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我国北方地区儿童与青少年季节性变应性鼻炎致敏花粉的特征分析

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文章导航 > 临床耳鼻咽喉头颈外科杂志 > 2020 > 34(11): 1005-1010
王晓艳, 郭淼颖, 王洪田, 等. 我国北方地区儿童与青少年季节性变应性鼻炎致敏花粉的特征分析[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(11): 1005-1010. doi: 10.13201/j.issn.2096-7993.2020.11.011
引用本文: 王晓艳, 郭淼颖, 王洪田, 等. 我国北方地区儿童与青少年季节性变应性鼻炎致敏花粉的特征分析[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(11): 1005-1010. doi: 10.13201/j.issn.2096-7993.2020.11.011
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WANG Xiaoyan, GUO Miaoying, WANG Hongtian, et al. Pollen allergen sensitization feature of seasonal allergic rhinitis in children and adolescents in northern China[J]. J Clin Otorhinolaryngol Head Neck Surg, 2020, 34(11): 1005-1010. doi: 10.13201/j.issn.2096-7993.2020.11.011
Citation: WANG Xiaoyan, GUO Miaoying, WANG Hongtian, et al. Pollen allergen sensitization feature of seasonal allergic rhinitis in children and adolescents in northern China[J]. J Clin Otorhinolaryngol Head Neck Surg, 2020, 34(11): 1005-1010. doi: 10.13201/j.issn.2096-7993.2020.11.011
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我国北方地区儿童与青少年季节性变应性鼻炎致敏花粉的特征分析

    • 首都医科大学附属北京世纪坛医院变态反应科 首都医科大学附属北京世纪坛医院变态反应中心(北京，100038)

  • 基金项目:
    北京世纪坛医院院内课题(No：2020C02)；北京市医管中心青苗计划(No：QML20180702)；北京市医管局科研培育计划(No：PX2017020)；北京市医管中心扬帆计划(No：ZYLX201826)
详细信息

Pollen allergen sensitization feature of seasonal allergic rhinitis in children and adolescents in northern China

    • Allergy Department/Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China

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    摘要
  • 目的 对我国北方地区儿童与青少年季节性变应性鼻炎(SAR)致敏花粉的特征进行分析。方法 回顾性分析于北京世纪坛医院变态反应中心确诊为SAR的我国北方地区儿童和青少年患者。皮肤点刺试验(SPT)所用过敏原点刺液为13种北方地区常见花粉。采用SPSS 23.0软件分析花粉过敏原的致敏在年龄、性别、致敏模式等方面的差异。结果 374例SAR患儿纳入研究。最常见的致敏花粉为藜科(73.8%)、葎草(67.6%)、大籽蒿(64.7%)；重度致敏率较高的是大籽蒿(53.7%)、葎草(46.8%)、藜科(42.0%)。不同花粉的致敏率及致敏模式无性别差异(P>0.05)。青少年组圆柏致敏率高于儿童组(55.1% vs 42.9%，P=0.023)，2组其余花粉过敏原及致敏模式比较差异无统计学意义(P>0.05)。树木花粉的多重致敏率为57.2%，杂草花粉为59.6%。全部花粉的多重致敏率为81.3%。树木花粉间及杂草花粉间均有显著相关性(P < 0.01)。除圆柏外，其他7种树木花粉与草花粉间有显著相关性(P < 0.01)。4种杂草花粉的单一致敏率低(1%~8%)，49.2%的患儿对4种杂草花粉均过敏。结论 儿童和青少年期的SAR花粉的致敏率无显著性别及年龄差异。花粉间具有广泛的交叉过敏反应，尤其在杂草花粉间。
    Objective  The prevalence of seasonal allergic rhinitis(SAR) is high in children and adolescents population. The aim of this study is to explore the feature of pollen allergen sensitization of SAR in children and adolescents. Method  Children and adolescents with self-reported seasonal allergic rhinitis in an allergy center of a tertiary hospital were enrolled and received skin prick test(SPT) of 13 common pollen allergens. SAR was defined with positive SPT to any pollen allergen. SPSS software was applied to analyze the differences in age, gender, sensitization pattern. Result  In total, 374(85.6%) SAR cases with self-reported seasonal allergic rhinitis were enrolled, including 213 males (57%) and 161 females (43%). There are 198 children (2-12 years old) and 176 adolescents (13-17 years old). The highest sensitization rate was presented in Chenopodium (73.8%), Humulus(67.6%) and Artemisia (64.7%).The severe sensitization was presented in Artemisia(53.7%), Humulus(46.8%) and Chenopodium (42.0%). No gender difference was found among different pollen allergens and sensitization patterns(P>0.05). No age difference was found between different pollen allergens and sensitization patterns except that Cupressaceae was higher in adolescent group than that in children group(55.1% vs 42.9%, P=0.023). Poly-sensitization rate was 57.2% in tree pollens, 59.6% in weed pollens and 81.3% in total. Significant correlation was found among different tree pollens and weed pollens(P < 0.01). Tree pollen sensitization was significantly correlated with weed pollens except Cupressaceae(P < 0.01). The mono-sensitization rate is low in all 4 weed pollen allergens ranged from 1% to 8% while 49.2% of SAR patients were allergic to all of the 4 weed pollen allergens. Conclusion  The prevalent pollen allergens in SAR were similar in children and adolescent comparing to adults. No obvious gender and age differences were found. An extensive co-sensitizations were found among pollens especially in weed pollens.
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  • 图 1  花粉过敏原的致敏率和致敏严重性的分布

