哮喘，过敏性鼻炎患者过敏原调查研究

发布时间：2018-03-13 19:07

本文选题：粉尘螨　切入点：交错霉菌　出处：《安徽医科大学》2011年硕士论文　论文类型：学位论文

【摘要】：研究背景从1970年代以来,许多报告指出,全世界过敏疾病的发病率持续增加,台湾地区过敏疾病的发病率也愈来愈高。一项台北市大规模问卷调查显示,7-15岁的学童为对象,哮喘病发病率在1974年为1.30%,1985年为5.08%,1991年为5.80%,至1994年已高达10.79%,在20年间增加8倍之多；过敏性鼻炎发病率在1985年为7.84%,1991年为20.67%,至1994年高达33.53%,在10年间亦增加4倍之多；而异位性皮肤炎和荨麻疹的发病率也有类似逐年增高的趋势.台湾中部及南部地区学童的过敏疾病发病率,虽然较北部为低,但逐年增加的趋势则是一致的,非甾体抗炎药物过敏亦逐年增加,尤其对于哮喘和过敏性鼻炎的患者。临床医师需密切关注非甾体抗炎药物的过敏反应,对初诊患者须小心问诊以避免发生药物过敏反应,发生过敏的机率约为0.6-2.5%。目的本研究主要调查台湾中部地区哮喘和过敏性鼻炎患者的过敏原检测及对非甾体抗炎药物产生过敏的情况。方法2003-2007年间,收集了台湾台中县大雅地区林钊尚小儿科诊所哮喘患者235例,过敏性鼻炎139例,共计374位,收集这些患者临床表现、性别分布、主要的过敏原、对非甾体抗炎药过敏情况等资料,采用卡方检验和fisher确切概率的统计学方法进行统计分析,总结两种过敏性疾病的过敏原,调查其对非甾体消炎药过敏情况。结果235例哮喘患者中,男125例,女110例,139例过敏性鼻炎患者中,男63例,女76例,两组中性别分布无差异(X2=2.16,P0.05) 235例哮喘患者中,21例患者对非甾体抗炎药物过敏,产生药疹,嘴唇黏膜水肿或眼睛充血合并结膜水肿,约占所有哮喘患者的8.9%,139例过敏性鼻炎患者中,7例患者对非甾体抗炎药物过敏,产生药疹或嘴唇黏膜水肿或眼睛充血合并结膜水肿,约占过敏性鼻炎患者的5%,哮喘组与过敏性鼻炎组对非甾体抗炎药过敏无差异。(x2=1.92,P0.05) 哮喘组对非甾体抗炎药过敏的21例患者中,女性14位,男性7位。过敏性鼻炎组对非甾体抗炎药过敏的7例患者中,女性6位,男性1位。非甾体抗炎药过敏的患者在男女人群中分布无差异(P0.05)。 230例患者接受特异过敏原检测(MAST),其结果为粉尘螨189例(82.1%)、屋尘螨177例(77%)、热带无爪螨57例(24.8%)、交错霉菌57例(24.8%)、虾47例(20.4%)。哮喘最常见的过敏原依次为粉尘螨、屋尘螨、交错霉菌。过敏性鼻炎最常见的过敏原依次为粉尘螨、屋尘螨、热带无爪螨、家尘。哮喘组中交错霉菌、青霉菌、狗毛、白色念珠菌、鲑鱼和烟色曲菌过敏原检出率均高于过敏性鼻炎组,奇异果检出率低于过敏性鼻炎组,差异具有统计学意义(P0.05) 230例患者有特异过敏原(MAST)阳性患者中对非甾体抗炎药物过敏发生药疹的共有20例(9.1%),其余144例无特异过敏原患者中有8例(5.5%)对非甾体抗炎药物过敏发生药疹。非甾体抗炎药物在过敏原阳性组与阴性组之间的比较无差异。(x2=1.26,P0.05)。结论 1.哮喘和过敏性鼻炎是常见的过敏性疾病,特异过敏原检测能检出多种过敏原。 2.哮喘最常见的过敏原依次为粉尘螨、屋尘螨、交错霉菌。过敏性鼻炎最常见的过敏原依次为粉尘螨、屋尘螨、热带无爪螨、家尘。哮喘患者的交错霉菌、青霉菌、狗毛、白色念珠菌、鲑鱼和烟色曲菌过敏原检出率高于过敏性鼻炎的患者,奇异果检出率低于过敏性鼻炎的患者。 3.哮喘和过敏性鼻炎的患者存在过敏体质,易发生对非甾体抗炎药的过敏反应。
[Abstract]:Research background since 1970s, many reports pointed out that the incidence of allergic diseases in the world the rate continues to increase, the incidence of allergic diseases in Taiwan area were also more and more high. According to a large-scale Taipei survey, 7-15 students as the object, the incidence of asthma in 1974 1.30%, 1985 5.08%, 1991 5.80%. To 1994 has reached 10.79%, increased by 8 times in 20 years; allergic rhinitis incidence rate in 1985 was 7.84%, 1991 20.67%, 1994 reached 33.53%, in 10 years has increased by 4 times; and the incidence of atopic dermatitis and urticaria have similar rate increased year by year. Students in Taiwan central and southern regions of the allergic disease incidence, although relatively low in the north, but the increasing trend is consistent, non steroidal anti-inflammatory drug allergy has increased year by year, especially for patients with asthma and allergic rhinitis. Clinicians should pay close attention to the anaphylaxis of non steroidal anti-inflammatory drugs. We should be careful to inquiring the first diagnosed patients so as to avoid anaphylaxis and the risk of allergy is about 0.6-2.5%..
Objective the purpose of this study was to investigate the allergen detection of asthma and allergic rhinitis in central Taiwan and the allergy to non steroidal anti-inflammatory drugs.
For 2003-2007 years, Taiwan County, Taichung area Lin Zhaoshang pediatric clinic patients with asthma were collected in the 235 patients, 139 cases of allergic rhinitis, a total of 374, the collection of these clinical manifestations, sex distribution, major allergens of non steroidal anti-inflammatory drugs, allergies and other data, using statistical method of chi square test and Fisher exact probability for statistical analysis, summed up the two kinds of allergens of allergic diseases, the investigation on non steroidal anti-inflammatory drug allergy.
