北京地区职业人群过敏性鼻炎患者过敏原分布及影响因素研究

doi:10.12183/j.scjpm.2023.0578

摘要/Abstract

摘要： 目的分析过敏性鼻炎患者的过敏原分布情况及患病的影响因素。方法选择2022年1—12月在北京航天总医院健康体检的某科技园区职工作为研究对象,通过调查问卷、体格检查及过敏原特异性IgE抗体检测诊断过敏性鼻炎,采用描述性方法分析患病情况及过敏原分布特征;采用单、多因素分析法对过敏性鼻炎患病的影响因素进行分析。结果共调查11 541名职工,其中1 849例职工被诊断为过敏性鼻炎,患病率为16.02%。经过敏原检测,吸入性过敏原患者1 610例,阳性率为87.07%;食物性过敏原患者484例,阳性率为26.18%;吸入性过敏原排名前5位的过敏原分别是尘螨（52.68%）、屋尘（40.51%）、树花粉（27.69%）、艾蒿（13.90%）、豚草（11.52%）;食物性过敏原排名前5位的过敏原分别是鳕鱼/龙虾/扇贝（6.65%）、黄豆（5.84%）、淡水鱼（4.98%）、蟹（3.52%）、虾（3.14%）。其中736例患者是单一过敏原,占39.26%,1 113例患者有≥2种过敏原,占60.74%;多因素Logistic回归分析结果显示,年龄18~29岁（OR=2.159）、年龄30~39岁（OR=2.115）、BMI≥28.0 kg/m²（OR=1.717）、管理岗位（OR=1.358）、既往过敏史（OR=1.765）、父母过敏性鼻炎（OR=1.444）、吸烟或被动吸烟（OR=1.513）是北京地区职业人群过敏性鼻炎患病的影响因素。结论北京地区职业人群过敏性鼻炎患病率较高,过敏原以吸入性过敏原为主;年龄、BMI≥28.0 kg/m²、管理岗位员工、既往过敏史、父母过敏性鼻炎及吸烟或被动吸烟是过敏性鼻炎患病的影响因素。

关键词: 过敏性鼻炎, 过敏原, 吸入性过敏原, 食物性过敏原, 影响因素

Abstract: Objective To analyze the distribution of allergens and the influencing factors in patients with allergic rhinitis. Methods Employees of a science and technology park who underwent physical examinations at Beijing Aerospace General Hospital from January to December 2022 were selected for the study. Allergic rhinitis was diagnosed by questionnaire, physical examination, and allergen-specific IgE antibody testing. Descriptive methods were used to analyze the prevalence of allergic rhinitis and distribution characteristics of allergens. The influencing factors of allergic rhinitis were analyzed by univariate and multivariate analysis methods. Results A total of 11 541 employees were surveyed, among whom 1 849 were diagnosed with allergic rhinitis, with a prevalence rate of 16.02%. After allergen testing, there were 1 610 patients with inhaled allergens, for a positive rate of 87.07%; 484 patients with food allergens, for a positive rate of 26.18%. The top five inhaled allergens were dust mites （52.68%）, house dust （40.51%）, tree pollen （27.69%）, mugwort （13.90%）, and ragweed （11.52%）. The top five food allergens were cod/lobster/scallop （6.65%）, soybean （5.84%）, freshwater fish （4.98%）, crab （3.52%）, and shrimp （3.14%）. Among them, 736 patients were single allergens, accounting for 39.26%, and 1 113 patients had two allergens and over, accounting for 60.74%. Multivariate Logistic regression analysis showed that aged 18-29 years （OR=2.159）, aged 30-39 years （OR = 2.115）, BMI≥28.0 kg/m² （OR=1.717）, management position （OR= 1.358）, previous allergic history （OR=1.765）, parental allergic rhinitis （OR=1.444）, smoking or passive smoking （OR=1.513） were the influencing factors for allergic rhinitis. Conclusions The prevalence of allergic rhinitis among the occupational population in Beijing is high, and the main allergens are inhaled allergens. Age, BMI≥28 kg/m², employee in management position, previous allergic history, parental allergic rhinitis, and smoking or passive smoking were the influencing factors for allergic rhinitis.

Key words: Allergic rhinitis, Allergen, Inhaled allergen, Food allergen, Influencing factor

中图分类号:

R765.21

朱海莉, 李玲, 于眉, 蔡宝石, 李梅, 王颖超. 北京地区职业人群过敏性鼻炎患者过敏原分布及影响因素研究[J]. 华南预防医学, 2023, 49(5): 578-582.

