【作者】 杨越楠；

【导师】 徐凌忠； 王媚媚；

【作者基本信息】 山东大学 ， 社会医学与卫生事业管理， 2010， 硕士

【摘要】 研究背景：近50年来,由于工业化的加剧、环境的污染、饮食结构的改变以及心理压力增大等诸多因素,使得变态反应性疾病的发病率呈逐年上升趋势。目前全球共有2.5亿人罹患变态反应性疾病,占世界总人口的22%。变态反应性疾病涉及多个临床科室,包括皮肤科、耳鼻喉科、呼吸科等,临床上以湿疹、特异性皮炎、过敏性鼻炎、过敏性哮喘等疾病最常见。因其症状复杂,种类繁多,难以根治,成为长期以来医学界的一大难题。变态反应性疾病发生与多种内外因素相关,除患者有一定的遗传基础外,还受到多种致敏因素的影响,其中过敏原在变应性疾病的发生、发展中起着关键性的作用。国外调查报告显示：54%-69%的变态反应性疾病是由于吸入性过敏原引起的。约33%的变态反应由食物诱发。因此是预防和治疗变态反应性疾病的重要举措之一。目前包头地区未开展此领域的研究。本研究皆在了解包头地区某些变应性疾病的主要过敏原及过敏原在不同性别、不同年龄、不同时间、不同地区、不同职业、不同疾病患者中可能存在的差异,从而更好地为临床提供诊疗依据。研究目的：探讨包头市某医院常见变应性疾病的主要过敏原及过敏原在不同性别、不同年龄、不同季节、不同地区、不同职业、不同疾病患者中可能存在的差异,为临床诊疗提供依据,从而提出预防和治疗过敏性疾病的有效措施。研究方法：应用德国Regumed公司生产的百康生物共振系统(BICOM-2000)治疗仪对2008年2月1日-2009年1月31日到包头医学院第一附属医院皮肤科就诊的变态反应性疾病患者(共计1902人)进行过敏原检测,询问一般情况并进行登记,将检测资料整理后建立数据文件。用Epidata3.0软件建立数据库输入数据,SPSS11.5软件包进行相关统计学分析。主要结果：(1)1902例患者过敏原检测结果：过敏率排在前十位的分别为屋尘螨(52.9%),羊肉(41.9%),粉尘螨(39.3%),牛奶(34.9%)甲醛(32.0%),鱼类混合物(32.0%),蒿(31.2%),动物皮毛(31.0%),真菌混合物(29.7%),牛肉(28.5%),毛霉菌混合物(27.5%)。其中吸入组以屋尘螨、粉尘螨、蒿、动物皮毛为主；食物及添加剂类以羊肉、牛奶、鱼类混合物、苯甲酸为主,化学、接触性物质类以甲醛、细菌、农药为主。(2)不同性别的患者中香料、农药、苯胺、杨属、辣椒、乙醇、真菌混合物等过敏原的阳性检出率存在差异。(3)不同年龄的患者中毛霉菌混合物、羊肉、二甲基亚硝胺、牛奶、鱼类混合物、鸡蛋、细菌、香料、甲醛的过敏原阳性检出率存在差异。(4)不同地区的患者中黄曲霉菌、毛霉菌混合物、动物皮毛、甲醛、细菌、苯并芘、杨属、玉米花粉、鱼类混合物、辣椒、苯甲酸等过敏原阳性检出率存在差异。(5)6种职业的患者中屋尘螨、粉尘螨、黄曲霉素、毛霉菌混合物等49种过敏原阳性检出率存在差异。其中工人、学生、干部阳性率较高,农民、儿童阳性率较低。(6)四个季节中除真菌混合物、二甲基亚硝胺之外,其他52种过敏原阳性率均有差异。(7)不同变应性疾病患者的过敏原阳性率比较：54种主要过敏原在8种变态反应性疾病中均有差异。结论与建议：变应性疾病就医患者过敏原种类较多、阳性检出率高,其中屋尘螨、粉尘螨、羊肉、牛奶、甲醛、蒿、杨属是主要过敏原。建议在医院和社区采取健康教育活动等形式,使患者了解过敏原在变应性疾病的发病中的重要性,避免相关过敏原的接触,减少疾病的发生。还要改善居住环境,保持室内干燥、通风,经常晒洗衣服、被褥,经常清洗空调、洗衣机,减少一切接触变应原的可能。同时建议政府部门采取有效措施对包头市主要绿化植物的蒿草、杨树进行环境干预,减少和消除过敏原。更多还原

【Abstract】 BACKGROUNDDuring the past 50 years,due to the factors of the aggravating industrialization,environmental pollution,dietary changes and the increasing psychological pressure,allergic diseases are increasing year by year.Presently there are 250 million people suffering from allergic diseases, accounting for 22% of the total world population.Allergic diseases involved multiple clinical departments such as dermatology, ENT,respiratory,etc.It had become a diffcult problem.Allergic diseases relate to multi-factors, including a variety of internal and external factors.Allergens play a very important role in allergic diseases. Foreign survey reports show that 54%-69% of the allergic diseases are caused by inhalation of allergen and about 33% are food-induced allergic reaction. The study in order to understand the primary allergens and discrepancies between different genders ages,seasons,nationalities, regions, occupations and diseases of allergens in Baotou,and to provide the basis for clinical diagnosis and treatment better. OBJECTIVBESTo explore the primary allergens and discrepancies of allergens between genders, ages, seasons, nationalities, regions, occupations and diseases in Baotou,and to provide the basis for clinical diagnosis and treatment better and to propose effective measures for allergic diseases prevention and treatments.METHODOLGYWe chose the patients who got allergic diseases and went to in the First affiliated hospital of Baoto Medical College on May 1,2008 to May 1,2009.The patients were examined and recorded by the BICOM 2000. The data was analzed by SPSS11.5.RESULTS(1) The top ten allergens were:house dust mite (52.9%), mutton (41.9%), dust mite (39.3%), animal fur (38.9%), milk (34.9%), formaldehyde (32.0%), fish mixture (32.0%), Artemisia (31.2%), fungal mixture (29.7%), beef (28.5%), Mucor mixture (27.5%).(2) The positive rate of allergens,such as spices, pesticides, aniline, Populus, pepper, alcohol, fungus mixture etc, had statistically significant genders.(3) The positive rate of allergens, such as fungus mixture, lamb, dimethylnitrosamine, milk, fish mixture, eggs, bacteria, perfume, formaldehyde,had statistically significant with different ages. (4) The positive rate of allergens,such as aspergillus flavus, mucor mixture, animal fur, formaldehyde, bacteria, benzopyrene, Populus, corn pollen, fish mixture, pepper, benzoic acid, had statistically significant with different regions.(5) The positive rate of 49 kinds of allergens, such as house dust mite.dust mite,Aspergillus flavus,mucor and so on, had statistically significant with different professions. (6) Except for fungal compounds and domethylnitrosamine,the positive rate of the other 52 kinds of allergens all had statistically significant in four seasons.(7) The comparison of the positive rate of different kinds of allergic patients showed that 54 kinds of major allergens had statistically significant in 8 kinds of allergic diseases.CONCLUSIONThe main allergens were house dust mites, dust mites, mutton, milk, formaldehyde, Artemisia and poplars.The kinds of allergens were more and the positive rate was higher of the allergic patients in Baotou. Hospitals and communities should take health education activities and make patients understand the inportance of the allergens to avoid contacting interrelated allergens in order to reduce the diseases. Living conditions should be improved and governments should take effctive in tervention measures to reduce and dliminate allergens.更多还原