Silvestri M, Oddera S, Rossi G A, Crimi P
Divisione di Pneumologia, G. Gaslini Institute, Genoa, Italy.
Ann Allergy Asthma Immunol. 1996 Mar;76(3):239-44. doi: 10.1016/s1081-1206(10)63433-3.
Allergy is one of the most common causes of respiratory symptoms in children and youth.
Evaluate the presence and the type of allergic sensitization in a paediatric population with respiratory symptoms.
We studied 564 consecutive children, 5 months to 17 years of age, with a male to female ratio (M/F) = 1.4, referred to our outpatient clinic in a 12-month period retrospectively. Patients were arbitrarily divided into four groups (grs) according to their age: gr1 = 5 months to 4 years old (181 patients), gr2 = 4 to 7 years (201 patients), gr3 = 7 to 10 years (96 patients), and gr4 = 10 to 17 years (86 patients). Sensitization to house dust mites, pollens, animal dander, and molds was determined by skin prick testing.
Sensitization to at least one class of allergen occurred in 304 of the 564 patients (53.9%, M/F ratio = 2.0); the percentage of allergic patients increased with age as follows: 29.8% (54 patients) of the patients in gr1, 55.2% (111 patients) in gr2, 68.8% (66 patients) in gr3 and 84.9% (73 patients) in gr4 (chi(2) = 84.1, P < .01). In the entire allergic population and in gr1 to gr3, the most common positive allergic reaction was to house dust mites (P < .01, chi(2) test each comparison). In contrast, gr4 patients showed a nearly equal percentage of sensitization to pollens and to house dust mites (79.5% and 78.1% respectively) (chi(2) = 0.0, P = >.1). Sensitization to only one class of allergen occurred in 51.3% of the allergic patients and the percentage of these monosensitized patients tended to decrease from gr1 to gr4 (chi(2) = 15.2, P < .1). In the monosensitized group, sensitization to house dust mites was the most frequent in gr1 to gr3 (age <10 years) as in the whole sample. In gr4, the frequency of sensitization to house dust mites was similar to that of sensitization to pollens. On the contrary, within the patient group sensitized to two or more allergens (polysensitized patients), sensitization to house dust mites was as frequent as sensitization to pollens already in gr2 as compared with monosensitized patients.
In children with respiratory symptoms, the percentage of allergic individuals was high and increased with the age of the patients. This phenomenon was associated with an age-related enhancement in the ratio of polysensitized to monosensitized patients and with an age-related increase in the frequency of sensitization to seasonal allergens (ie, pollens).
过敏是儿童和青少年呼吸道症状最常见的病因之一。
评估有呼吸道症状的儿科人群中过敏致敏的存在情况及类型。
我们回顾性研究了连续564例年龄在5个月至17岁之间的儿童，男女比例（M/F）为1.4，这些儿童在12个月期间被转诊至我们的门诊。根据年龄将患者任意分为四组：第1组=5个月至4岁（181例患者），第2组=4至7岁（201例患者），第3组=7至10岁（96例患者），第4组=10至17岁（86例患者）。通过皮肤点刺试验确定对屋尘螨、花粉、动物皮屑和霉菌的致敏情况。
564例患者中有304例（53.9%，M/F比例=2.0）对至少一类过敏原致敏；过敏患者的百分比随年龄增长如下：第1组患者中29.8%（54例），第2组中55.2%（111例），第3组中68.8%（66例），第4组中84.9%（73例）（χ²=84.１，P<.01）。在整个过敏人群以及第1组至第3组中，最常见的阳性过敏反应是对屋尘螨（P<.01，每次比较χ²检验）。相比之下，第4组患者对花粉和屋尘螨的致敏百分比几乎相等（分别为79.5%和78.1%）（χ²=0.0，P>.1）。51.3%的过敏患者仅对一类过敏原致敏，这些单致敏患者的百分比从第1组到第4组呈下降趋势（χ²=15.2，P<.1）。在单致敏组中，与整个样本一样，第1组至第3组（年龄<10岁）中对屋尘螨的致敏最为常见。在第4组中，对屋尘螨的致敏频率与对花粉的致敏频率相似。相反，在对两种或更多种过敏原致敏的患者组（多致敏患者）中，与单致敏患者相比，第2组中对屋尘螨的致敏频率与对花粉的致敏频率一样高。
有呼吸道症状的儿童中，过敏个体的百分比很高且随患者年龄增加。这一现象与多致敏患者与单致敏患者比例随年龄增长而增加以及对季节性过敏原（即花粉）的致敏频率随年龄增长而增加有关。
