湖北襄阳地区变应性鼻炎患者血清变应原特征分析

Characteristic analysis of serum allergens in patients with allergic rhinitis in Xiangyang area, Hubei

摘要:

目的 调查湖北省襄阳地区变应性鼻炎（AR）患者变应原谱的分布，为襄阳地区AR防治提供依据，为我国AR的变应原频谱分布特征提供有益补充。方法 选择2017年1月—2020年1月就诊的1 000例拟诊为AR患者作为研究对象，采用免疫印迹定量检测法测定患者血清总免疫球蛋E（IgE）及特异性IgE（sIgE）抗体的分布，以确定变应原；分析阳性变应原的分布情况；年龄与变应原阳性检出率的关系。结果 襄阳地区1 000例拟诊AR患者中，血清sIgE检测呈阳性反应907例，总IgE阳性936例。血清sIgE检测结果分析：吸入性变应原（705例，77.73%），其中粉尘螨户尘螨组合阳性率60.86%、霉菌组合9.26%、猫狗毛组合7.06%；食入性变应原（356例，39.25%），其中牛奶阳性率24.48%、牛羊肉组合17.20%、鸡蛋白13.12%。血清总IgE与血清sIgE同时也是阳性的例数为881例（97.13%）。sIgE阳性的患者人群中，3~14岁年龄段（422例，46.53%）；15~35岁年龄段（249例，27.45%）；36～65年龄段（236例，26.02%）。儿童组与青年组、儿童组与中老年组间比例差异具有统计学意义（P<0.05）。结论 儿童和少年时最主要的易患人群；襄阳地区AR的变应原频谱具有地域特征。血清总IgE与血清sIgE二者存在很强的一致性。据此，儿童是AR防治的重点人群；尽管螨虫AR是防治的重点，但在襄阳地区要兼顾其他吸入性变应原的防治。

Abstract:

Objective To investigate the distribution of allergen spectrum in patients with allergic rhinitis (AR) in Xiangyang, Hubei Province, so as to provide a basis for AR prevention and treatment in Xiangyang and a useful supplement for the allergen spectrum of AR in our country.Methods A total of 1,000 suspected AR patients who visited our clinic between Jan 2017 and Jan 2020 were selected as the research objects. The serum total immunoglobulin E (tIgE) and specific IgE (sIgE) antibodies were determined by Western blot quantitative detection method to determine the allergens. The distribution of positive allergens was analyzed, and the relationship between patients’ age and the positive detection rate of allergens was studied.Results Among the 1,000 patients, 907 cases were positive for serum sIgE test, and 936 for tIgE test. Analysis of serum sIgE test results revealed that 705 (77.73%) were positive to inhaled allergens, including dermatophagoides farinae combined with dermatophagoides pteronyssinus (60.86%), mold combination (9.26%), cat and dog hair combination (7.06%). The serum sIgE test also found that 356 patients were positive to ingested allergens (39.25%), including milk (24.48%), beef and mutton combination (17.20%), egg white (13.12%). The case number with simultaneous positive tIgE and sIgE was 881 (97.13%). The patients with positive sIgE included 422 (46.53%) in the group of 3~14 years old (children group), 249 (27.45%) in the group of 15~35 (youth group), and 236 (26.02%) in the group of 36~65 (middle and old aged group). The differences of positive sIgE rate between the children group and the youth group as well as the middle and old aged group were both statistically insignificant (P<0.05).Conclusions Children and adolescents are the most susceptible population of AR. The allergen spectrum of AR in Xiangyang area has regional characteristics. There is a strong consistency between serum tIgE and sIgE. Accordingly, children are the key population for AR prevention and treatment. Although mites are the most predominant allergens of AR, the prevention and treatment of other inhaled allergens should be taken into consideration in Xiangyang.