过敏性疾病患儿血清特异性过敏原分析

Analysis of serum specific allergens in children with allergic diseases

摘要

目的 本研究旨在分析儿童过敏性疾病的流行状况,通过探讨儿童过敏原的特异性分布,为制定有效的预防和治疗策略提供科学依据。方法 选择2019年7月20日至2023年5月30日于上海交通大学医学院附属上海儿童医学中心诊断过敏性疾病的1486名0~16岁患儿为研究对象.采用Phadia过敏原检测系统,通过荧光免疫法检测患儿血清中特异性IgE水平,涵盖20种单价过敏原及9种混合过敏原检测项目.分析比较不同性别、年龄、季节患儿特异性过敏原情况。结果 本研究共计494名患儿(33.24%)总IgE为阳性,男性阳性比例高于女性,差异有统计学意义(χ²=10.925,P<0.05),且随着年龄增长,总IgE阳性比例逐渐增加,差异具有统计学意义(χ²=104.211,P<0.05);特异性过敏原检测中,食物组合fx5(鸡蛋白、牛奶、鳕鱼、小麦、花生和大豆)的IgE阳性率最高(46.74%),其次是吸入物变应原(45.06%);与女性相比,男性患儿吸入物变应原、屋尘组合、粉尘螨、霉菌混合及烟曲霉阳性率较高,差异有统计学意义(χ²值介于3.905~8.012之间,P<0.05);从年龄维度看,对于多数吸入性过敏原,其阳性率随着年龄增长而增加,如粉尘螨的IgE阳性率在<1岁和1~3岁患儿中的阳性率低于30%,但在3岁以上患儿中高达50%以上(χ²=273.742,P<0.05);相反,对于多数饮食来源的过敏原,其IgE阳性率随年龄增长而下降,如牛奶的IgE阳性率在3岁以下儿童中约50%,但在3岁以上儿童中下降至20~30%(χ²=107.097,P<0.05);从季节维度看,多数花粉和杂草类过敏原阳性率在7~9月份达到峰值,随后逐渐下降,直至次年5月开始上升;患有不同过敏性疾病的患儿在特异性过敏原反应上也表现出显著差异,如皮肤过敏性疾病患儿中,食物组合fx5的特异性过敏原阳性率(68.48%)高于呼吸道疾病(42.46%)和其他疾病(44.72%),差异有统计学意义(χ²=36.104,P<0.05)。结论 儿童过敏性疾病中,男性儿童IgE阳性率高于女性,食物过敏原主要影响0~1岁儿童,吸入性过敏原对3岁以上儿童影响更显著,且春秋季节高发.不同疾病类型对过敏原的敏感性存在差异,为过敏性疾病的预防和治疗提供了依据.

Abstract

Objective This study aimed to analyze the prevalence of allergic diseases in children, providing a scientific basis for developing effective prevention and treatment strategies by exploring the specific distribution of allergens in children. Methods A total of 1486 children aged 0-16 years old diagnosed with allergic diseases at Shanghai Children's Medical Center, affiliated with Shanghai Jiao Tong University School of Medicine from July 20, 2019 to May 30, 2023 were selected as the research subjects. The Phadia allergen detection system was used to detect the specific IgE level in the serum of the children by fluorescence immunoassay, covering 20 monovalent allergens and 9 mixed allergen detection items. The specific allergens of children of different genders, ages and seasons were analyzed and compared. Results A total of 494 children (33.24%) were positive for total IgE, and the proportion of males was higher than that of females, with a statistically significant difference (χ²=10.925, P<0.05), and the proportion of total IgE positivity gradually increased with age, and the difference was statistically significant (χ²=104.211, P<0.05). Among the specific allergen detections, the food combination fx5 (chicken protein, milk, cod, wheat, peanut and soybean) had the highest IgE positivity rate (46.74%), followed by inhaled allergens (45.06%). Compared with females, male children had higher positive rates of inhaled allergens, house dust combinations, dust mites, mold mixtures and Aspergillus fumigatus (χ² values ranged from 3.905-8.012, P<0.05). For example, the positive rate of IgE for dust mites is less than 30% in children aged 1 year and 1-3 years old, but as high as more than 50% in children over 3 years old (χ²=273.742, P<0.05). On the contrary, for most dietary allergens, the IgE positivity rate decreases with age, such as the IgE positivity rate of milk is about 50% in children under 3 years of age, but decreases to 20%-30% in children over 3 years of age (χ²=107.097, P<0.05). From the seasonal perspective, the positive rate of most pollen and weed allergens peaked in July-September, and then gradually decreased until May of the following year. For example, the positive rate of specific allergens of food combination fx5 (68.48%) was higher than that of respiratory diseases (42.46%) and other diseases (44.72%), and the difference was statistically significant (χ²=36.104, P<0.05). Conclusion Among children's allergic diseases, the positive rate of IgE in male children is higher than that in women, food allergens mainly affect children aged 0-1 year, and inhalation allergens have a more significant impact on children over 3 years old, and the incidence is high in spring and autumn. There are differences in the sensitivity of different disease types to allergens, which provides a basis for the prevention and treatment of allergic diseases.

关键词

儿童 / 过敏原 / 特异性IgE / 过敏性疾病 / 特应性皮炎

Key words

children / allergens / specific IgE / allergic diseases / atopic dermatitis

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基金资助

国家自然科学基金委青年科学基金(82203910)

上海申康临床研究计划(SHDC22022302)