ZHU Haili, LI Ling, YU Mei, CAI Baoshi, LI Mei, WANG Yingchao. Allergen distribution and influencing factors among occupational population with allergic rhinitis in Beijing[J]. South China Journal of Preventive Medicine, 2023, 49(5): 578-582.

参考文献

[1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.中国变应性鼻炎诊断和治疗指南(2022年,修订版)[J].中华耳鼻咽喉头颈外科杂志,2022,57(2):106-1029.
[2] 李爱群,苏春娥,杨慧慧.阜阳市城区居民变应性鼻炎流行病学调查[J]. 华南预防医学,2022,48(7):882-884,888.
[3] 何璐宏,陈檬,张佳琦.变应性鼻炎发病流行病学特征及与血清IFN-γ及IL-4水平的相关性分析[J]. 公共卫生与预防医学,2023,34(1):113-116.
[4] 董博,金修桥.变应性鼻炎治疗的研究进展[J]. 医学综述,2021,27(1):141-145.
[5] 祝戎飞,刘争.变应性鼻炎的分级预防[J]. 中华耳鼻咽喉头颈外科杂志,2022,57(4):379-384.
[6] 《中国成人超重和肥胖预防控制指南》修订委员会.中国成人超重和肥胖预防控制指南(2021)[M].北京:人民卫生出版社,2021:3.
[7] 仲艾芳,温建立,陈玉秀,等.遵义市中青年男性脑卒中患者吸烟行为特点及相关因素分析[J]. 华南预防医学,2020,46(1):30-33.
[8] 申静蓉,蔡乐,王旭明,等.云南省白族居民吸烟和被动吸烟现状及其对脑卒中患病影响[J]. 中国公共卫生,2021,37(1):58-60.
[9] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24.
[10] Zhang Y, Zhang L.Increasing prevalence of allergic rhinitis in China[J]. Allergy Asthma Immun, 2019, 11(2): 156
[11] Barni S,Liccioli G,Sarti L,et al.Immunoglobulin E(IgE)-mediated food allergy in children:Epidemiology,pathogenesis,diagnosis,prevention,and management[J]. Medicina(Kaunas),2020,56(3):111.
[12] Sicherer SH,Sampson HA.Food allergy:A review and update on epidemiology, pathogenesis,diagnosis,prevention,and management[J]. J Allergy Clin Immunol,2018,141(1) : 41-58.
[13] 邹亚平,尤慧华,杨蓓蓓.金华地区变应性鼻炎患者变应原检测分析[J].中国耳鼻咽喉头颈外科,2022,29(9):604-605.
[14] 宋红毛,怀德.江苏淮安地区 452 例变应性鼻炎患者变应原谱分析[J].中国中西医结合耳鼻咽喉科杂志,2020,28(2):116-117,123.
[15] 马婷婷,王洪田,陈艳蕾,等.北京地区门诊患者常见吸入过敏原致敏谱[J].中华临床免疫和变态反应杂志,2021,15(2):136-143.
[16] 秦晓燕,郭广宏,康慧媛,等.北京地区变应性鼻炎患者血清总IgE及sIgE结果分析[J].标记免疫分析与临床,2020,27(5):741-745.
[17] 刘秀玲,付雪梅,郑成彬.日照市成年荨麻疹患者血清过敏原特异性 IgE 检测结果分析[J]. 华南预防医学,2021,47(8):1047-1049
[18] 林红艳,尚红坤,潘利平.变应性鼻炎T淋巴细胞亚群、IFN-γ及IgE水平与VitD的关系[J].分子诊断与治疗杂志,2022,14(8):1407-1410.
[19] Waage J, Standl M, Curtin JA, et al.Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis[J].Nat Genet, 2018, 50(8): 1072-1080.
[20] 邵凤勤,陈春英,张庆华,等.儿童过敏性鼻炎过敏原调查和相关危险因素分析[J].中国妇幼保健,2021,36(18):4299-4302.
[21] Kahveci OK,Kuzu S,Altıntaş M,et al.The Effect of nasal steroid and antihistamine use on total oxidative stress and antioxidant status in the treatment of allergic rhinitis[J].Am J Rhinol Allergy,2021,35(1):52-58.