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摘要: 目的 了解北京地区葎草花粉致敏的人群分布特点及致敏特征。方法 选取2017年1月—2019年12月门诊诊断为变应性鼻炎、过敏性哮喘及变应性鼻炎合并哮喘的患者8380例。采用葎草变应原试剂行皮肤点刺试验(SPT)，比较葎草花粉致敏人群分布，分析葎草花粉的主要致敏特征。结果 葎草花粉SPT总阳性率达49.59%，其中10~14岁致敏性最高(71.98%)，且与其他年龄组比较差异有统计学意义(P < 0.01)；小于10岁患儿SPT阳性率随年龄增长逐渐增加，50岁以上患者SPT阳性率随年龄增长逐渐减低。葎草花粉SPT强阳性患者占41.43%，与SPT+、++、+++的差异有统计学意义(P < 0.01)。单一葎草致敏较少(23.87%)，多合并多种花粉致敏(76.13%)，且常合并灰藜花粉致敏(92.81%)。结论 北京地区变应性鼻炎或哮喘患者葎草花粉致敏率较高，尤以10~14岁年龄段致敏率最高。提示葎草花粉是变应性鼻炎、哮喘的主要致敏原，且葎草花粉致敏多趋向于多重致敏。Abstract: Objective To understand the sensitization characteristics of humulus pollen in patients with allergic rhinitis or allergic asthma in Beijing, and to explore the proportion of the population allergic to humulus pollen.Methods Selected 8380 patients who were diagnosed with allergic rhinitis, allergic asthma, and allergic rhinitis combined with asthma in outpatient clinic from January 2017 to December 2019. SPT test was performed with humulus allergen reagent to compare the sensitization distribution of humulus pollen by age and disease, and analyze the sensitization characteristics of humulus pollen.Results The total positive rate of humulus pollen SPT reached 49.59%.The positive rate of humulus pollen SPT was the highest in the age group of 10 to 14 years old, reaching 71.98%, compared with other age groups, there was a statistical difference (P < 0.01); and the positive rate of SPT in patients under 10 years of age gradually increased with age, and the positive rate of SPT in patients over 50 years of age gradually decreased with age. Humulus pollen SPT positive patients ++++ and above accounted for 41.43%, which was significantly different from other groups (P < 0.01). Single humulus was less allergenic, accounting for about 23.87%. Most of them were combined with multiple pollen allergies (76.13%), and often combined with chenopodiaceae pollen sensitization (92.81%).Conclusion The SPT positive rate of humulus pollen in patients with allergic rhinitis or asthma in Beijing area is nearly 50%. The positive rate of SPT is the highest among patients aged 10-14, and most of them show strong positive reactions. It is suggested that humulus pollen is the main allergen of allergic rhinitis and asthma, and the sensitization of humulus pollen tends to be multiple allergens.
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Key words:
- rhinitis, allergic /
- asthma /
- humulus /
- pollen /
- skin prick test
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表 1 患者的基本资料
变量 例(%) 性别 男 3406(40.64) 女 4974(59.36) 年龄/岁 0~4 115(1.37) 5~9 543(6.48) 10~14 464(5.54) 15~19 298(3.56) 20~29 1588(18.95) 30~39 2543(30.35) 40~49 1236(14.75) 50~59 922(11.00) 60~69 544(6.49) ≥70 127(1.52) 变应性鼻炎 8077(96.38) 过敏性哮喘 1085(12.95) 变应性鼻炎合并哮喘 782(9.33) 单一变应性鼻炎a) 7295(87.05) 单一过敏性哮喘b) 303(3.62) 注：a)指变应性鼻炎为临床唯一诊断；b)指过敏性哮喘为临床唯一诊断。 
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表 2 单一葎草花粉致敏与多重葎草花粉致敏的基本特征
变量 单一葎草花粉致敏(n=992) 多重葎草花粉致敏(n=3164) P值 性别 0.000 5 男 395(39.82) 1458(46.08) 女 597(60.18) 1706(53.92) 年龄/岁 33.99±17.28 33.03±15.42 0.096 2 年龄/岁 33(24，45) 33(24，42) 0.352 2 年龄段/岁 < 0.000 1 0~4 18(1.81) 20(0.63) 5~9 85(8.57) 213(6.73) 10~14 69(6.96) 265(8.38) 15~19 34(3.43) 170(5.37) 20~29 171(17.24) 561(17.73) 30~39 293(29.54) 981(31.01) 40~49 123(12.40) 479(15.14) 50~59 113(11.39) 298(9.42) 60~69 62(6.25) 151(4.77) ≥70 24(2.42) 26(0.82) 变应性鼻炎 965(97.28) 3120(98.61) 0.004 8 过敏性哮喘 126(12.70) 356(11.25) 0.213 3 变应性鼻炎合并哮喘 99(9.98) 312(9.86) 0.912 8 单一变应性鼻炎 866(87.30) 2808(88.75) 0.213 3 单一过敏性哮喘 27(2.72) 44(1.39) 0.004 8
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表 3 葎草花粉SPT阳性患者合并其他吸入性变应原情况
变应原 阳性例数 阳性率/% 灰藜 3857 92.81 大籽蒿 3513 84.53 豚草 3373 81.16 向日葵 3053 73.46 玉米 2987 71.87 柳树 2841 68.36 油菜花 2708 65.16 洋白蜡 2649 63.74 杨树 2629 63.26 圆柏 2614 62.90 桦树 2588 62.27 梧桐 2563 61.67 槐树 2375 57.15 榆树 2320 55.82 银杏 2066 49.71
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表 4 不同疾病葎草花粉致敏情况
病种 例数 葎草花粉致敏/例(%) 变应性鼻炎 8077 4085(50.58) 过敏性哮喘 1085 482(44.42) 变应性鼻炎合并哮喘 782 411(52.56) 单一变应性鼻炎 7295 3674(50.36) 单一过敏性哮喘 303 71(23.43)
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