Analysis of allergen distribution and indoor factors in allergic rhinitis in Chaoshan area
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摘要: 目的 探讨潮汕地区变应性鼻炎患者的常见过敏原分布以及影响病情的室内相关因素。方法 选取来自汕头、揭阳、潮州诊断为变应性鼻炎并行血清过敏原IgE检测的患者，行问卷调查，通过分析过敏原特异性IgE检测及问卷调查，探讨患者的过敏原分布情况及影响患者病情严重程度的室内相关因素。结果 共回收问卷1 800份，回收有效问卷1 646份，有效回收率91.4%。纳入研究的变应性鼻炎患者共1 646例，其中儿童(≤14岁)1 285例，成人(>14岁)361例；男999例，女647例。阳性率最高的前3位过敏原分别为户尘螨(n=1 457，88.5%)、牛奶(n=569，34.6%)、蟹(n=360，21.9%)。户尘螨、屋尘、狗毛皮屑、鸡蛋白、牛奶、鱼、蟹、虾、牛肉过敏比例，在儿童与成人之间差异均有统计学意义(P < 0.01)，男女之间蟹、虾过敏比例差异有统计学意义(P < 0.01)。通过多因素分析，主动/被动吸烟、祭祀、使用空调、饲养宠物、使用空气净化器、洗晒被褥均为影响变应性鼻炎患者病情的室内因素，其中主动/被动吸烟、祭祀、使用空调、饲养宠物为加重变应性鼻炎患者病情的危险因素，而使用空气净化器、洗晒被褥是其保护因素。结论 户尘螨是潮汕地区变应性鼻炎患者最主要的过敏原。主动/被动吸烟、祭祀、使用空调、饲养宠物可加重变应性鼻炎病情，使用空气净化器、洗晒被褥有利于控制病情。本研究结果可供临床参考。
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关键词:
- 变应性鼻炎 /
- 过敏原 /
- 潮汕地区 /
- 调查研究 /
- logistic分析
Abstract: Objective To investigate the distribution of common allergens and indoor factors influencing the severity of allergic rhinitis in patients from the Chaoshan region.Methods Patients diagnosed with allergic rhinitis from Shantou, Jieyang, and Chaozhou were selected for serum allergen-specific IgE testing. A questionnaire survey was conducted to analyze the distribution of allergens and indoor factors affecting the severity of the disease.Results A total of 1 800 questionnaires were collected, with 1 646 valid responses, resulting in an effective response rate of 91.4%. Among the 1 646 included patients with allergic rhinitis, there were 1 285 children(≤14 years), 361 adolescents and adults(>14 years); of which 999 were males and 647 were females. The top three allergens with the highest positive rates were house dust mites(n=1 457, 88.5%), milk(n=569, 34.6%), and crab(n=360, 21.9%). The proportions of allergen sensitization to house dust mites, house dust, dog dander, egg white, milk, fish, crab, shrimp, and beef showed statistically significant differences between children and adolescents and adults(P < 0.01). There were also statistically significant differences in crab and shrimp sensitization between males and females(P < 0.01). Multivariate analysis revealed that active/passive smoking, religious rituals, air conditioning usage, pet ownership, air purifier usage, and bedding drying were indoor factors influencing the severity of allergic rhinitis. Among them, active/passive smoking, religious rituals, air conditioning usage, and pet ownership were risk factors for exacerbating the disease, while air purifier usage and bedding drying were protective factors.Conclusion House dust mites are the most common allergen in patients with allergic rhinitis in the Chaoshan region. Active/passive smoking, religious rituals, air conditioning usage, and pet ownership can worsen the condition, while air purifier usage and bedding drying can help control the disease. The results of this study can provide clinical reference.-
Key words:
- allergic rhinitis /
- allergens /
- chaoshan area /
- research /
- logistic analysis
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表 1 潮汕地区AR过敏原分布情况
