Distribution characteristics and results of allergens in patients with allergic rhinitis in Ningxia area
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摘要: 目的 探讨宁夏地区变应性鼻炎(AR)患者变应原的分布情况，为本地区AR防治提供理论数据。方法 回顾性收集2018年1月-2021年12月在银川市第一人民医院耳鼻咽喉头颈外科医院门诊诊断为AR且同期接受血清变应原特异性lgE(sIgE)检测的患者1 664例。采用变应原sIgE抗体检测试剂盒(免疫印迹法)检测患者的吸入性变应原和食入性变应原。结果 ① IgE检测阳性1 158例(69.59%)；②吸入性变应检测阳性1 096例(65.87%)，食入性变应原检测阳性330例(19.83%)；③艾蒿是致敏程度最高的变应原，阳性级别≥3级的患者占76.32%；④仅对1种变应原过敏者为294例(25.39%)，2种244例(21.07%)，对3种及以上变应原过敏者620例(53.54%)；⑤不同的就诊季节里，夏季检出变应原阳性例数最多，为968例(83.59%)，主要变应原为艾蒿(69.01%)；2019冠状病毒病(Corona Virus Disease 2019，COVID-19)流行后，AR患者sIgE阳性率较之前降低，差异有统计学意义(P < 0.001)；⑥艾蒿、狗上皮、真菌组合、鸡蛋、花生、黄豆、海鱼组合及水果组合均在不同性别分组间差异有统计学意义(P < 0.05)；⑦普通豚草、艾蒿、尘螨组合、蟑螂、鸡蛋、牛奶、海鱼组合、虾、水果组合及坚果组合均在不同年龄分组间差异有统计学意义(P < 0.05)；⑧干草尘埃在不同民族间差异有统计学意义(P < 0.05)。结论 宁夏地区主要变应原以艾蒿为主，不同变应原分布特点受就诊季节、COVID-19流行、性别、年龄、民族等因素影响而呈现一定的分布特点及规律。Abstract: Objective To investigate the distribution of allergens in patients with allergic rhinitis (AR) in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region.Methods A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit (immunoblotting method) to detect inhalation and ingestion allergens in patients.Results ① Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases (25.39%) were allergic to only one allergen, 244 cases (21.07%) were allergic to two allergens, and 620 cases (53.54%) were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases (83.59%). Mugwort was the main allergen during this season (69.01%). After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant (P < 0.001); ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups (P < 0.05); ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups (P < 0.05); ⑧There were statistically significant differences in hay dust among different ethnic groups (P < 0.05).Conclusion Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.
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Key words:
- rhinitis, allergic /
- allergen detection /
- skin prick test /
- Corona Virus Disease 2019
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表 1 AR患者一般信息分布
例(%) AR患者 sIgE阳性患者 sIgE阳性检出率/% 种类 吸入组 1 664(100.00) 1 096(65.87) 65.87 食入组 1 664(100.00) 330(19.83) 19.83 性别 男 764(45.80) 520(44.90) 68.06 女 900(54.20) 638(55.10) 70.89 年龄/岁 0~4 54(3.25) 12(1.04) 22.22 5~11 210(12.62) 146(12.60) 69.52 12~18 134(8.05) 114(9.84) 85.07 19~35 482(28.97) 314(27.11) 65.15 35~59 644(38.70) 472(40.76) 73.29 ≥60 140(8.41) 100(8.64) 71.43 季节 春(3~5月) 96(5.77) 38(3.28) 39.58 夏(6~8月) 1 162(69.83) 968(83.59) 83.30 秋(9~11月) 312(18.75) 112(9.67) 35.90 冬(12~次年2月) 94(5.65) 40(3.45) 42.55 年份 2020年前 926(55.65) 884(76.34) 95.46 2020年后 738(44.35) 274(23.66) 37.13 民族 汉族 672(40.38) 644(55.61) 95.83 回族 246(14.78) 232(20.03) 94.30 满族 8(0.48) 8(0.69) 100.00 不详 738(44.35) 274(23.66) 37.13 
