Wüthrich B, Annen H
Schweiz Med Wochenschr. 1979 Sep 1;109(33):1212-8.
Case histories are analyzed of 1565 hay fever patients first attending an allergy unit. The mean age of the test persons was 19.5 years. 40% were in the age group 5 to 15 years. The sex distribution showed a slight but statistically significant prevalence of males (56.6%). 56.8% had a positive family history of allergies and 44.2% had other allergic conditions such as atopic dermatitis (31.6%), perennial rhinitis and perennial asthma (19% each), urticaria, food allergy and drug allergy (5% each) and insect sting allergy (3%). A clear cut peak both for rhinitis and for asthmatic symptoms %30.5% and 20.2% respectively) was found in the age group 5--9 years. Up to the 14th year the symptoms of pollen allergy were already exhibited by 68.5% of the patients. 97% of the pollen allergics suffered from rhinitis, 95% from conjunctivitis, 40% from bronchial asthma and another 20% from tracheobronchitis or asthmatic bronchitis. As additional symptoms of pollen allergy due to haematogenous spread of the pollen antigens we observed a seasonal form of atopic dermatitis in 3%, a seasonal urticaria or angioedema in 3.5%, migraine in 6.3% and arthralgia, gastro-intestinal troubles and fever in fewer than 1% each. Almost 98% of the patients were sensitized to grass or cereal pollens. However, only 18% suffered from an isolated grass pollinosis (summer hay fever). The other patients were additionally clinically sensitized by other pollens with different blossoming periods, i.e. 35% by three pollens responsible for the so-called spring pollinosis, and 50% by weeds (plantain, nettle, mugwort) the cause of late summer pollinosis. Only 13 patients suffered from an isolated spring pollinosis (hazel, alder, birch, willow). In 14 patients (not quite 1%) with a clear-cut history and clinical symptoms of pollinosis, all the skin tests were negative. In these cases the sensitization was probably restricted to the respiratory tract. Despite the new in-vitro methods such as the RAST, carefully performed skin tests linked to a knowledge of the pollen calendars of the region and the allergological history remain the most reliable and cheapest procedure for the specific diagnosis of pollen allergy.
分析了1565例首次到过敏科就诊的花粉症患者的病历。受试人员的平均年龄为19.5岁。40%在5至15岁年龄组。性别分布显示男性患病率略高但具有统计学意义(56.6%)。56.8%有过敏家族史,44.2%有其他过敏病症,如特应性皮炎(31.6%)、常年性鼻炎和常年性哮喘(各19%)、荨麻疹、食物过敏和药物过敏(各5%)以及昆虫叮咬过敏(3%)。在5至9岁年龄组中,鼻炎和哮喘症状分别有明显高峰(分别为30.5%和20.2%)。到14岁时,68.5%的患者已出现花粉过敏症状。97%的花粉过敏者患有鼻炎,95%患有结膜炎,40%患有支气管哮喘,另外20%患有气管支气管炎或哮喘性支气管炎。作为花粉抗原经血行传播导致的花粉过敏的附加症状,我们观察到3%的患者出现季节性特应性皮炎,3.5%出现季节性荨麻疹或血管性水肿,6.3%出现偏头痛,关节痛、胃肠道不适和发热各不到1%。几乎98%的患者对草或谷物花粉过敏。然而,只有18%患有单纯性草花粉症(夏季花粉症)。其他患者还因不同开花期的其他花粉而出现临床过敏,即35%因导致所谓春季花粉症的三种花粉过敏,50%因杂草(车前草、荨麻、艾蒿)过敏,杂草是夏末花粉症的病因。只有13例患者患有单纯性春季花粉症(榛树、桤木、桦树、柳树)。在14例有明确花粉症病史和临床症状的患者(不到1%)中,所有皮肤试验均为阴性。在这些病例中,致敏可能仅限于呼吸道。尽管有新的体外检测方法,如放射变应原吸附试验(RAST),但结合该地区花粉日历知识和过敏病史仔细进行的皮肤试验仍然是花粉过敏特异性诊断最可靠、最便宜的方法。