higher prevalence of HDM, animal dander, and Alternaria than those with allergic rhinitis ( < 0.05).

CONCLUSION

The prevalence of sensitization to aeroallergens increased with age in children with atopic diseases in Greater Beijing Region. Alternaria was the predominant allergen before 5 years of age, and tree pollen had delayed sensitization in adolescents. Sensitization to perennial allergens such as HDM, cats, and Alternaria was more strongly associated with asthma risk. Sensitization to more than one allergen significantly affected asthmatic patients.

摘要

目的

评估特应性疾病患儿对空气变应原的致敏率及分布情况。

方法

对首都儿科研究所附属儿童医院变态反应科9527例0至17岁患特应性疾病的儿科患者进行皮肤点刺试验。比较不同组间空气变应原的阳性率。

结果

男孩皮肤点刺试验结果的阳性率(69.5%)高于女孩(59.8%;χ² = 91.7,P < 0.01),对空气变应原的致敏率从0至5岁组的56.1%升至12岁以上患者的73.0%。律草(36.2%)和屋尘螨(28.1%)分别是最常见的室外和室内空气变应原。从低年龄组到高年龄组,屋尘螨的阳性检出率分别为20.3%、30.6%和33.5%,其次是粉尘螨(15.7%、24.8%和30.0%)和猫皮屑(分别为8.6%、19.8%和27.9%),狗皮屑和蟑螂也呈相同趋势。学龄前儿童室外空气变应原阳性检出率前三位的是链格孢(30.9%)、律草(26.7%)和蒿属(23.7%)。6至11岁患者中,最常见的三种是律草(39.2%)、链格孢(36.4%)和白蜡花粉(34.4%)。律草(43.8%)、圆柏(41.1%)和桦树花粉(39.6%)在青少年中成为越来越常见的变应原。变应性鼻窦炎(χ² = 10.2,P < 0.01)和变应性鼻窦炎合并变应性鼻炎组(χ² = 9.7,P < 0.01)中对链格孢强阳性反应的患者多于变应性鼻炎组。哮喘患者的多重阳性反应显著高于变应性鼻炎患者(P < 0.01)。哮喘患者中屋尘螨、动物皮屑和链格孢的患病率远高于变应性鼻炎患者(P < 0.05)。

结论

在大北京地区,特应性疾病患儿对空气变应原的致敏率随年龄增长而升高。5岁前链格孢是主要变应原,树木花粉在青少年中致敏较晚。对屋尘螨、猫和链格孢等常年性变应原的致敏与哮喘风险关联更强。对一种以上变应原致敏对哮喘患者影响显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb3c/9161292/269f87d654d3/fped-10-848357-g0001.jpg

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