Analysis of allergen distribution and clinical characteristics of autumn allergic rhinitis in Changchun and surrounding areas
-
摘要: 目的 探讨长春及周边地区秋季变应性鼻炎(AR)变应原特征、分布情况及临床症状特点。方法 记录2019年8—10月及2020年8—10月就诊于吉林大学第二医院耳鼻咽喉头颈外科的1080例来自于长春及周边地区的AR疑似患者的变应原检测结果，对比分析主要变应原的阳性率及其在性别、年龄、不同年份、临床症状之间的差异。结果 ① 1080例就诊的AR疑似患者中，变应原阳性患者共804例(74.44%)。②长春及其周边地区秋季前3位变应原为蒿(36.20%)、矮豚草(33.24%)、念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉(19.81%)。蒿与矮豚草的阳性率男性高于女性(P < 0.05)。③蒿是少年组、青年组、中年组秋季AR最主要的变应原。④2种及2种以上变应原阳性率为单一变应原阳性率的2.39倍。⑤秋季花粉变应原阳性患者的鼻塞、眼红/痒、溢泪三个症状相比其他组患者更严重。结论 季节性AR有典型临床症状特点。长春及其周边地区秋季AR以秋季花粉变应原(蒿、矮豚草、葎草)阳性为主，变应原分布在性别、年龄、不同年份之间存在差异。
-
关键词:
- 鼻炎，变应性，季节性 /
- 变应原 /
- 临床特征
Abstract: Objective To investigate the allergen characteristics, allergen distribution and clinical symptoms of autumn allergic rhinitis in Changchun and surrounding areas.Methods The allergen test results of 1080 allergic rhinitis(AR) suspected patients from Changchun and surrounding areas were collected, from August to October 2019 and August to October 2020 in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University. The positive rates of major allergens and their differences in gender, age, different years and clinical symptom were compared and analyzed.Results ① Among the 1080 suspected AR patients, 804 patients(74.44%) had positive allergens. ②The top 3 allergens of autumn AR in Changchun and surrounding areas were Artemisia(36.20%), Dwarf ragweed(33.24%) and Candida/Penicillium notarum/Cladosporium/Alternaria/Aspergillus niger(19.81%). The positive rates of Artemisia and Dwarf ragweed were higher in men than in women(P < 0.05). ③Artemisia was the major allergen of autumn AR in juvenile group, youth group and middle-aged group. ④The positive rate of two or more allergens was 2.39 times that of single allergen. ⑤Patients with positive autumn pollen allergens had more severe symptoms of nasal congestion, red eye/eye itching and epiphora than those in other groups.Conclusion Seasonal AR had typical clinical symptom characteristics. Major allergens in autumn AR in Changchun and surrounding areas are autumn pollen allergens(Artemisia, Dwarf ragweed, Humulus). The distribution of those allergens was different in gender, age, and different years.-
Key words:
- rhinitis, allergic, seasonality /
- allergens /
- clinical features
-
-
表 1 秋季常见变应原阳性率及性别分布差异