    下载: 全尺寸图片 幻灯片

    图 2  杂草花粉致敏的韦恩图

    下载: 全尺寸图片 幻灯片

    表 1  SAR患者花粉过敏原致敏率的年龄和性别分布例(%)

    过敏原 性别 P 年龄分组 P 总计
    男(n=213) 女(n=161) 儿童组(n=198) 青少年组(n=176)
    圆柏 99(46.5) 83(51.6) 0.348 85(42.9) 97(55.1) 0.023 182(48.7)
    杨树 103(48.4) 78(48.4) 1.000 99(50.0) 82(46.6) 0.535 181(48.4)
    柳树 106(49.8) 91(56.5) 0.210 99(50.0) 98(55.7) 0.300 197(52.7)
    槐树 54(25.4) 42(26.1) 0.905 50(25.3) 46(26.1) 0.906 96(25.7)
    桦树 95(44.6) 68(42.2) 0.674 83(41.9) 80(45.5) 0.531 163(43.6)
    悬铃木 92(43.2) 65(40.4) 0.598 76(38.4) 81(46.0) 0.143 157(42.0)
    洋白蜡 99(46.5) 80(49.7) 0.601 90(45.5) 89(50.6) 0.351 179(47.9)
    榆树 91(42.7) 74(46.0) 0.599 84(42.4) 81(46.0) 0.532 165(44.1)
    豚草 106(49.8) 81(50.3) 0.917 93(47.0) 82(53.4) 0.254 187(50.0)
    葎草 140(65.7) 113(70.2) 0.374 130(65.7) 123(69.9) 0.438 253(67.6)
    藜科 157(73.7) 119(73.9) 0.965 144(72.7) 132(75.0) 0.639 276(73.8)
    大籽蒿 139(65.3) 103(64.0) 0.827 127(64.1) 115(65.3) 0.829 242(64.7)
    禾本科 104(48.8) 78(48.4) 0.942 93(47.0) 89(50.6) 0.534 182(48.7)
    下载: 导出CSV

    表 2  花粉不同致敏类型在SAR患者中的性别和年龄差异例(%)

