上海地区儿童过敏性疾病血清过敏原检测结果分析

doi:10.16150/j.1671-2870.2025.03.013

摘要/Abstract

摘要：

目的：分析上海过敏性疾病患儿血清过敏原分布情况，为过敏性疾病的防治提供诊疗依据。方法：纳入2021年至2023年在瑞金医院儿科门诊就诊的诊断为过敏性疾病的连续病例（包括支气管哮喘、变应性鼻炎、特应性皮炎等共560例），通过散射比浊法检测其血清中的总IgE抗体，用免疫印记法检测血清中过敏原特异性IgE种类，并进行回顾性分析。结果：560例患儿中，总IgE阳性率高且存在多种过敏原阳性，过敏原主要以粉尘螨(59.11%)、屋尘螨（58.75%）、牛奶(28.04%)、鸡蛋(22.14%)和念珠分枝交链黑曲霉(21.43%)为主，过敏原分布无性别差异（P>0.05）。吸入性过敏原中，屋尘螨、粉尘螨、猫毛皮屑随年龄增长逐渐上升，其中7~15岁患儿的阳性率最高（72.55%、71.76%、26.67%），差异具有统计学意义（P<0.05）；食入性过敏原中，牛奶在幼儿期阳性率最高（34.55%），其后随年龄增长阳性率逐渐下降（P<0.05）。吸入性过敏原中，念珠分枝交链黑曲霉阳性率有季节差异（P<0.05），其中秋季最高（28.89%）。蟑螂阳性的患儿中虾/蟹阳性率高达38.5%，且蟑螂与甲壳类食物间的致敏性显著相关（P<0.05）。结论：上海地区过敏性疾病的儿童中，吸入性过敏原阳性率最高的是粉尘螨，其余依次是屋尘螨、猫毛皮屑，且分布具有年龄差异；食入性过敏原阳性率最高的是牛奶，其余依次是鸡蛋白、花生/黄豆、羊肉/牛肉、腰果、开心果、杏仁、核桃。蟑螂与虾/蟹间的致敏性强相关，提示甲壳类食物致敏的儿童需高度警惕存在蟑螂致敏。

关键词: 过敏性疾病, IgE, 过敏原

Abstract:

Objective To analyze the distribution of serum allergens in children with allergic diseases in Shanghai and provide diagnostic and therapeutic evidence for the prevention and management of allergic diseases. Methods A total of 560 children diagnosed with allergic diseases (including bronchial asthma, allergic rhinitis, and atopic dermatitis) who attended the pediatric outpatient clinic at Ruijin Hospital from 2021 to 2023 were enrolled. Total serum IgE levels were measured using scattering turbidimetry, and specific serum IgE antibodies against various allergens were detected by immunoblotting. A retrospective analysis was performed. Results 1. Among the 560 children, the positive rate of total IgE was high, and multiple allergens were commonly found. 2. The allergens were mainly Dermatophagoides farinae (59.11%), Dermatophagoides pteronyssinus (58.75%), cow’s milk (28.04%), egg (22.14%) and Aspergillus niger with rosary branches (21.43%). No significant gender differences were observed in allergen distribution (P>0.05). 3. For inhalant allergens, the positive rates of Dermatophagoides farinae, Dermatophagoides pteronyssinus, and cat dander increased with age, with the highest rates observed in children aged 7-15 years (72.55%, 71.76%, and 26.67%, respectively), and the differences were statistically significant (P<0.05). For food allergens, the positive rate for cow’s milk was highest during early childhood (34.55%) and decreased with age (P<0.05). 4. Regarding inhalant allergens, the positive rate for Aspergillus niger with rosary branches showed seasonal variation (P<0.05), peaking in autumn (28.89%). Among children sensitized to cockroaches, the positive rate for shrimp/crab was as high as 38.5%, and a significant correlation was observed between cockroach sensitization and crustacean food allergens (P<0.05). Conclusions In children with allergic diseases in Shanghai, the most common inhalant allergen is Dermatophagoides farinae, followed by Dermatophagoides pteronyssinus and cat dander, with age-related differences observed. The most common food allergen is cow’s milk, followed by egg white, peanut/soy, lamb/beef, cashew, pistachio, almond, and walnut. There is a significant correlation between cockroach and shrimp/crab sensitization, suggesting that children sensitized to crustaceans should be closely monitored for potential cockroach sensitization.

