摘要
目的分析腺样体肥大合并鼻炎患儿随访3年后的变应原谱变化特征。方法纳入2017年7月~2017年10月就诊于首都儿科研究所附属儿童医院耳鼻咽喉头颈外科,诊断腺样体肥大伴鼻炎的患儿,观察随访至2021年3月。记录基线及随访时血清变应原特异性IgE(sIgE)结果,以及腺样体大小、改良Lund-Kennedy(MLK)鼻内镜评分结果。结果共纳入36例诊断腺样体肥大合并鼻炎的患儿,9例(25%)为女性,27例(75%)为男性,平均年龄(7.8±2.5)岁,27例(75%)患儿合并变应性鼻炎。基线及随访3年后霉菌均为最主要的变应原,3年后合并尘螨过敏的患儿比例较入组时有下降趋势(37%vs 24%,P=0.28),蒿sIgE水平有上升趋势[4.2(1.7-23.2)vs 9.3(2.8-88.5)KU/L,P=0.35]。分层分析发现在6岁以上患儿中屋尘螨sIgE水平较前明显下降[1.8(1.2-2.6)KU/L vs 0.1(0.0-0.7)KU/L,P<0.05]。患儿经药物或手术治疗后,腺样体较前明显缩小,MLK鼻内镜评分较前显著下降(6.6±0.9 vs 4.3±1.6,P<0.05)。结论腺样体肥大合并鼻炎患儿中霉菌为最主要的变应原,3年后随访尘螨过敏比例呈下降趋势。药物或手术治疗后患儿腺样体大小及MLK评分均有显著下降。
Objective To analyze the change of allergen spectrum after following up for more than 3 years in children with adenoid hypertrophy and rhinitis.Methods Children who were diagnosed with adenoid hypertrophy and rhinitis in Department of Otorhinolaryngology Head and Neck Surgery,Capital Institute of Pediatrics affiliated Children's Hospital from July to October,2017 were enrolled and followed up to March 2021.Serum allergen specific IgE(sIgE),size of adenoid,and modified Lund-Kennedy(MLK)nasal endoscopic score were collected.Results In total 36 children with adenoid hypertrophy and rhinitis were enrolled.9(25%)were girls and 27(75%)were boys,with the mean age of 7.8±2.5 years old.27(75%)children had allergic rhinitis.Mold was the most common allergen,positive rate of dust mite sIgE decreased after 3 years(37%vs.24%,P=0.28),and Artemisia sIgE increased.In children elder than 6 years old,Dermatophagoides pteronyssinus sIgE declined significantly(median 1.8(IQR 1.2-2.6)vs.0.1(0.0-0.7),P<0.05).After drug treatment or surgery,adenoids were much smaller and MLK scores significant decreased than before(6.6±0.9 vs.4.3±1.6,P<0.05).Conclusion In children with adenoid hypertrophy and rhinitis,mold was the most common allergen,children with dust mite sensitization decreased after 3 years.Size of adenoid and MLK score were significantly declined after treatment.
作者
边赛男
庞冲
王雨农
林枫
尹旭
杜君
刘晨
刘畅
梁洁琼
宋贝贝
关凯
BIAN Sainan;PANG Chong;WANG Yunong;LIN Feng;YIN Xu;DU Jun;LIU Chen;LIU Chang;LIANG Jieqiong;SONG Beibei;GUAN Kai(Department of Allergy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease,Beijing 100730,China;National Clinical Research Center for Dermatologic and Immunologic Diseases,Beijing 100730,China;Department of Otorhinolaryngology Head and Neck Surgery,Capital Institute of Pediatrics Affiliated Children's Hospital,Beijing 100020,China)
出处
《西部医学》
2022年第5期694-698,共5页
Medical Journal of West China
基金
国家自然科学基金面上项目(82070033)
中国医学科学院医学与健康科技创新工程项目(2020-I2M-C&T-B-007)
北京自然科学基金面上项目(7212074)。
关键词
腺样体肥大
鼻炎
变应原
变应性疾病
Adenoid hypertrophy
Rhinitis
Allergen
Allergen diseases