例(%) 项目 性别 合计 儿童 成人 χ2 P 男 女 χ2 P 总IgE 1 285(78.1) 361(21.9) 999(60.7) 647(39.3) 1 646(100.0) 户尘螨 1 109(86.3) 348(96.4) 28.260 < 0.001 880(88.1) 577(89.2) 0.461 0.497 1 457(88.5) 屋尘 201(15.6) 83(23.0) 10.663 < 0.001 170(17.0) 114(17.6) 0.100 0.752 284(17.3) 猫毛皮屑 54(4.2) 9(2.5) 2.237 0.135 41(4.1) 22(3.4) 0.528 0.467 63(3.8) 狗毛皮屑 93(7.2) 15(4.2) 4.367 0.037 73(7.3) 35(5.4) 2.307 0.129 108(6.6) 矮豚草 99(7.7) 25(6.9) 0.246 0.620 76(7.6) 48(7.4) 0.020 0.887 124(7.5) 桑树 85(6.6) 24(6.6) 0.010 0.982 66(6.6) 43(6.6) 0.001 0.975 109(6.6) 蟑螂 85(6.6) 34(9.4) 3.303 0.069 74(7.4) 45(7.0) 0.120 0.729 119(7.2) 霉菌混合 46(3.6) 21(5.8) 3.613 0.057 39(3.9) 28(4.3) 0.181 0.671 67(4.1) 树混合 95(7.4) 26(7.2) 0.015 0.902 66(6.6) 55(8.5) 2.069 0.150 121(7.4) 腰果 93(7.2) 29(8.0) 0.260 0.610 76(7.6) 46(7.1) 0.142 0.706 122(7.4) 鸡蛋白 224(17.4) 10(2.8) 49.678 < 0.001 149(14.9) 85(13.1) 1.017 0.313 234(14.2) 牛奶 525(40.9) 44(12.2) 102.399 < 0.001 358(35.8) 211(32.6) 1.804 0.179 569(34.6) 鱼 227(17.3) 12(3.3) 46.701 < 0.001 151(15.1) 88(13.6) 0.725 0.394 239(14.5) 蟹 317(24.7) 43(11.9) 26.884 < 0.001 237(23.7) 123(19.0) 5.104 0.024 360(21.9) 虾 307(23.9) 28(7.8) 45.261 < 0.001 225(22.5) 110(17.0) 7.384 0.007 335(20.4) 贝 102(7.9) 29(8.0) 0.004 0.953 83(8.3) 48(7.4) 0.424 0.515 131(8.0) 牛肉 108(8.4) 18(5.0) 4.659 0.031 77(7.7) 49(7.6) 0.010 0.920 126(7.7) 羊肉 97(7.5) 22(6.1) 0.889 0.346 77(7.7) 42(6.5) 0.866 0.352 119(7.2) 芒果 99(7.7) 25(6.9) 0.246 0.620 74(7.4) 50(7.7) 0.058 0.810 124(7.5) 
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表 2 Spearman秩相关分析
变量 年龄 性别 主动/被动吸烟 祭祀 使用空调 饲养宠物 使用空气净化器 洗晒被褥 病情 年龄 1.000 性别 0.166** 1.000 主动/被动吸烟 -0.027 0.003 1.000 祭祀 -0.030 0.053* 0.052* 1.000 使用空调 -0.017 0.036 0.058* 0.052* 1.000 饲养宠物 0.008 0.000 0.070** 0.130** 0.003 1.000 使用空气净化器 0.026 -0.018 -0.108** -0.210** -0.151** -0.204** 1.000 洗晒被褥 0.001 -0.016 -0.031 -0.096** -0.053* -0.106** 0.059* 1.000 病情 -0.019 0.013 0.167** 0.205** 0.183** 0.239** -0.329** -0.229** 1.000 *P < 0.05，**P < 0.01。
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[1] Wu AC, Dahlin A, Wang AL. The role of environmental risk factors on the development of childhood allergic rhinitis[J]. Children(Basel), 2021, 8(8): 708.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国变应性鼻炎指南(2022年修订版)[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(2): 106-129. doi: 10.3760/cma.j.cn115330-20211228-00828
[3] 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
[4] 孙娜, 龚静蓉, 郝亚楠, 等. 上海地区大气PM 2.5浓度与变应性鼻炎发病的相关性研究[J]. 临床耳鼻咽喉头颈外科杂志, 2023, 37(6): 434-441. doi: 10.13201/j.issn.2096-7993.2023.06.006
[5] Lin H, Lin R, Li N. Sensitization rates for various allergens in children with allergic rhinitis in Qingdao, China[J]. Int J Environ Res Public Health, 2015, 12(9): 10984-10994. doi: 10.3390/ijerph120910984
[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] Chen KB, Li YQ, Ji J, et al. Diurnal temperature range impacts on outpatients department visits for allergic rhinitis in Lanzhou, China[J]. Int Arch Occup Environ Health, 2023, 96(4): 587-595. doi: 10.1007/s00420-023-01951-2
[8] 袁峰. 影响变应性鼻炎发病及预后的相关危险因素Logistic回归分析[J]. 中国耳鼻咽喉颅底外科杂志, 2017, 23(3): 266-270. https://www.cnki.com.cn/Article/CJFDTOTAL-ZEBY201703017.htm
[9] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 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. https://xuewen.cnki.net/CCND-HJRB202406130011.html
[10] 张楠楠, 吴云文, 张庆丰, 等. 深圳地区的变应性鼻炎患者吸入性变应原分布特点及结果分析[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(6): 467-472. doi: 10.13201/j.issn.2096-7993.2022.06.012
[11] 钟洁, 刘大波, 黄振云. 广州地区2136例变应性鼻炎儿童吸入性变应原皮肤点刺试验结果分析[J]. 中国耳鼻咽喉头颈外科, 2014, 21(9): 481-485. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT201409010.htm