例(%) 变应原种类 阳性 总计 χ2 P 男 女 蒿 232(59.34) 159(40.66) 391(36.20) 4.459 0.035 矮豚草 217(60.45) 142(39.55) 359(33.24) 6.228 0.013 念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉 123(57.48) 91(42.52) 214(19.81) 0.613 0.414 粉尘螨 107(54.31) 90(45.69) 197(18.24) 0.059 0.808 刺柏/桦 84(58.33) 60(41.67) 144(13.33) 0.705 0.401 猫毛皮屑 79(58.52) 56(41.48) 135(12.50) 0.732 0.392 户尘螨 67(56.78) 51(43.22) 118(10.93) 0.152 0.696 悬铃木/白蜡 70(62.50) 42(37.50) 112(10.37) 2.771 0.096 桤/杨/柳/山毛榉/橡/胡桃 67(65.69) 35(34.31) 102(9.44) 5.109 0.024 牛奶 64(66.67) 32(33.33) 96(8.89) 5.705 0.017 
下载: 导出CSV
表 2 秋季常见变应原年龄段阳性率差异
例(%) 变应原种类 ≤6岁 7~17岁 18~40岁 41~65岁 ≥66岁 P 秋季花粉组合 77(14.47) 212(39.85) 195(36.65) 47(8.83) 1(0.19) < 0.05 蒿 61(15.60) 154(39.39) 142(36.32) 34(8.70) 0(0) < 0.05 矮豚草 55(15.32) 150(41.78) 125(34.82) 28(7.80) 1(0.28) < 0.05 葎草 9(13.85) 31(47.92) 18(27.69) 6(9.23) 1(1.54) < 0.05 春季花粉组合 39(16.25) 92(38.33) 90(37.5) 19(7.92) 0(0) < 0.05 刺柏/桦 18(12.50) 53(36.81) 58(40.28) 14(9.72) 1(0.69) >0.05 悬铃木/白蜡 20(16.13) 40(32.26) 56(45.16) 8(6.45) 0(0) < 0.05 桤/杨/柳/山毛榉/橡/胡桃 21(20.59) 37(36.27) 36(35.29) 8(7.84) 0(0) < 0.05 室内尘螨组合 26(12.04) 89(41.20) 85(39.35) 13(6.02) 3(1.39) < 0.05 粉尘螨 30(15.23) 82(41.62) 73(37.06) 10(5.08) 2(1.02) < 0.05 户尘螨 15(12.30) 51(41.80) 49(40.16) 6(4.92) 1(0.82) < 0.05 念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉 67(31.31) 89(41.59) 45(21.03) 12(5.61) 1(0.47) < 0.05 猫毛皮屑 23(17.04) 65(48.15) 38(28.15) 9(6.67) 0(0) < 0.05 秋季花粉组合+室内尘螨组合 13(11.21) 58(50.00) 41(35.34) 4(3.45) 0(0) < 0.05 牛奶 37(38.54) 38(39.58) 19(19.79) 2(2.08) 0(0) < 0.05
下载: 导出CSV
表 3 多重过敏及性别分布差异
例(%) 变应原种数 男 女 总数 χ2 P 单一变应原阳性 123(51.90) 114(48.10) 237 1.252 0.263 双重变应原阳性 120(55.30) 97(44.70) 217 0.005 0.945 三重变应原阳性 73(59.35) 50(40.65) 123 1.017 0.313 四重及以上变应原阳性 141(62.11) 86(37.89) 227 5.728 0.017
下载: 导出CSV
表 4 秋季常见变应原及变应原组合年份分布差异
例(%) 变应原种类 2019年阳性 2020年阳性 χ2 P 蒿 202(34.47) 189(38.26) 1.665 0.197 矮豚草 188(32.08) 171(34.61) 0.775 0.379 念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉 93(15.87) 121(24.49) 12.546 0.000 粉尘螨 89(15.19) 108(21.86) 8.007 0.005 刺柏桦 75(12.80) 69(13.97) 0.317 0.573 猫毛皮屑 96(16.68) 39(7.89) 17.654 0.000 户尘螨 48(8.19) 70(14.17) 9.845 0.002 悬铃木/白蜡 57(9.73) 55(11.13) 3.037 0.081 桤/杨/柳/山毛榉/橡/胡桃 47(8.02) 55(11.13) 5.109 0.024 葎草 41(7.00) 24(4.86) 2.167 0.141 秋季组合 276(47.10) 256(51.82) 2.392 0.122 春季组合 122(20.82) 118(23.89) 1.459 0.227 室内尘螨组合 98(16.72) 118(23.89) 8.596 0.003 秋季组合+室内尘螨组合 46(7.85) 70(14.17) 11.168 0.001
下载: 导出CSV
表 5 变应原阳性分组及其症状表现评分
x±s 症状 秋季花粉变应原阳性组 其他变应原阳性组 全阴性组 鼻痒 1.78±0.95 1.67±0.95 1.61±1.03 喷嚏 2.12±0.81 2.16±0.83 2.03±0.88 鼻溢 2.13±0.92 1.97±0.96 2.11±0.90 鼻塞 2.23±0.90 1.95±1.011) 1.92±0.961) 眼红/痒 1.87±1.08 1.36±1.091) 1.25±1.181) 溢泪 1.22±1.07 0.88±0.941) 0.88±0.991) 与秋季花粉变应原阳性组比较，1)P < 0.05。
下载: 导出CSV
-
[1] Wise SK, Lin SY, Toskala E, et al. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis[J]. Int Forum Allergy Rhinol, 2018, 8(2): 108-352.