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表 2 变应原在不同季节中的分布特点
例(%) 变应原 季节分布 χ2 P 春季(n=38) 夏季(n=968) 秋季(n=112) 冬季(n=40) 树木组合 6(15.79) 504(52.07) 46(41.07) 12(30.00) 29.006 ＜0.001 普通豚草 8(21.05) 516(53.31) 32(28.57) 14(35.00) 40.870 ＜0.001 艾蒿 26(68.42) 668(69.01) 76(67.86) 24(60.00) 1.476 0.689 尘螨组合 0(0.00) 216(22.31) 4(3.57) 4(10.00) 34.684 ＜0.001 干草尘埃 0(0.00) 58(5.99) 8(7.14) 0(0.00) 4.833 0.148 猫上皮 4(10.53) 148(15.29) 20(17.86) 2(5.00) 4.507 0.212 狗上皮 2(5.26) 64(6.61) 12(10.71) 4(10.00) 3.451 0.320 蟑螂 2(5.26) 306(31.61) 8(7.14) 12(30.00) 39.913 ＜0.001 真菌组合 0(0.00) 294(30.37) 14(12.50) 4(10.00) 37.499 ＜0.001 葎草 2(5.26) 232(23.97) 20(17.86) 6(15.00) 10.358 0.016 鸡蛋 2(5.26) 50(5.17) 12(10.71) 2(5.00) 5.267 0.130 牛奶 2(5.26) 34(3.51) 6(5.36) 2(5.00) 2.248 0.469 花生 2(5.26) 136(14.05) 4(3.57) 4(10.00) 12.234 0.007 黄豆 2(5.26) 2(0.21) 0(0.00) 14(35.00) 89.105 ＜0.001 牛肉 0(0.00) 20(2.07) 12(10.71) 4(10.00) 23.673 ＜0.001 羊肉 0(0.00) 24(2.48) 8(7.14) 0(0.00) 7.333 0.039 海鱼组合 0(0.00) 80(8.26) 8(7.14) 2(5.00) 3.851 0.268 虾 2(5.26) 52(5.37) 0(0.00) 2(5.00) 8.604 0.026 螃蟹 2(5.26) 32(3.31) 8(7.14) 10(25.00) 26.820 ＜0.001 水果组合 0(0.00) 8(0.83) 6(5.36) 0(0.00) 10.960 0.008 坚果组合 0(0.00) 6(0.62) 4(3.57) 0(0.00) 7.108 0.049
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表 3 变应原在防控期和非防控期的分布特点
例(%) 变应原 时间分布 χ2 P 非防控期
(n=884)防控期
(n=274)吸入性 树木组合 482(54.52) 86(31.39) 44.809 ＜0.001 普通豚草 502(56.79) 68(24.82) 85.534 ＜0.001 艾蒿 624(70.59) 170(62.04) 7.085 0.008 尘螨组合 210(23.76) 14(5.11) 46.612 ＜0.001 干草尘埃 56(6.33) 10(3.65) 2.806 0.094 猫上皮 134(15.16) 40(14.60) 0.051 0.821 狗上皮 64(7.24) 18(6.57) 0.143 0.705 蟑螂 296(33.48) 32(11.68) 48.987 ＜0.001 真菌组合 292(33.03) 20(7.30) 70.363 ＜0.001 葎草 218(24.66) 42(15.33) 10.462 0.001 食入性 鸡蛋 48(5.43) 18(6.57) 0.505 0.477 牛奶 32(3.62) 12(4.38) 0.330 0.566 花生 136(15.38) 10(3.65) 26.142 ＜0.001 黄豆 0(0.00) 18(6.57) 54.775 ＜0.001 牛肉 12(1.36) 24(8.76) 38.043 ＜0.001 羊肉 22(2.49) 10(3.65) 1.049 0.306 海鱼组合 72(8.14) 18(6.57) 0.724 0.395 虾 48(5.43) 8(2.92) 2.864 0.091 螃蟹 28(3.17) 24(8.76) 15.249 ＜0.001 水果组合 0(0.00) 14(5.11) 41.543 ＜0.001 坚果组合 0(0.00) 10(3.64) 28.420 ＜0.001
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表 4 变应原在不同性别中的分布特点