[12] Calderón MA, Linneberg A, Kleine-Tebbe J, et al. Respiratory allergy caused by house dust mites: What do we really know?[J]. J Allergy Clin Immunol, 2015, 136(1): 38-48. doi: 10.1016/j.jaci.2014.10.012
[13] El-Qutob D. Shrimp allergy: beyond avoidance diet[J]. Eur Ann Allergy Clin Immunol, 2017, 49(6): 252-256. doi: 10.23822/EurAnnACI.1764-1489.16
[14] Muraro A, Worm M, Alviani C, et al. EAACI guidelines: Anaphylaxis(2021 update)[J]. Allergy, 2022, 77(2): 357-377. doi: 10.1111/all.15032
[15] 顾建青. 婴幼儿避免食物过敏的最佳时期[J]. 中华临床免疫和变态反应杂志, 2023, 17(5): 497-498. doi: 10.3969/j.issn.1673-8705.2023.05.019
[16] 马婷婷, 蔡惠娇, 柳馨, 等. 尘螨-食物过敏综合征[J]. 中华临床免疫和变态反应杂志, 2023, 17(2): 169-174. doi: 10.3969/j.issn.1673-8705.2023.02.012
[17] Dror AA, Eisenbach N, Marshak T, et al. Reduction of allergic rhinitis symptoms with face mask usage during the COVID-19 pandemic[J]. J Allergy Clin Immunol Pract, 2020, 8(10): 3590-3593. doi: 10.1016/j.jaip.2020.08.035
[18] Eguiluz-Gracia I, Mathioudakis AG, Bartel S, et al. The need for clean air: The way air pollution and climate change affect allergic rhinitis and asthma[J]. Allergy, 2020, 75(9): 2170-2184. doi: 10.1111/all.14177
[19] Naclerio R, Ansotegui IJ, Bousquet J, et al. International expert consensus on the management of allergic rhinitis(AR)aggravated by air pollutants: Impact of air pollution on patients with AR: Current knowledge and future strategies[J]. World Allergy Organ J, 2020, 13(3): 100106. doi: 10.1016/j.waojou.2020.100106
[20] Raulf M, Bergmann KC, Kull S, et al. Mites and other indoor allergens-from exposure to sensitization and treatment[J]. Allergo J Int, 2015, 24(3): 68-80. doi: 10.1007/s40629-015-0049-1
[21] Lee A, Lee SY, Lee KS. The use of heated tobacco products is associated with asthma, allergic rhinitis, and atopic dermatitis in Korean adolescents[J]. Sci Rep, 2019, 9: 17699. doi: 10.1038/s41598-019-54102-4
[22] Grillo C, La Mantia I, Grillo CM, et al. Influence of cigarette smoking on allergic rhinitis: a comparative study on smokers and non-smokers[J]. Acta Biomed, 2019, 90(7-S): 45-51.
[23] Songnuy T, Scholand SJ, Panprayoon S. "Effects of tobacco smoke on aeroallergen sensitization and clinical severity among university students and staff with allergic rhinitis"[J]. J Environ Public Health, 2020, 2020: 1692930.
[24] Drago G, Perrino C, Canepari S, et al. Relationship between domestic smoking and metals and rare earth elements concentration in indoor PM2.5[J]. Environ Res, 2018, 165: 71-80. doi: 10.1016/j.envres.2018.03.026
[25] Lee S, Hyun C, Lee M. Machine learning big data analysis of the impact of air pollutants on rhinitis-related hospital visits[J]. Toxics, 2023, 11(8): 719. doi: 10.3390/toxics11080719
[26] Saulyte J, Regueira C, Montes-Martínez A, et al. Active or passive exposure to tobacco smoking and allergic rhinitis, allergic dermatitis, and food allergy in adults and children: a systematic review and meta-analysis[J]. PLoS Med, 2014, 11(3): e1001611. doi: 10.1371/journal.pmed.1001611
[27] 马云凤, 高雅倩, 刘艳华, 等. 黑炭在环境中的分布及其环境效应研究进展[J]. 环境化学, 2022, 41(8): 2586-2595. https://www.cnki.com.cn/Article/CJFDTOTAL-HJHX202208013.htm
[28] Wilson JM, Platts-Mills TAE. Home environmental interventions for house dust mite[J]. J Allergy Clin Immunol Pract, 2018, 6(1): 1-7. doi: 10.1016/j.jaip.2017.10.003
[29] 芮晓清, 姜艳蕊, 朱绮, 等. 学龄前儿童过敏性鼻炎合并哮喘的危险因素与生活质量分析[J]. 中国耳鼻咽喉头颈外科, 2020, 27(5): 263-266. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT202005008.htm
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