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摘要: 目的 通过对深圳地区变应性鼻炎(AR)患者的变应原进行检测和分析，筛查深圳地区常见吸入性变应原，绘制深圳地区AR患者的变应原分布图谱，为科学、合理地预防和治疗AR提供依据。方法 对3351例AR患者采用BioSciTec GmbH公司的检测系统，对18种吸入性变应原进行血清特异性IgE检测，测定致敏变应原，并按性别、年龄、严重程度以及季节性变应原等进行统计学分析。结果 3351例AR患者中，最常见的前5种吸入性变应原依次为热带无爪螨2231例(66.6%)，户尘螨2212例(66.0%)，粉尘螨1986例(59.3%)，蟑螂967例(28.9%)，矮豚草844例(25.2%)。变应原严重程度分布中，户尘螨≥3级的占41.3%(1385/3351)，粉尘螨≥3级的占40.6%(1360/3351)，热带无爪螨以2级为主，其他变应原以1、2级为主。不同年龄段、不同性别变应原的检出率差异有统计学意义(P < 0.05和P < 0.01)。结论 深圳地区主要的吸入性变应原为热带无爪螨、户尘螨、粉尘螨、蟑螂及矮豚草。变应原的分布与性别、年龄、月份有一定相关性。Abstract: Objective To analyzed allergens and screen for common airborne allergens in patients with allergic rhinitis (AR) in Shenzhen, and identified the distribution pattern of allergens in this region. We aimed to provide scientific and feasible statistical and clinical basis for prevention and treatment of allergenic rhinitis.Methods For 3351 suspected cases of allergenic rhinitis, 18 kinds of airborne allergen serum-specific IgE were determined using a detection system of BioSciTec GmbH company, and statistical analysis was carried out according to sex, age, severity and seasonal allergen.Results A total of 3, 351 cases with allergic rhinitis were positive for airborne allergens. The top five inhalation allergens were Blomia tropicalis (2231, 66.6%), Dermatophagoides pterronyssinus (2212, 66.0%), Dermatophagoides farinae (1986, 59.3%), Cockroach (967, 28.9%), and Short ragweed (844, 25.2%). For the severity of the allergen, Dermatophagoides pterronyssinus ≥ level 3 accounted for 41.3% (1385/3351 cases) and Dermatophagoides farinae ≥level 3 accounted for 40.6% (1360/3351 cases). Blomia tropicalis were classified as level 2, and other allergens were mainly classified as level 1 or 2. The detection rate among different age groups and gender is significantly different.Conclusion The main airborne allergens in Shenzhen were Blomia tropicalis, Dermatophagoides pterronyssinus, Dermatophagoides farinae, Cockroach, as well as Short ragweed. The distribution of allergens was affected by sex, age and season.
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Key words:
- rhinitis, allergic /
- airborne allergen /
- specific IgE
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表 1 变应原结果的判定
级别 参考范围/(IU·mL-1) 特异性IgE浓度 6级 >100.00 极高 5级 50.00~100.00 较高 4级 17.50~49.90 高 3级 3.50~17.49 显著增加 2级 0.70~3.49 增加(中等) 1级 0.35~0.69 低 0级 0.00~0.35 无(检测不到) 
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表 2 不同性别AR患者吸入性变应原分布情况
例(%) 变应原 男性(n=1964) 女性(n=1387) χ2 P值 户尘螨 1325(67.5) 887(64.0) 4.472 0.034 粉尘螨 1202(61.2) 784(56.5) 7.173 0.007 热带无爪螨 1322(67.3) 909(65.5) 1.15 0.283 猫毛皮屑 283(14.4) 185(13.3) 0.776 0.378 狗毛皮屑 425(21.6) 302(21.8) 0.009 0.926 蟑螂 576(29.3) 391(28.2) 0.512 0.474 蚕丝 227(11.6) 156(11.2) 0.078 0.781 矮豚草 489(24.9) 355(25.6) 0.209 0.647 蒿 80(4.1) 68(4.9) 1.324 0.250 葎草 139(7.1) 122(8.8) 3.343 0.067 藜/反枝苋 379(19.3) 241(17.4) 1.991 0.158 刺柏/桦 98(5.0) 67(4.8) 0.044 0.834 悬铃木/白蜡 309(15.7) 223(16.1) 0.072 0.788 杨柳山毛榉橡胡桃 217(11.0) 144(10.4) 0.376 0.540 六月禾黑麦草梯牧草 214(10.9) 146(10.5) 0.116 0.733 复叶槭桑洋槐榆柏构树 192(9.8) 140(10.1) 0.092 0.762 烟曲霉 223(11.4) 141(10.2) 1.186 0.276 念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉 229(11.7) 185(13.3) 2.114 0.146
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表 3 不同年龄段AR患者变应原分布
例 变应原 ≤14岁组(n=1747) >14~24岁组(n=296) >24~34岁组(n=699) >34~44岁组(n=390) >44~54岁组(n=132) >54岁组(n=87) χ2 P值 户尘螨 1225 218 438 231 65 35 74.646 0.000 粉尘螨 1123 205 384 191 59 24 100.757 0.000 热带无爪螨 1183 219 444 245 93 47 20.786 0.001 猫毛皮屑 310 36 84 26 9 3 54.688 0.000 狗毛皮屑 482 73 103 38 22 9 98.555 0.000 蟑螂 518 77 187 118 38 29 4.431 0.489 蚕丝 145 43 110 54 16 15 37.734 0.000 矮豚草 428 62 188 104 39 23 6.203 0.287 蒿 57 11 39 22 10 9 19.841 0.001 葎草 123 29 48 32 13 16 18.341 0.003 藜/反枝苋 337 49 123 69 23 19 2.758 0.737 刺柏/桦 96 15 28 17 6 3 3.200 0.669 悬铃木/白蜡 267 50 100 82 17 16 11.022 0.051 杨柳山毛榉橡胡桃 185 36 74 46 11 9 1.938 0.858 六月禾黑麦草梯牧草 166 38 84 46 15 11 6.175 0.290 复叶槭桑洋槐榆柏构树 150 29 85 38 16 14 11.860 0.037 烟曲霉 144 36 96 51 16 21 36.879 0.000 念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉 195 47 91 45 15 21 17.489 0.004
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表 4 AR患者不同变应原的等级分布
例 变应原 1级 2级 3级 4级 5级 6级 户尘螨 251 576 745 426 92 122 粉尘螨 154 472 857 375 72 56 热带无爪螨 542 931 278 63 4 1 猫毛皮屑 24 62 33 7 0 1 狗毛皮屑 103 71 10 2 0 0 蟑螂 504 428 32 3 0 0 蚕丝 184 166 32 1 0 0 矮豚草 537 284 20 1 2 0 蒿 81 35 18 4 5 5 葎草 167 75 15 2 0 2 藜/反枝苋 410 191 16 2 1 0 刺柏/桦 98 59 8 0 0 0 悬铃木/白蜡 377 146 9 0 0 0 杨柳山毛榉橡胡桃 253 100 7 1 0 0 六月禾黑麦草梯牧草 256 87 12 4 0 1 复叶槭桑洋槐榆柏构树 230 90 10 2 0 0 烟曲霉 182 141 32 6 0 3 念珠菌/点青霉/分枝孢霉/交链孢霉/黑曲霉 168 190 44 9 2 1
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