Key words: Allergic diseases, IgE, Allergens

中图分类号:

R781.67

赵雪奇, 闾佳佳, 吴群. 上海地区儿童过敏性疾病血清过敏原检测结果分析[J]. 诊断学理论与实践, 2025, 24(03): 333-341.

ZHAO Xueqi, LÜ Jiajia, WU Qun. Analysis of serum allergen test results in children with allergic diseases in Shanghai[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(03): 333-341.

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Positive allergens types	Number of patients	proportion
Total IgE positive cases	293	55.50%
Single allergen positive cases	66	11.79%
Two allergens positive cases	40	7.14%
Three or more allergens positive cases	367	65.54%

Allergens	Total positives(n=560)	Male(n=349)	Female(n=211)	χ²	P
Food-ingested allergens
Egg white	124(22.14)	76(21.78)	48(22.75)	4.811	0.568
Milk	157(28.04)	104(29.80)	53(25.12)	4.167	0.244
Peanut / soybean	31(5.54)	22(6.30)	9(4.27)	5.652	0.463
Wheat / buckwheat	17(3.04)	12(3.44)	5(2.37)	3.617	0.460
Cashew pistachio almond walnut	6(1.07)	4(1.15)	2(0.95)	5.727	0.126
Mutton / beef	15(2.68)	12(3.44)	3(1.42)	3.511	0.476
Shrimp / crab	45(8.04)	28(8.02)	17(8.06)	3.045	0.693
Peach, apple, mango, litchi, and strawberry	2(0.36)	2(0.57)	0(0.00)	1.214	0.271
Inhaled allergens
House dust mites	329(58.75)	210(60.17)	119(56.40)	2.758	0.839
Cat fur dander (concentration grade)	114(20.36)	73(20.92)	41(19.43)	4.372	0.736
Dust mites	331(59.11)	215(61.60)	116(54.98)	7.092	0.312
Dog fur crumbs	87(15.54)	49(14.04)	38(18.01)	3.313	0.769
Cockroach	13(2.32)	7(2.01)	6(2.84)	2.573	0.462
Short guinea pig grass	10(1.79)	7(2.01)	3(1.42)	0.256	0.613
Wormwood	7(1.25)	6(1.72)	1(0.47)	2.463	0.482
Humulus	17(3.04)	13(3.72)	4(1.90)	4.868	0.301
Burr / birch	13(2.32)	7(2.01)	6(2.84)	2.551	0.279
Suzuka / paraffin	11(1.96)	6(1.72)	5(2.37)	1.257	0.739
Kai Yang willow beech oak walnut	13(2.32)	9(2.58)	4(1.90)	5.439	0.142
A. niger with rosary branches	120(21.43)	70(20.06)	50(23.70)	4.268	0.748

Allergens	0< Age ≤3 (n=55)	4≤ Age ≤6 (n=250)	7≤ Age ≤15 (n=255)	χ²	P
Food-ingested allergens
Egg white	15(27.27)	62(24.80)	47(18.43)	22.505	0.032
Milk	19(34.55)	60(24.00)	55(22.75)	19.638	0.003
Peanut / soybean	8(14.55)	14(5.60)	9(3.53)	29.934	0.003
Wheat / buckwheat	4(7.27)	7(2.80)	6(2.35)	14.111	0.079
Cashew pistachio almond walnut	3(5.45)	2(0.80)	1(0.39)	28.385	0.000
Mutton / beef	5(9.09)	7(2.80)	3(1.18)	23.758	0.003
Shrimp / crab	8(14.55)	21(8.40)	16(6.27)	13.646	0.190
Peach, apple, mango, litchi, and strawberry	0(0.00)	0(0.00)	2(0.78)	2.401	0.301
Inhaled allergen
House dust mites	19(34.55)	125(50.00)	185(72.55)	52.547	0.000
Cat fur dander (concentration grade)	8(14.55)	38(15.20)	68(26.67)	29.244	0.010
Dust mites	18(32.73)	130(52.00)	183(71.76)	51.458	0.000
Dog fur crumbs	5(9.09)	30(12.00)	52(20.39)	16.052	0.189
Cockroach	1(1.82)	3(1.20)	9(3.53)	8.431	0.208
Short guinea pig grass	1(1.82)	5(2.00)	4(1.57)	0.134	0.935
wormwood	0(0.00)	5(2.00)	2(0.78)	3.445	0.751
humulus	2(3.64)	7(2.80)	8(3.14)	7.913	0.442
Burr / birch	1(1.82)	6(2.40)	6(2.35)	0.227	0.994
Suzuka / paraffin	1(1.82)	5(2.00)	5(1.96)	3.196	0.784
Kai Yang willow beech oak walnut	2(3.64)	7(2.80)	4(1.57)	6.660	0.353
A. niger with rosary branches	8(14.55)	44(17.60)	68(26.67)	15.031	0.376

