摘要： 目的 分析大连市尘螨过敏变应性鼻炎患者变应原谱分布情况，为变应性鼻炎的精准防控奠定基础。方法 收集2015年1月至2022年12月大连大学附属中山医院就诊的变应性鼻炎患者的临床资料。按照性别、年龄、变应原检出情况及反应级别、合并其他过敏原情况及检测时间分组，比较不同组间变应原谱分布情况。结果 共纳入1 330例，其中尘螨过敏总检出率为60.83%（809/1330），单纯尘螨致敏330例（40.79%），多重致敏479例（59.21%）。多重致敏者变应原谱种类繁多，尘螨基础上合并了20种变应原，其中合并致敏前三位的变应原依次为艾蒿、猫毛和普通豚草，合计占64.52%（522/809）。尘螨合并1~3种变应原居多，占88.73%（425/479），最多同时合并10种变应原。合并1~3种变应原中以吸入性变应原为主，合并≥4种变应原均为吸入与食物性变应原。变应原反应级别分析显示，尘螨致敏反应较为强烈，≥3级占61.19%（495/809），其他合并变应原除艾蒿外，致敏反应以1级、2级为主。男性、女性尘螨过敏检出率分别为61.84%、59.94%，男女比较无统计学差异（χ²=4.000，P=0.261）。< 20岁年龄组尘螨过敏检出率最高，而且随年龄增长尘螨过敏检出率下降（χ²=69.984，P < 0.001）。尘螨过敏变应性鼻炎主要在8~10月份发生，10月份尘螨检出率最高，达80.16%。结论 大连市尘螨过敏变应性鼻炎发生率较高，多重致敏多见，以合并1~3种吸入性变应原为主，艾蒿、猫毛和普通豚草是尘螨最常合并的变应原。因此应针对本地区尘螨过敏特点重点防控。

大连市尘螨过敏变应性鼻炎患者变应原谱分析

洪志军¹, 李锐², 姜涛², 赵迪², 鹿伟理², 李宪华², 曹志伟³

1. 大连医科附属第一医院健康管理中心, 辽宁 大连 116021;
2. 大连大学附属中山医院耳鼻咽喉科, 辽宁 大连 116001;
3. 中国医科大学附属盛京医院耳鼻咽喉科, 沈阳 110004

收稿日期:2023-07-12出版日期:2023-12-30发布日期:2023-12-12
通讯作者:姜涛E-mail:15142436156@163.com
作者简介:洪志军(1980-),女,副主任医师,硕士
基金资助:辽宁省中央引导地方科技发展资金计划项目（2023JH6/100100011）


关键词: 变应性鼻炎, 尘螨过敏, 变应原
Abstract: Objective To investigate the allergen profiles of dust mite-sensitive allergic rhinitis patients in Dalian, and to lay the foundation for precise prevention and control of allergic rhinitis.Methods Clinical data of allergic rhinitis patients treated at Affiliated Zhongshan Hospital of Dalian University from January 2015 to December 2022 were collected. The allergen distribution spectrums were compared between different groups designated according to sex, age, allergen reaction level, combination of other allergens, and testing time.Results A total of 1 330 allergic rhinitis patients were included, among whom the total detection rate of dust mite allergy was 60.83% (n=809), with 330 (40.79%) of these having dust mite sensitization alone and 479 (59.21%) having multiple sensitization. There were many kinds of allergens in multiple sensitization. Among those with dust mite allergy, all 20 combined allergens detected in this group were analyzed, and mugwort, cat hair, and common rinea grass were the top three allergens in combined sensitization, accounting for 64.52%. The number of other allergens combined with dust mite was mainly 1-3 species (88.73%), and a maximum of 10 allergens were simultaneously present. Patients with 1-3 other combined sensitivities were mainly reactive to respiratory allergens, and those with 4 or more allergens essentially had joint sensitization to respiratory and food allergens. As for the allergen reaction level, the dust mite sensitivity reaction was relatively strong, with grade 3 or above accounting for 61.19%. Except for mugwort, the other combined allergens elicited mainly grade 1 and grade 2 reactions. The detection rates of dust mite allergy were 61.84% in male patients and 59.94% in female patients, with no statistical difference between the sexes (χ²=4.000, P=0.261). The detection rate of dust mite sensitization was highest in the group aged < 20 years and decreased with age (χ²=69.984, P < 0.001). Dust mite-sensitive allergic rhinitis mainly occurred from August to October, and the detection rate of dust mite sensitization was the highest in October, reaching 80.16%.Conclusion The dust mite sensitization rate in patients with allergic rhinitis in the Dalian area is relatively high, and multiple sensitization is more common. Combinations of respiratory allergens mainly involve 1-3 types, and mugwort, cat hair, and common ragweed are the most common allergens combined with dust mite. Therefore, prevention and control of allergic rhinitis should focus on the characteristics of dust mite allergy in this region.
Key words: allergic rhinitis, dust mite, allergen
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