[2] Wang XD, Zheng M, Lou HF, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011[J]. Allergy, 2016, 71(8): 1170-1180. doi: 10.1111/all.12874
[3] Zhang Y, Zhang L. Prevalence of allergic rhinitis in china[J]. Allergy Asthma Immunol Res, 2014, 6(2): 105-113. doi: 10.4168/aair.2014.6.2.105
[4] Reinmuth-Selzle K, Kampf CJ, Lucas K, et al. Air Pollution and Climate Change Effects on Allergies in the Anthropocene: Abundance, Interaction, and Modification of Allergens and Adjuvants[J]. Environ Sci Technol, 2017, 51(8): 4119-4141. doi: 10.1021/acs.est.6b04908
[5] Lou H, Ma S, Zhao Y, et al. Sensitization patterns and minimum screening panels for aeroallergens in self-reported allergic rhinitis in China[J]. Sci Rep, 2017, 7(1): 9286. doi: 10.1038/s41598-017-10111-9
[6] Wang XY, Ma TT, Wang XY, et al. Prevalence of pollen-induced allergic rhinitis with high pollen exposure in grasslands of northern China[J]. Allergy, 2018, 73(6): 1232-1243. doi: 10.1111/all.13388
[7] 李全生, 江盛学, 李欣泽, 等. 中国气传致敏花粉的季节和地理播散规律[J]. 解放军医学杂志, 2017, 42(11): 951-955. doi: 10.11855/j.issn.0577-7402.2017.11.03
[8] 崔巧玉, 赵艳, 秦锋, 等. 中国东北表土花粉组合特征及其在古气候重建中的意义[J]. 中国科学: 地球科学, 2020, 50(1): 134-148. https://www.cnki.com.cn/Article/CJFDTOTAL-JDXK202001009.htm
[9] 程雷, 董震, 孔维佳, 等. 变应性鼻炎诊断和治疗指南(2015年, 天津)[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(1): 6-24. doi: 10.3760/cma.j.issn.1673-0860.2016.01.004
[10] 孙立薇. 长春地区变应性鼻炎患者吸入性变应原分析[D]. 吉林大学, 2019.
[11] 邓月, 张健, 程寅, 等. 上海地区变应性鼻炎患者变应原特征分析[J]. 第二军医大学学报, 2020, 41(10): 1062-1067. https://www.cnki.com.cn/Article/CJFDTOTAL-DEJD202010002.htm
[12] 孔维佳, 陈建军. 变应性鼻炎的流行病学研究[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(23): 1098-1104. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201023023.htm
[13] Klis K, Wronka I. Association of Estrogen-Related Traits with Allergic Rhinitis[J]. Adv Exp Med Biol, 2017, 968: 71-78.
[14] Ridolo E, Incorvaia C, Martignago I, et al. Sex in Respiratory and Skin Allergies[J]. Clin Rev Allergy Immunol, 2019, 56(3): 322-332. doi: 10.1007/s12016-017-8661-0
[15] Lee JE, Ahn JC, Han DH, et al. Variability of offending allergens of allergic rhinitis according to age: optimization of skin prick test allergens[J]. Allergy Asthma Immunol Res, 2014, 6(1): 47-54. doi: 10.4168/aair.2014.6.1.47
[16] 罗向前, 刘大波. 儿童过敏性鼻炎的流行病学[J]. 中国实用儿科杂志, 2019, 34(3): 197-199. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK201903009.htm
[17] 陈洁, 李幼瑾, 江帆. 儿童变应性鼻炎气象环境因素研究[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(14): 1015-1019. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201414002.htm
[18] Hong SN, Won JY, Nam EC, et al. Clinical Manifestations of Allergic Rhinitis by Age and Gender: A 12-Year Single-Center Study[J]. Ann Otol Rhinol Laryngol, 2020, 129(9): 910-917. doi: 10.1177/0003489420921197
[19] 娄鸿飞, 马思远, 赵岩, 等. 京津冀地区自报过敏性鼻炎病人吸入过敏原检测临床相关性分析[J]. 首都医科大学学报, 2017, 38(05): 665-670. doi: 10.3969/j.issn.1006-7795.2017.05.008
[20] Marogna M, Spadolini I, Massolo A, et al. Long-lasting effects of sublingual immunotherapy according to its duration: a 15-year prospective study[J]. J Allergy Clin Immunol, 2010, 126(5): 969-975. doi: 10.1016/j.jaci.2010.08.030
[21] 俞黎黎, 张承伯, 滕飞翔, 等. 我国尘螨分布的Meta分析[J]. 中国病原生物学杂志, 2017, 12(5): 423-427, 433. https://www.cnki.com.cn/Article/CJFDTOTAL-ZISC201705010.htm
[22] Li J, Huang Y, Lin X, et al. Influence of degree of specific allergic sensitivity on severity of rhinitis and asthma in Chinese allergic patients[J]. Respir Res, 2011, 12: 95. doi: 10.1186/1465-9921-12-95
-