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摘要: 目的 了解北京地区变应性鼻炎(allergic rhinitis，AR)和(或)过敏性哮喘患者豚草花粉致敏特点，为豚草花粉致敏患者的防治提供依据。方法 回顾性分析2017年1月—2019年12月就诊于北京世纪坛医院变态反应科门诊AR和(或)哮喘的患者，采用豚草花粉过敏原试剂进行皮肤点刺试验(skin prick test，SPT)，比较不同年龄、性别和呼吸道疾病患者中豚草花粉致敏情况，观察豚草花粉致敏的人群分布特征。采用SAS 9.4软件进行统计学分析。结果 纳入9 727例患者，豚草花粉SPT总阳性率达45.50%(4 426/9 727)，其中13~17岁阳性率最高(65.54%)；AR合并哮喘患者豚草花粉SPT阳性率最高(49.79%)，其次为AR(46.46%)，单一过敏性哮喘患者最低(19.42%)。豚草花粉致敏和非豚草花粉致敏2组患者均为女性多于男性(P < 0.05)，30~39岁高于其他年龄段(P < 0.05)。AR组豚草花粉致敏高于非豚草花粉致敏(98.49% vs 94.76%，P < 0.05)。豚草花粉SPT阳性患者合并其他夏秋花粉过敏原中，排名前3位的是灰藜花粉、葎草花粉和大籽蒿花粉，阳性率分别为90.42%、89.63%和85.40%。豚草合并其他花粉致敏者占99.57%(4 407/4 426)。无论是单一豚草花粉或合并其他花粉致敏的患者均以AR为主，但2组差异无统计学意义(94.97% vs 98.50%，P>0.05)。结论 北京地区豚草花粉致敏性较高，单一豚草致敏少见，常合并多重花粉致敏，且以AR为主。Abstract: Objective To investigate the sensitization characteristics of ragweed pollen in patients with allergic rhinitis(AR) and(or) allergic asthma in Beijing area, and to provide basis for the prevention and treatment of ragweed pollen sensitized population.Methods Patients with allergic rhinitis and/or asthma from January 2017 to December 2019 in the outpatient department of Allergy Department of Beijing Shijitan Hospital were retrospectively analyzed in this study. Skin prick test(SPT) was performed with ragweed pollen allergen reagents to compare different ages, genders and respiratory diseases allergen distribution, and to observe the sensitization characteristics of its population. All of the analyses were performed using SAS software version 9.4.Results A total of 9 727 patients were enrolled in the end. The total positive rate of ragweed pollen SPT was 45.50%(4 426/9 727), the highest positive rate was 65.54% in 13-17 years old group; The positive rate of ragweed pollen SPT was 49.79% in allergic rhinitis combined with asthma patients, followed by 46.46% in allergic rhinitis patients, and the lowest rate was 19.42% in single allergic asthma patients. There were more females than males in both ragweed pollen sensitized and non-ragweed pollen sensitized groups(P < 0.05), and the proportion was higher in 30-39 years old than in other age groups(P < 0.05). Ragweed pollen sensitization was higher than non-ragweed pollen sensitization in the allergic rhinitis group(98.49% vs 94.76%, P < 0.05). Ragweed pollen with other summer and autumn pollen allergens in patients with positive SPT, the top three were Chenopodium pollen, Humulus pollen and Artemisia grandis pollen, with positive rates of 90.42%, 89.63% and 85.40%, respectively. Ragweed combined with other pollen sensitization accounted for 99.57%(4 407/4 426). Allergic rhinitis was the main disease in patients sensitized with ragweed pollen alone or combined with other pollens, and there was no significant difference between the two groups(94.97% vs 98.50%, P>0.05).Conclusion Ragweed pollen is highly sensitized in Beijing area, single ragweed pollen sensitization is rare, often combined with multiple pollen sensitization, and allergic rhinitis is the main disease.
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Key words:
- allergic rhinitis /
- allergic asthma /
- ragweed /
- skin prick test /
- cross-reaction
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表 1 患者基本资料(n=9727)
项目 豚草花粉致敏(n=4 426) 非豚草花粉致敏1)(n=5 301) χ2/t P 年龄/岁 34.13±15.53 36.36±16.34 6.9 < 0.000 1 年龄段/例(%) 169.8 < 0.000 1 0~6岁 112(2.53) 248(4.68) 7~12岁 387(8.74) 291(5.49) 13~17岁 253(5.72) 133(2.51) 18~29岁 860(19.43) 1 068(20.15) 30~39岁 1 372(31.00) 1 604(30.26) 40~49岁 681(15.39) 777(14.66) 50~59岁 469(10.6) 657(12.39) 60~69岁 247(5.58) 426(8.04) ≥70岁 45(1.02) 97(1.83) 性别/例(%) 34.7 < 0.000 1 男 1 943(43.90) 2 015(38.01) 女 2 483(56.10) 3 286(61.99) 疾病组 AR 4 359(98.49) 5 023(94.76) 98.1 < 0.000 1 过敏性哮喘 551(12.45) 766(14.45) 8.2 0.004 1 单一AR2) 3 875(87.55) 4 535(85.55) 8.2 0.004 1 单一过敏性哮喘3) 67(1.51) 278(5.24) 98.1 < 0.000 1 AR合并哮喘 484(10.94) 488(9.21) 8.0 0.004 6 注：1)除豚草花粉致敏以外的所有花粉致敏患者；2)AR为临床唯一诊断；3)过敏性哮喘为临床唯一诊断。 
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表 2 AR和(或)哮喘患者豚草花粉致敏情况
疾病类型 患者例数(n=9 727) 豚草致敏例数(n=4 426) 百分比/% AR 9 382 4 359 46.46 过敏性哮喘 1 317 551 41.84 AR合并哮喘 972 484 49.79 单一AR 8 410 3 875 46.08 单一过敏性哮喘 345 67 19.42
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表 3 豚草花粉SPT阳性患者合并其他夏秋季花粉过敏原情况(n=4 426)
花粉过敏原 阳性例数 阳性率/% 灰藜花粉 4 002 90.42 葎草花粉 3 967 89.63 大籽蒿花粉 3 780 85.40 向日葵花粉 3 313 74.85 玉米花粉 3 264 73.75 油菜花花粉 2 811 63.51 银杏花粉 2 381 53.80
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表 4 单一豚草致敏与合并其他花粉致敏患者基本特征比较
例(%) 特征 单一豚草致敏(n=19) 合并其他花粉致敏(n=4 407) χ2/t P 性别 4.0 0.044 3 男 4(21.05) 1939(44.00) 女 15(78.95) 2468(56.00) 年龄/岁 9.0 0.346 4 0~6 2(10.53) 110(2.50) 7~12 1(5.26) 386(8.76) 13~17 1(5.26) 252(5.72) 18~29 4(21.05) 856(19.42) 30~39 4(21.05) 1368(31.04) 40~49 1(5.26) 680(15.43) 50~59 5(26.32) 464(10.53) 60~69 1(5.26) 246(5.58) ≥70 0(0) 45(1.02) 疾病类型 AR 18(94.74) 4341(98.50) 1.1 0.293 7 过敏性哮喘 6(31.58) 545(12.37) 4.8 0.028 7 AR合并哮喘 5(26.32) 479(10.87) 3.5 0.061 6 单一AR 13(68.42) 3862(87.63) 4.8 0.028 7 单一过敏性哮喘 1(5.26) 66(1.50) 1.1 0.293 7
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