Allergens	AD (n=130)	AR (n=391)	AS (n=184)	χ²	P
Food-ingested allergens
Egg white	37(28.46)	81(20.72)	39(21.20)	40.999	0.515
Milk	31(23.85)	110(28.13)	55(28.89)	24.630	0.264
Peanut / soybean	12(9.23)	17(4.35)	6(3.26)	40.093	0.555
Wheat / buckwheat	5(3.85)	9(2.30)	4(2.17)	17.169	0.945
Cashew pistachio almond walnut	3(2.31)	1(0.26)	2(1.09)	15.103	0.818
Mutton / beef	3(2.31)	9(2.30)	5(2.72)	26.161	0.564
Shrimp / crab	14(10.77)	27(6.91)	15(8.15)	30.775	0.672
Peach, apple, mango, litchi, and strawberry	0(0.00)	1(0.26)	2(1.09)	5.089	0.649
Inhaled allergen
House dust mites	79(60.77)	229(58.57)	110(59.78)	50.692	0.168
Cat fur dander (concentration grade)	28(21.54)	75(19.18)	43(23.37)	54.162	0.284
Dust mites	78(60.00)	232(59.34)	112(60.87)	47.556	0.257
Dog fur crumbs	27(20.77)	55(14.07)	26(14.13)	38.464	0.627
Cockroach	2(1.54)	7(1.79)	6(3.26)	11.437	0.954
Short guinea pig grass	3(2.31)	6(1.53)	2(1.09)	3.673	0.817
wormwood	0(0.00)	6(1.53)	5(2.72)	12.430	0.927
humulus	3(2.31)	13(3.32)	5(2.72)	37.539	0.107
Burr / birch	2(1.54)	9(2.30)	5(2.72)	12.977	0.528
Suzuka / paraffin	4(3.08)	7(1.79)	3(1.63)	20.784	0.472
Kai Yang willow beech oak walnut	4(3.08)	7(1.79)	4(2.17)	19.848	0.531
A. niger with rosary branches	22(16.92)	93(23.79)	29(15.76)	38.584	0.857

Inhaled allergen	Spring（March-May）（n=106）	Summer（June- August）（n=190）	Autumn（September- November）（n=135）	Winter（December- February）（n=190）	χ²	P
House dust mites	62(58.49)	119(62.63)	86(63.70)	62(48.06)	26.491	0.089
Cat fur dander (concentration grade)	20(18.87)	37(19.47)	35(25.93)	22(17.05)	16.008	0.763
Dust mites	61(57.55)	122(64.21)	89(65.93)	59(45.74)	27.096	0.077
Dog fur crumbs	13(12.26)	34(17.89)	26(19.26)	14(10.85)	15.914	0.599
Cockroach	2(1.89)	3(1.58)	5(3.70)	3(2.33)	6.600	0.679
Short guinea pig grass	3(2.83)	5(2.63)	2(1.48)	0(0.00)	3.851	0.278
wormwood	2(1.89)	3(1.58)	2(1.48)	0(0.00)	7.764	0.558
humulus	5(4.72)	3(1.58)	5(3.70)	4(3.10)	7.665	0.811
Burr / birch	3(2.83)	7(3.68)	3(2.22)	0(0.00)	6.186	0.403
Suzuka / paraffin	3(2.83)	3(1.58)	5(3.70)	0(0.00)	8.792	0.457
Kai Yang willow beech oak walnut	3(2.83)	5(2.63)	4(2.96)	1(0.78)	7.471	0.588
A. niger with rosary branches	16(15.09)	45(23.68)	39(28.89)	20(15.50)	33.965	0.037