武汉市气传花粉和真菌监测及临床意义

发布时间：2018-06-21 16:08

本文选题：花粉 + 真菌　；参考：《华中科技大学》2011年博士论文

【摘要】：目的调查武汉市气传花粉和真菌的种类和飘散规律及武汉市过敏性疾病患者的过敏原分布情况,并探讨花粉浓度对过敏性鼻炎患者临床症状及抗过敏治疗效果的影响。方法2010年1月至2011年1月期间,采用Rotorod容量法采样器每日进行气传花粉和真菌曝片,计数每日花粉和真菌的种类和数量；对2010年1月至2010年12月在我科就诊的1945例过敏性疾病患者进行过敏原皮肤点刺试验,记录结果并进行临床分析；在法国梧桐花粉播散期,选择30例梧桐花粉过敏的季节性过敏性鼻炎患者为试验组,同时选择30例尘螨过敏的过敏性鼻炎患者作为对照组,每日口服氯雷他定片10毫克,连用28天,5例法国梧桐花粉过敏患者未予治疗随访完整个花粉季节,所有过敏性鼻炎患者每天均记录过敏性鼻炎症状。结果：(1)全年监测到花粉种类44种,武汉市气传花粉飘散高峰期在春季3-4月份和秋季9-10月份,春季花粉以树类花粉如桑科、悬铃木属花粉为主,秋季花粉以草类花粉蒿草、凬草、豚草花粉为主；(2)全年监测到真菌种类47种,武汉市气传真菌飘散高峰期在春季3-5月份和秋季8-10月份,武汉市最常见的气传真菌为芽枝菌、黑粉菌、链格孢霉、小球腔菌和附球菌。(3)1945例患者中,过敏原检查阳性率为67.04%,最常见的过敏原为尘螨和蟑螂。花粉过敏的比例为9.46%,真菌过敏的比例为7.20%。过敏性鼻炎合并哮喘、过敏性鼻炎、支气管哮喘的过敏原检查阳性率分别为84.88%、76.69%和73.91%,荨麻疹、湿疹/特应性皮炎的过敏原检查阳性率分别为39.22%和39.60%。(4)法国梧桐花粉浓度在200粒/m3以下时,花粉浓度与法国梧桐花粉过敏性鼻炎患者症状积分显著相关；花粉播散期法国梧桐花粉过敏性鼻炎患者的症状积分高于尘螨过敏性鼻炎患者,而在花粉播散期过后,法国梧桐花粉过敏性鼻炎患者的症状积分要低于尘螨过敏性鼻炎患者。结论：本研究明确了武汉市气传花粉和真菌的种类和季节性特征,对本地区花粉和真菌相关的过敏性疾病的防治提供了参考资料；尘螨、蟑螂、花粉和真菌是武汉市过敏性疾病患者的最常见过敏原,呼吸道过敏性疾病的过敏原阳性检出率高于皮肤过敏性疾病；花粉浓度对过敏性鼻炎抗过敏治疗效果有重要影响,在对过敏性鼻炎治疗药物的效果进行评价时,应同时对相关过敏原如花粉等进行监测。
[Abstract]:Objective to investigate the types and patterns of airborne pollen and fungi in Wuhan and the distribution of allergens in patients with allergic diseases in Wuhan, and to explore the effect of pollen concentration on the clinical symptoms and antiallergic effects of allergic rhinitis.
Methods from January 2010 to January 2011, the Rotorod volumetric sampler was used for daily pollen and fungal aeration to count the types and quantities of daily pollen and fungi. The allergen skin skin prick test was carried out in 1945 patients with allergic diseases from January 2010 to December 2010, and the results were recorded and clinical analyzed. In the period of the parasol pollen dissemination in France, 30 cases of allergic rhinitis with allergic Rhus pollen allergy were selected as the experimental group, and 30 allergic rhinitis patients with allergy to dust mite were selected as the control group. 10 mg of Loratadine Tablets was taken daily for 28 days, and 5 cases of Chinese parasol powder allergy were not treated in the whole pollen season. All allergic rhinitis patients have symptoms of allergic rhinitis every day.
Results: (1) 44 kinds of pollen species were monitored throughout the year. The peak period of pollen dispersal in Wuhan was in spring 3-4 and autumn 9-10. In spring, pollen was dominated by tree pollen, such as Morus, and Artemisia Artemisia, herbage and ragweed in autumn. (2) 47 species of fungi were monitored and Wuhan gas facsimile was monitored in the year. The peak period was in the spring 3-5 months and the autumn 8-10 months. The most common gas borne fungi in Wuhan were buds, powdery mildew, cyclosporin, mylmaria, and Streptococcus. (3) the positive rate of allergen was 67.04%, the most common allergy was dust mites and cockroaches. The proportion of pollen allergy was 9.46%, and the proportion of fungal allergy was 7. .20%. the positive rates of allergic rhinitis with asthma, allergic rhinitis, and bronchial asthma were 84.88%, 76.69% and 73.91%, urticaria, and eczema / atopic dermatitis were 39.22% and 39.60%. (4), respectively, when the pollen concentration of French parasol was below 200 /m3, and the pollen concentration and the anaphylaxis of Chinese parasol pollen The symptom score of the patients with rhinitis was significantly correlated, and the symptom scores of the anaphylactic rhinitis patients in the stage of pollen dissemination were higher than those of the dust mite allergic rhinitis, and the symptom score of the anaphylactic rhinitis in French parasol pollen was lower than that of the allergic rhinitis patients after the pollen dissemination period.
Conclusion: This study provides a reference for the prevention and control of anaphylactic diseases related to pollen and fungi in Wuhan. Dust mites, cockroaches, pollen and fungi are the most common anaphylaxis in patients with allergic diseases in Wuhan and allergen positive detection of respiratory allergic diseases. The rate of anaphylaxis is higher than that of skin allergic diseases; pollen concentration has an important effect on the antiallergic effect of allergic rhinitis. When the effect of allergic rhinitis is evaluated, the related allergen, such as pollen, should be monitored at the same time.
【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2011
【分类号】：R758.2;R765.21

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