目的 了解大连地区儿童变应性鼻炎患者血清特异性IgE情况,为临床诊疗及流行病学防治提供参考。方法 分析2014年8月—2020年7月年龄小于14周岁的变应性鼻炎患者血清312例的特异性IgE结果,按性别、变应原阳性例数、变应原阳性的种类数量、检测时间等进行分组,比较不同组间变应原的分布情况。结果 变应原阳性例数前三位依次为屋尘螨/粉尘螨(34.1%)、艾蒿(18.6%)、猫(8.9%),后三位为羊肉(0.3%)、花生(0.6%)、螃蟹(0.9%);单一变应原患者126例,双重及以上变应原患者186例,差异具有统计学意义(χ²=15.75,P=0.031);变应原种类最多的依次为双重(47.8%)、三重(26.3%)和四重(14.0%)。Pearson相关分析显示,变应原个数与相应人数之间呈负相关(r=-0.800,P=0.017),最多有11种变应原阳性,仅1例。占比最高的双重变应原患者中,屋尘螨/粉尘螨+艾蒿组合数量最多,其次为屋尘螨/粉尘螨+猫组合。两性中变应原种类阳性例数最多的前三种均为屋尘螨/粉尘螨、艾蒿和猫,男童中艾蒿、屋尘螨/粉尘螨、屋尘、狗、啤酒花、牛肉、虾变应原阳性患者数量多于女童(χ²=13.64、11.67、9.45、8.63、10.31、8.36、5.37,P＜0.05),蛋清变应原阳性在女童中更多(χ²=18.67,P=0.027)。患者数量最高月份依次为9月(31.41%)、8月(20.51%)、7月(8.01%),此间为本地的夏末秋初,占全年患者量的59.93%;而患者数量最少的月份依次为1月(1.60%)、3月(1.60%)、2月(1.88%),此间为本地的冬末春初,仅占全年患者量的5.08%。结论 螨、艾蒿和猫是大连地区儿童变应性鼻炎常见变应原,夏末秋初高发,应作为本地区防治的重点。

Objective To explore the distribution and characteristics of serum specific IgE of children with allergic rhinitis(AR) in Dalian,so as to provide reference for clinical diagnosis,treatment and epidemiological prevention of AR. Methods The serum specific IgE results of 312 patients with allergic rhinitis aged less than 14 years from August 2014 to July 2020 were analyzed. The distribution of allergens was compared in different groups by gender,number of allergenic positive cases,number of types of allergenic positive and detection time. Results The top three allergens included house dust mite/duster mite (34.1%),mugwormwood (18.6%) and cat (8.9%),while mutton (0.3%),peanut (0.6%) and crab (0.9%) ranked in the last three places. There were 126 patients positive to single allergen and 186 patients positive to double or more allergens(χ²=15.75,P=0.031). Double (47.8%),triple (26.3%) and quadruple (14.0%) were the most common allergens. Pearson correlation test showed that there was a negative correlation between the original number of allergens and the corresponding number of people (r =-0.800,P= 0.017). There was only 1 case with a maximum of 11 allergens positive. Among the patients with the highest proportion of dual allergens,house dust mite/duster mite + mugwort combination was the most,followed by house dust mite/duster mite + cat combination. The top three allergenic species with the most positive cases in both sexes were house dust mite/duster mite,mugwort and cats. The number of male patients positive to some allergens was higher than that in females,including mugworm,house dust mite/dust mite,house dust,dogs,hops,beef and shrimp(χ²=13.64,11.67,9.45,8.63,10.31,8.36,5.37,P＜0.05). Egg white allergen was positive in females more than that in females(χ²=18.67,P=0.027). The number of allergic patients was highest in September (31.41%),August (20.51%) and July (8.01%),when it was the late summer and early autumn in local area,accounting for 59.93% of the total number of patients in the whole year. The month with the lowest number of allergic patients was January (1.60%),March (1.60%) and February (1.88%),when it was the end of winter and the beginning of spring locally,accounting for only 5.08% of the annual number of patients. Conclusion As the common allergens of allergic rhinitis in children in Dalian area,mites,mugwormwood and cats allergens are more prevalent in late summer and early autumn,which should be the focus of local prevention and control.