天津市变应性鼻炎患者变应原谱分析

发布时间：2018-06-26 05:55

本文选题：鼻炎 + 变应性　；参考：《天津医科大学》2010年硕士论文

【摘要】： 目的使用标准化的皮肤点刺原液——阿罗格试剂,对天津地区变应性鼻炎患者的变应原进行筛查,为变应性鼻炎的全国流行病学调查提供一定的参考意义；帮助患者尽量避免接触这些变应原以减少发病；并为当地变应性鼻炎患者的特异性免疫治疗提供理论依据；便于国际交流。方法选取2009年1月～2009年12月在我院耳鼻喉科门诊拟诊为变应性鼻炎的患者527例为调查和研究对象,其中男266例,女261例,年龄8-77岁。所有患者均接受阿罗格试剂(共38种试剂,包括吸入性和食物性变应原的单一、棍合制剂)和标准的点刺针进行的皮肤点刺试验,并对其进行变应性鼻炎类型、家族史、是否合并哮喘等相关病史资料的收集。应用SPSS 16.0软件进行分析,采用χ2检验,以P0.05具有统计学意义。结果 1、527例受试者中441例患者呈阳性反应(83.7%)。 2、吸入性变应原筛查显示前九位排序分别为：粉尘螨(58.7%)、屋尘螨(56.0%)、白色念珠菌(31.7%)、胶乳(23.6%)、烟曲霉(19.5%)、特异青霉(18.8%)、霉菌Ⅰ(17.5%)、艾蒿(17.5%)。 3、食物性变应原前九位排序为：小虾(9.1%)、鲤鱼(8.4%)、大鳌虾(8.2%)、柑橘(5.4%)、核桃(4.8%)、花生(4.5%)、欧芹(4.1%)、桃子(4.1%) 4、本地区变应性鼻炎患者以中青年居多,类型以持续性中重度为主(59.0%)。阳性等级以“+++”为主(39.9%)。有家族史、哮喘组变应原阳性率与各自对照组相比,χ2值分别为9.285、4.917,差异有统计学意义(P0.05)。在变应原阳性强弱方面,前两者与各自对照组相比,χ2值依次为10.024、19.903,差异有统计学意义(P0.05),而性别与变应原阳性强弱无显著关系(χ2=2.361,P0.05)。结论 1、天津地区变应性鼻炎吸入性变应原筛查结果显示：尘螨位居首位,与我国大部分地区流行病学调查结果一致。其次是真菌,考虑与以下因素有关：本地区工商业发达,人们居住、工作环境中使用空调的频率很高,霉菌可在通风换气管道(中央供暖和空调设备)和水管中生长；生活水平提高,家养观赏植物增多,霉菌可生长在经常浇水的植物上、墙纸、毛绒玩具上、食物和食品添加剂中。当地属于沿海城市,暖温带半湿润气候,有明显由陆到海的过渡特点：冬夏较长,春秋短促；近20年来,天津地区的归一化植被指数总体上呈降低趋势,植被生长状况向差的方向发展,可能与花粉排序靠后有关。 2、食物性变应原阳性率低,说明其在变应性鼻炎发病中不占主要地位。海产品排序靠前,可能与天津位于渤海湾,本地区海鲜、河鲜非常丰富和居民喜好食海鲜习惯有关。由于食物与花粉存在交叉抗原,故更应结合病史做出诊断。 3、本地区变应性鼻炎患者以中青年居多。变应原阳性等级以“+++”为主,阳性强弱与家族史、哮喘显著相关,而与性别无显著关系。临床就诊的变应性鼻炎患者以持续性中重度为主,考虑与现在患者工作生活节奏快、压力大、就医意识差,症状严重时才去医院就诊有关。
[Abstract]:objective
The standard skin pricking fluid, arrog's reagent, is used to screen allergens in allergic rhinitis patients in Tianjin, providing some reference for the national epidemiological investigation of allergic rhinitis, and helping patients avoid exposure to these allergen to reduce the incidence of disease and to be specific for patients with local allergic rhinitis. It provides theoretical basis for sex immunotherapy and facilitates international exchange.
Method
527 cases of allergic rhinitis in the Department of ENT of Department of ENT of our hospital from January 2009 to December 2009 were investigated and studied in 527 cases, including 266 males, 261 females and 8-77 years old. All the patients received Arog reagent (a total of 38 reagents, including the single inhalation and food allergen, the stick combination) and the standard punct needles. The skin pricking test was performed and the data of allergic rhinitis, family history, and asthma were collected. The SPSS 16 software was used to analyze the data, and the x 2 test was used to make P0.05 statistically significant.
Result
Of the 1527 subjects, 441 patients were positive (83.7%).
2, inhaled allergens screening showed that the first nine were dusts (58.7%), house dust mites (56%), Candida albicans (31.7%), latex (23.6%), Aspergillus fumigatus (19.5%), Penicillium (18.8%), mould I (17.5%), and Artemisia (17.5%).
3, the top nine food allergens were: Shrimp (9.1%), carp (8.4%), big shrimps (8.2%), orange (5.4%), walnut (4.8%), peanuts (4.5%), parsley (4.1%), peach (4.1%).
4, the majority of the local allergic rhinitis patients were middle-aged and young, and the main type was persistent medium and severe (59%). The positive grade was mainly "+ + +" (39.9%). Family history, the positive rate of allergen in the asthma group was 9.285,4.917 compared with the control group, the difference was statistically significant (P0.05). In the positive and weak of allergens, the former two were Compared with the control group, the chi square value of 10.024,19.903 was 2, the difference was statistically significant (P0.05), while gender had no significant correlation with the positive and negative intensity of allergen (chi 2=2.361, P0.05).
conclusion
1, the screening results of allergic rhinitis inhalation allergen in Tianjin area show that dust mites are the first place, which is in line with the results of epidemiological investigation in most areas of China. Secondly, fungi are considered to be related to the following factors: the industrial and commercial industry in the region is developed, people live, the frequency of air conditioning is very high in the working environment, and the mould can be ventilated and ventilated. (central heating and air conditioning equipment) and water pipe growth; living standards increase, domestic ornamental plants increase, mould can grow on frequently watered plants, wallpaper, plush toys, food and food additives. It belongs to coastal cities, warm temperate and semi humid climate, and has a clear transition from land to sea: long winter and summer, short spring and autumn. In the past 20 years, the normalized vegetation index of Tianjin region has been decreasing in general, and the growth of vegetation is developing towards the poor direction, which may be related to the sorting of pollen.
2, the positive rate of food allergens is low, indicating that it does not occupy the main position in allergic rhinitis. The sequencing of seafood may be related to Tianjin's Bohai Bay, the local seafood, the river fresh is very rich and the residents prefer to eat seafood habits.
3, the majority of the local allergic rhinitis patients are young and middle-aged. The positive grade of allergens is mainly "+ + +". The positive strength is closely related to family history and asthma, but there is no significant relationship with sex. The patients with allergic rhinitis in clinical treatment are mainly with persistent medium and severe, and the patient's working life rhythm is fast, the pressure is great, and the medical consciousness is poor. When the shape is serious, it is related to the hospital.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R765.21

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