Results among the 235 cases of asthma, there were 125 males, 110 females, 139 cases of allergic rhinitis, 63 males and 76 females. There was no difference in sex distribution in the two groups (X2=2.16, P0.05).
235 cases of patients with asthma, 21 patients of non steroidal anti-inflammatory drugs have allergies, drug eruption, lip mucosa edema or bloodshot eyes with conjunctival edema, accounting for about 8.9% of all patients with asthma, 139 cases of allergic rhinitis patients, 7 patients were allergic to non steroidal anti-inflammatory drugs, or lip mucosal edema or produce drug eruption bloodshot eyes with conjunctival edema, accounting for about 5% of the patients with allergic rhinitis, asthma and allergic rhinitis were allergic to non steroidal anti-inflammatory drugs had no difference (x2=1.92, P0.05).
In asthma group, there were 14 women in the asthma group and 7 men in the 21 patients who were allergic to NSAIDs. Among the 7 cases of allergic rhinitis group, 7 were allergic to NSAIDs, 6 were females and 1 were males. There was no difference in the distribution of the NSAIDs among the men and women (P0.05).
230 patients received specific allergen detection (MAST), the results for the dust mite in 189 cases (82.1%), 177 (77%) cases of house dust mite Blomia tropicalis, 57 cases (24.8%), 57 cases (24.8%) staggered mold, shrimp 47 cases (20.4%). The most common allergens in asthma dust mites, house dust mites, staggered mold. The most common allergens of allergic rhinitis were dust mites, house dust mites, Blomia tropicalis, house dust. Asthma group staggered mold, Penicillium, fur, Candida albicans, salmon and Aspergillus fumigatus allergen detection rate was higher than the allergic rhinitis group, singular the detection rate is lower than the allergic rhinitis group, the difference was statistically significant (P0.05)
230 patients with specific allergen (MAST) positive patients of non steroidal anti-inflammatory drug allergy drug eruption occurred a total of 20 cases (9.1%), 144 cases had no specific allergens in 8 patients (5.5%) of non steroidal anti-inflammatory drug allergy drug eruption. Non steroidal anti-inflammatory drugs in allergy the positive and negative groups were no difference. (x2=1.26, P0.05).
conclusion
1. asthma and allergic rhinitis are common allergic diseases, and a variety of allergens can be detected by specific allergen detection.
The most common allergens of 2. asthma were dust mites, house dust mites, staggered mold. The most common allergens of allergic rhinitis were dust mites, house dust mites, Blomia tropicalis, house dust. Staggered mold, asthma hair, Penicillium, Candida albicans, salmon and Aspergillus fumigatus allergen detection the rate is higher than that of patients with allergic rhinitis, kiwi fruit detection rate was lower than that in patients with allergic rhinitis.
3. patients with asthma and allergic rhinitis have anaphylaxis and are susceptible to anaphylaxis to NSAIDs.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R725.6;R765.21

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