    过敏原 性别 P 年龄分组 P 总计
    男(n=213) 女(n=161) 儿童组(n=198) 青少年组(n=176)
    树木花粉 0.624 0.346
      单一致敏 22(10.3) 21(13.0) 22(11.1) 21(11.9) 43(11.5)
      双重致敏 25(11.7) 16(9.9) 25(12.6) 16(9.1) 41(11.0)
      多重致敏 119(55.9) 95(59.0) 106(53.5) 108(61.4) 214(57.2)
      任一花粉 166(77.9) 132(82.0) 153(77.3) 145(82.4) 298(79.7)
    禾本科花粉 104(48.8) 78(48.4) 0.942 93(47.0) 89(50.6) 0.534 182(48.7)
    杂草花粉 0.792 0.471
      单一致敏 26(12.2) 22(13.7) 29(14.6) 19(10.8) 48(12.8)
      双重致敏 22(10.3) 21(13.0) 19(9.6) 24(13.6) 43(11.5)
      多重致敏 129(60.6) 94(58.4) 117(59.1) 106(60.2) 223(59.6)
      任一花粉 177(83.1) 137(85.1) 165(83.3) 149(84.7) 314(84.0)
    任一花粉 0.476 0.471
      单一致敏 23(10.8) 24(14.9) 24(12.1) 23(13.1) 47(12.6)
      双重致敏 14(6.6) 9(5.6) 15(7.6) 8(4.5) 23(6.1)
      多重致敏 176(82.6) 128(79.5) 159(80.3) 145(82.4) 304(81.3)
      任一花粉 190(89.2) 137(85.1) 174(87.9) 153(86.9) 374(100.0)
    单一致敏指仅有1种花SPT阳性；双重致敏指2种花粉同时阳性；多重致敏指3种或以上花粉阳性。
    下载: 导出CSV

    表 3  不同花粉过敏原致敏的相关性分析

    花粉 圆柏 杨树 柳树 槐树 桦树 悬铃木 白蜡树 榆树 豚草 葎草 藜科 大籽蒿 禾本科
    圆柏 r 1 0.385 0.312 0.261 0.288 0.212 0.352 0.234 0.043 0.033 -0.016 0.025 0.037
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.409 0.525 0.759 0.630 0.479
    杨树 r 0.385 1 0.564 0.386 0.433 0.477 0.507 0.422 0.177 0.292 0.176 0.234 0.256
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.001 0.000 0.001 0.000 0.000
    柳树 r 0.312 0.564 1 0.459 0.444 0.448 0.512 0.508 0.241 0.272 0.239 0.252 0.301
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    槐树 r 0.261 0.386 0.459 1 0.483 0.455 0.417 0.439 0.306 0.197 0.169 0.255 0.322
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.001 0.000 0.000
    桦树 r 0.288 0.433 0.444 0.483 1 0.629 0.486 0.479 0.243 0.216 0.217 0.277 0.353
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    悬铃木 r 0.212 0.477 0.448 0.455 0.629 1 0.530 0.586 0.276 0.229 0.137 0.277 0.321
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.008 0.000 0.000
    白蜡树 r 0.352 0.507 0.512 0.417 0.486 0.530 1 0.615 0.273 0.262 0.267 0.204 0.352
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    榆树 r 0.234 0.422 0.508 0.439 0.479 0.586 0.615 1 0.318 0.258 0.187 0.307 0.395
    P 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    豚草 r 0.043 0.177 0.241 0.306 0.243 0.276 0.273 0.318 1 0.497 0.438 0.548 0.524
    P 0.409 0.001 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    葎草 r 0.033 0.292 0.272 0.197 0.216 0.229 0.262 0.258 0.497 1 0.576 0.590 0.467
    P 0.525 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    藜科 r -0.016 0.176 0.239 0.169 0.217 0.137 0.267 0.187 0.438 0.576 1 0.514 0.459
    P 0.759 0.001 0.000 0.001 0.000 0.008 0.000 0.000 0.000 0.000 0.000 0.000
    大籽蒿 r 0.025 0.234 0.252 0.255 0.277 0.277 0.204 0.307 0.548 0.590 0.514 1 0.630
    P 0.630 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    禾本科 r 0.037 0.256 0.301 0.322 0.353 0.321 0.352 0.395 0.524 0.467 0.459 0.630 1
    P 0.479 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
    下载: 导出CSV
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收稿日期:  2020-02-29
刊出日期:  2020-11-05

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