摘要
探讨呼吸道过敏性疾病患者过敏原致敏情况,为山西地区过敏性疾病的诊断、治疗及预防提供参考依据。本研究为横断面研究,回顾性收集2021年7月至2023年6月就诊于山西白求恩医院过敏反应科,完善血清过敏原sIgE检测和(或)皮肤点刺试验,并确诊为过敏性鼻炎和(或)哮喘的患者1680例,其中男772例、女908例;年龄范围3~88岁,中位年龄35岁,分为儿童组108例、青少年组102例、青年组819例、中年组498例和老年组153例;鼻炎组333例、哮喘组827例、鼻炎伴哮喘组520例,城市组1254例、农村组426例,晋北地区组253例、晋中地区组1195例和晋南地区组232例。采用χ^(2)检验或Fisher确切概率法进行统计分析,比较过敏原sIgE阳性率在性别、年龄、疾病、生活环境、地域上的差异。结果显示,1027例(61.1%)患者至少存在一种过敏原sIgE阳性,其中艾蒿阳性率最高(603/1680,35.9%),其次为普通豚草(302/1680,18.0%)和尘螨组合(245/1680,14.6%);单一过敏原sIgE阳性人数为357例(357/1027,34.8%),其中单一艾蒿sIgE阳性人数最多(114/357,31.9%);多种过敏原sIgE阳性人数为670例(670/1027,65.2%),以2种过敏原sIgE阳性患者为主(243/670,36.3%)。男性过敏原sIgE的总体阳性率显著高于女性(65.7%vs.57.3%,χ^(2)=12.405,P<0.001)。吸入性过敏原sIgE总体阳性率在儿童和青少年组较高(88.0%vs.88.2%vs.59.8%vs.40.2%vs.19.0%,χ^(2)=223.372,P<0.001),食物性过敏原sIgE阳性率在儿童组最高(54.6%vs.36.3%vs.26.0%vs.18.9%vs.21.6%,χ^(2)=66.383,P<0.001)。过敏性鼻炎组与过敏性鼻炎伴哮喘组的患者除蟑螂和霉菌外,其余吸入性过敏原sIgE阳性率均显著高于过敏性哮喘组(P<0.05)。城市患者的过敏原sIgE总体阳性率显著高于农村患者(66.2%vs.46.2%,χ^(2)=53.230,P<0.001)。不同区域患者过敏原sIgE总体阳性率比较差异无统计学意义(56.1%vs.62.0%vs.62.1%,χ^(2)=3.140,P=0.208),晋中与晋南地区的尘螨组合sIgE阳性率显著高于晋北地区(15.5%vs.18.1%vs.7.1%,χ^(2)=14.411,P=0.001)。综上,艾蒿可能是山西地区呼吸道过敏性疾病最主要致敏原。不同性别、不同年龄、不同疾病、不同生活环境、不同区域的致敏原种类和阳性率不同,过敏原检测有助于过敏性疾病的诊断、治疗和预防。
To explore the allergen sensitization status of patients with respiratory allergic diseases in Shanxi Province,and to provide a basis for the diagnosis,treatment and prevention of allergic diseases.It is a cross-sectional study,a total of 1680 patients with allergic rhinitis and/or asthma diagnosed at the Department of Allergic Reaction of Shanxi Bethune Hospital from July 2021 to June 2023 who underwent allergen sIgE testing and/or skin prick test were retrospectively enrolled.There were 772 males and 908 females.The age range was 3 to 88 years.The median age was 35 years.There were 108 cases in the child group(≤12 years old),102 cases in the adolescent group(13-17 years old),819 cases in the youth group(18-40 years old),498 cases in the middle-aged group(41-65 years old),and 153 cases in the elderly group(>65 years old).There were 333 cases in the allergic rhinitis group,827 cases in the allergic asthma group,and 520 cases in the allergic rhinitis with asthma group.There were 1254 urban patients and 426 rural patients.There were 253 cases in the northern Shanxi region,1195 cases in the central Shanxi region,and 232 cases in the southern Shanxi region.Statistical analyses were performed using theχ^(2) test or Fisher′s exact probability method to compare the differences in allergen sIgE positivity rates by sex,age,disease,living environment,and geography.The results showed that 1027 patients(61.1%)were positive for at least one allergen sIgE,with Artemisia having the highest rate of positivity(603/1680,35.9%),followed by ragweed(302/1680,18.0%)and dust mite combinations(245/1680,14.6%).The number of individuals with single-allergen sIgE positivity was 357(357/1027,34.8%),with the highest number of single-allergen sIgE positive results associated with Artemisia(114/357,31.9%).The number of multiple-allergen sIgE positive results was 670 cases(670/1027,65.2%),with the highest number of patients having 2 allergen sIgE positive results(243/670,36.3%).The overall positivity rate for allergen sIgE was significantly higher among males than among females(65.7%vs.57.3%,χ^(2)=12.405,P<0.001).Overall positivity for inhalant allergen sIgE was higher in the child and adolescent groups(88.0%vs.88.2%vs.59.8%vs.40.2%vs.19.0%,χ^(2)=223.372,P<0.001),and food allergen sIgE positivity was highest in the child group(54.6%vs.36.3%vs.26.0%vs.18.9%vs.21.6%,χ^(2)=66.383,P<0.001).The sIgE positivity rate of inhalant allergens was significantly higher in the allergic rhinitis group and the allergic rhinitis with asthma group than in the allergic asthma group,except for cockroaches and molds(P<0.05).The overall positive rate of allergen sIgE was significantly higher among urban patients than among rural patients(66.2%vs.46.2%,χ^(2)=53.230,P<0.001).The difference in the overall positive rate of allergen sIgE among patients from different regions was not statistically significant(56.1%vs.62.0%vs.62.1%,χ^(2)=3.140,P=0.208).The sIgE positivity of dust mite combinations was significantly higher in the central Shanxi region and the southern Shanxi region than in the northern Shanxi region(15.5%vs.18.1%vs.7.1%,χ^(2)=14.411,P=0.001).In conclusion,artemisia was the most important sensitizer for respiratory allergic diseases in Shanxi Province.The types of allergens and positivity rates were different for different sexes,ages,diseases,living environments,and regions.Therefore,patients with allergic diseases should be tested for allergens to help with the diagnosis,treatment and prevention of allergic diseases.
作者
李玉柱
张海燕
陈小雪
尹恺
姚琦
张焕萍
Li Yuzhu;Zhang Haiyan;Chen Xiaoxue;Yin Kai;Yao Qi;Zhang Huanping(Department of Allergy,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030032,China;Department of Allergy,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Third Hospital of Shanxi Medical University,Taiyuan 030032,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2023年第12期1978-1987,共10页
Chinese Journal of Preventive Medicine
基金
山西白求恩医院人才引进科研启动金项目(2020RC004)
山西省基础研究计划(自由探索类)自然科学研究项目(202203021211067)
吴阶平医学基金会临床科研专项资助基金(320.6750.2022-02-31)。
