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中华妇幼临床医学杂志(电子版) ›› 2015, Vol. 11 ›› Issue (06) : 780 -785. doi: 10.3877/cma.j.issn.1673-5250.2015.06.021

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论著

上海松江地区支气管哮喘患儿变态反应原分析
马卫宁1, 左晓玥1, 周小建1, 李臻1, 洪建国1,*()   
  1. 1. 201620 上海交通大学附属第一人民医院儿科
  • 收稿日期:2015-05-05 修回日期:2015-11-01 出版日期:2015-12-01
  • 通信作者: 洪建国

Analysis of allergens in children with bronchial asthma in Songjiang, Shanghai

Weining Ma1, Xiaoyue Zuo1, Xiaojian Zhou1, Zhen Li1, Jianguo Hong1()   

  1. 1. Department of Pediatrics, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 201620, China
  • Received:2015-05-05 Revised:2015-11-01 Published:2015-12-01
  • Corresponding author: Jianguo Hong
引用本文:

马卫宁, 左晓玥, 周小建, 李臻, 洪建国. 上海松江地区支气管哮喘患儿变态反应原分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2015, 11(06): 780-785.

Weining Ma, Xiaoyue Zuo, Xiaojian Zhou, Zhen Li, Jianguo Hong. Analysis of allergens in children with bronchial asthma in Songjiang, Shanghai[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(06): 780-785.

目的

探讨上海松江地区支气管哮喘患儿变态反应原情况,为预防和治疗支气管哮喘提供依据。

方法

选择2012年9月至2013年3月于上海交通大学附属第一人民院儿童哮喘专科门诊就诊的100例支气管哮喘患儿为研究对象,其户籍均隶属于上海松江地区。采用国际标准化变态反应原注射液对其进行变态反应原皮肤点刺试验,包括粉尘螨、屋尘螨、猫上皮、狗上皮、虾、蟹、牛奶、鸡蛋、花生、艾蒿、悬铃木共计11种变态反应原。采用《儿童哮喘控制测试(C-ACT)问卷调查表》对4~11岁哮喘患儿同时进行C-ACT问卷调查,对其哮喘控制情况进行判断。此外,同时进行血清变态反应原检测。对支气管哮喘患儿的变态反应原情况进行分析。本研究遵循的程序符合上海交通大学附属第一人民院人体试验委员会制定的伦理学标准,得到该委员会批准,并征得受试对象监护人的知情同意。

结果

①100例支气管哮喘患儿中,72例(72.0%,72/100)患儿对1种或多种变态反应原皮肤点刺试验呈阳性,粉尘螨变态反应原呈阳性者为64例(64.0%,64/100),屋尘螨变态反应原呈阳性者为56例(56.0%,56/100)。② 49例行血清变态反应原检测结果显示,血清变态反应原检测结果呈阳性者为39例(79.6%,39/49)。③ 49例抽血患儿中,两种检测方法对屋尘螨过敏原检出率比较(53.1% vs 42.9%),差异无统计学意义(χ2=1.022,P=0.312),而对粉尘螨变态反应原检出率比较(63.3% vs 40.8%),差异有统计学意义(χ2=4.947,P=0.026)。④《C-ACT问卷调查表》评分≤19分的患儿为32例(45.1%,32/71),其中,皮肤点刺试验结果呈阳性者为22例,阳性率为68.8%;≥20分患儿为39例(54.9%,39/71),其中,皮肤点刺试验结果呈阳性者为33例,阳性率为84.6%。二者阳性率比较,差异无统计学意义(χ2=2.535,P=0.111)。

结论

上海松江地区支气管哮喘患儿最常见的变态反应原为尘螨;变态反应原阳性率与患儿年龄有关。支气管哮喘患儿可同时对多种变态反应原呈阳性反应;支气管哮喘患儿控制情况与变态反应原无关。

Objective

To investigate the allergens conditions of children with bronchial asthma in Songjiang area of Shanghai, and to provide evidence for prevention and treatment of bronchial asthma.

Methods

From September 2012 to March 2013, a total of 100 cases of bronchial asthma who visited Childhood Asthma Specialist Clinics in the First People's Hospital Affiliated to Shanghai Jiao Tong University were selected as the research object, and their household registration was part of the Songjiang area, Shanghai. International standardized allergen injections were utilized for allergen skin prick test, including dust mites, house dust mite, cat epithelium, dog epithelium, shrimp, crab, milk, eggs, peanuts, mugwort, sycamore, a total of 11 kinds of allergens. At the same time, Childhood Asthma Control Test (C-ACT) Questionnaire was used for asthmatic children from 4 to 11 years old, to judge their asthma control situation. In addition, testing the allergen in serum. The allergens in children with bronchial asthma were Analyzed. This study followed the procedures in line with ethical standards, which were formulated by the Human Trial Committee of the First People's Hospital Affiliated to Shanghai Jiaotong University, approved by the committee, and informed consent of the trial subjects guardian consent. This study was approved by the Committee, and with the consent of the trial subjects guardian consent.

Results

① In 100 cases of bronchial asthmatic children, 72 cases (72.0%, 72/100) against one or more allergen skin prick tests were positive, for dust mite allergens were positive in 64 cases (64.0%, 64/100), housing dust mite allergens were positive in 56 cases (56.0%, 56/100). ② The result of 49 cases were examined by serum allergen test showed that serum allergen test results were positive in 39 cases (79.6%, 39/49). ③ A total of 49 cases of phlebotomized children, comparing house dust mite allergen detection rate (53.1% vs 42.9%) by using the two detection methods, the difference was not statistically significant (χ2=1.022, P=0.312); while comparing the dust mite allergen detection rate (63.3% vs 40.8%), the difference was statistically significant (χ2=4.947, P=0.026). ④C-ACT score ≤19 points were 32 cases of children (45.1%, 32/71), in which the skin prick test results were positive in 22 cases, the positive rate was 68.8%; ≥20 points were 39 cases in children (54.9%, 39/71), in which the skin prick test results were positive in 33 cases, the positive rate was 84.6%. Comparing both positive rate, the difference was not statistically significant (χ2=2.535, P=0.111).

Conclusions

The most common allergen in Shanghai Songjiang area was dust mites; The allergen positive rate was related to age. Bronchial asthmatic children can simultaneously multiple allergens were positive; bronchial asthmatic children control situation has nothing to do with the allergen.

表1 支气管哮喘患儿变态反应原皮肤点刺试验检测结果(n=100)
表2 支气管哮喘患儿接受变态反应原皮肤点刺试验反应与患儿性别、年龄的关系
表3 支气管哮喘患儿血清变态反应原检测结果(n=49)
表4 支气管哮喘患儿屋尘螨变态反应原皮肤点刺试验结果与血清检测结果比较(n=49)
表5 支气管哮喘患儿粉尘螨变态反应原皮肤点刺试验结果与血清检测结果比较(n=49)
表6 支气管哮喘患儿单种或同时多种变态反应原阳性率比较(n=72)
表7 支气管哮喘患儿《C-ACT问卷调查表》总分与粉尘螨变态反应严重程度关系(n=50)
表8 支气管哮喘患儿《C-ACT问卷调查表》总分与屋尘螨过敏严重程度关系(n=45)
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