例(%) 变应原 性别分布 χ2 P 男
(n=520)女
(n=638)吸入性 树木组合 256(49.23) 312(48.90) 0.012 0.912 普通豚草 272(52.31) 298(46.71) 3.594 0.058 艾蒿 380(73.08) 414(64.89) 8.909 0.003 尘螨组合 94(18.08) 130(20.38) 0.971 0.324 干草尘埃 22(4.23) 44(6.90) 3.788 0.052 猫上皮 74(14.23) 100(15.67) 0.467 0.494 狗上皮 22(4.23) 60(9.40) 11.655 0.001 蟑螂 144(27.69) 184(28.84) 0.186 0.666 真菌组合 124(23.85) 188(29.47) 4.599 0.032 葎草 116(22.31) 144(22.57) 0.011 0.915 食入性 鸡蛋 20(3.85) 46(7.21) 6.032 0.014 牛奶 20(3.85) 24(3.76) 0.006 0.940 花生 90(17.31) 56(8.78) 18.920 ＜0.001 黄豆 14(2.69) 4(0.63) 7.986 0.005 牛肉 12(2.30) 24(3.76) 2.011 0.156 羊肉 10(1.92) 22(3.45) 2.480 0.115 海鱼组合 26(5.00) 64(10.03) 10.118 0.001 虾 28(5.38) 28(4.39) 0.617 0.432 螃蟹 22(4.23) 30(4.70) 0.148 0.700 水果组合 10(1.92) 4(0.63) 4.030 0.045 坚果组合 6(1.15) 4(0.63) 0.416 0.519
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表 5 变应原在不同年龄分组中的分布特点
例(%) 变应原 年龄分布 χ2 P 婴幼儿
(n=12)儿童
(n=146)青少年
(n=114)青年
(n=314)中年
(n=472)老年
(n=100)树木组合 6(50.00) 82(56.16) 58(50.88) 158(50.32) 220(46.61) 44(44.00) 5.461 0.362 普通豚草 2(16.67) 78(53.42) 50(43.86) 154(49.04) 251(53.18) 35(35.00) 18.484 0.002 艾蒿 6(50.00) 118(80.82) 76(66.67) 232(73.89) 310(65.68) 52(52.00) 30.967 ＜0.001 尘螨组合 0(0.00) 12(8.22) 18(15.79) 80(25.48) 92(19.49) 22(22.00) 23.413 ＜0.001 干草尘埃 0(0.00) 6(4.11) 8(7.02) 22(7.01) 28(5.93) 2(2.00) 5.372 0.372 猫上皮 0(0.00) 32(21.92) 22(19.30) 44(14.01) 62(13.14) 14(14.00) 10.839 0.055 狗上皮 0(0.00) 8(5.48) 4(3.51) 20(6.37) 42(8.90) 8(8.00) 6.434 0.266 蟑螂 0(0.00) 12(8.22) 32(28.07) 98(31.21) 160(33.90) 26(26.00) 42.592 ＜0.001 真菌组合 2(16.67) 46(31.51) 22(19.30) 84(26.75) 128(27.12) 30(30.00) 6.061 0.300 葎草 0(0.00) 40(27.40) 32(28.07) 74(23.57) 94(19.92) 20(20.00) 9.905 0.078 鸡蛋 2(16.67) 2(1.37) 2(1.75) 16(5.10) 28(5.93) 16(16.00) 31.080 ＜0.001 牛奶 2(16.67) 2(1.37) 2(1.75) 18(5.73) 20(4.24) 0(0.00) 15.756 0.005 花生 2(16.67) 20(13.70) 18(15.79) 32(10.19) 68(14.41) 6(6.00) 8.398 0.136 黄豆 0(0.00) 2(1.37) 0(0.00) 4(1.27) 12(2.54) 0(0.00) 5.305 0.328 牛肉 2(16.67) 6(4.11) 4(3.51) 10(3.18) 12(2.54) 2(2.00) 6.785 0.204 羊肉 0(0.00) 0(0.00) 4(3.51) 10(3.18) 14(2.97) 4(4.00) 6.833 0.200 海鱼组合 0(0.00) 0(0.00) 4(3.51) 32(10.19) 42(8.90) 12(12.00) 22.098 0.001 虾 0(0.00) 0(0.00) 0(0.00) 20(6.37) 28(5.93) 8(8.00) 18.835 0.002 螃蟹 0(0.00) 2(1.37) 6(5.26) 18(5.73) 20(4.24) 6(6.00) 5.769 0.329 水果组合 0(0.00) 8(5.48) 4(3.51) 2(0.64) 0(0.00) 0(0.00) 27.101 ＜0.001 坚果组合 0(0.00) 6(4.11) 2(1.75) 2(0.64) 0(0.00) 0(0.00) 18.171 ＜0.001
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