本文選題：哮喘 + 皮膚點(diǎn)刺試驗(yàn)��； 參考：《遵義醫(yī)學(xué)院》2012年碩士論文

【摘要】：目的：了解哮喘患兒吸入性變應(yīng)原皮膚點(diǎn)刺試驗(yàn)的陽性率及遵義地區(qū)主要的變應(yīng)原,觀察及評價(jià)特異性脫敏治療兒童過敏性哮喘的臨床療效及安全性。 方法：選取2010年5月至2012年3月就診于遵醫(yī)附院兒科門診,臨床診斷哮喘,病情處于緩解期的439例哮喘患兒,其中男294例,女145例,0-3歲192例(男136例,女56例),3-6歲144例(男93例,女51例),6-14歲103例(男70例,女33例)。使用由丹麥ALK-ABELLO公司提供的11種常見吸入性過敏原(屋塵螨、粉塵螨、熱帶螨、貓毛、狗毛、德國大蠊、細(xì)鏈格孢霉、艾蒿、豚草、梯牧草、樺樹)進(jìn)行皮膚點(diǎn)刺試驗(yàn),生理鹽水作為陰性對照,濃度為0.01mg/ml的鹽酸組織胺為陽性對照,并同時(shí)對同期診斷為慢性咳嗽的189例患兒(以下簡稱咳嗽組)進(jìn)行皮膚點(diǎn)刺試驗(yàn)。比較哮喘組不同年齡段皮膚點(diǎn)刺試驗(yàn)陽性率；比較哮喘組與咳嗽組皮膚點(diǎn)刺試驗(yàn)陽性率。439例哮喘患兒中42例接受標(biāo)準(zhǔn)化屋塵螨脫敏治療,比較患兒治療前后的每年哮喘發(fā)作次數(shù)、峰值呼氣流速,評價(jià)治療效果和安全性。 結(jié)果：439例哮喘患兒皮膚點(diǎn)刺陽性率為35.8%,屋塵螨陽性率為72.6%；0-3歲年齡段皮膚點(diǎn)刺陽性率為23.0%,屋塵螨陽性率為72.7%；3-6歲年齡段皮膚點(diǎn)刺陽性率為40.3%,屋塵螨陽性率為67.2%；6-14歲年齡段陽性率為53.4%,屋塵螨陽性率為78.2%。6-14歲及3-6歲年齡段與0-3歲年齡段皮膚點(diǎn)刺陽性率比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.001)；6-14歲與3-6歲年齡段皮膚點(diǎn)刺陽性率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；咳嗽組皮膚點(diǎn)刺陽性率為21.7%,屋塵螨陽性率為41.7%,低于哮喘組皮膚點(diǎn)刺總陽性率及屋塵螨陽性率,差異有統(tǒng)計(jì)學(xué)意義(P0.001)。42例經(jīng)脫敏治療1.0年后峰值呼氣流速與治療前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.001)；治療前每年哮喘發(fā)作次數(shù)與治療后比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。42例患兒共接受957人次脫敏治療,局部不良反應(yīng)共有365人次,發(fā)生率為38.1%,發(fā)生全身不良反應(yīng)8次,發(fā)生率為0.8%。 結(jié)論：屋塵螨為遵義地區(qū)兒童哮喘最常見吸入性變應(yīng)原。標(biāo)準(zhǔn)化屋塵螨脫敏治療后患兒的臨床癥狀改善,PEF明顯升高,提示屋塵螨變應(yīng)原特異性免疫治療效果明顯,同時(shí)不良反應(yīng)發(fā)生率低,值得臨床推廣。
[Abstract]:Objective : To investigate the positive rate of skin prick test in children with asthma and the main allergens in compliance area , observe and evaluate the clinical curative effect and safety of specific desensitizing treatment for allergic asthma in children .

Methods : From May 2010 to March 2012 , 439 patients with asthma were diagnosed with asthma and in remission period . Among them , 294 were male , 145 were female , 192 were 0 - 3 years old ( 136 males , 56 females ) , 144 in 3 - 6 years ( male 93 , female 51 ) , aged 6 - 14 years ( male 70 , female 33 ) . The skin prick test was carried out using 11 common allergens ( house dust mites , dust mites , tropical mites , cat hair , dog hair , German cockroach , fine alternaria , wormwood , ragweed , ladder forage , birch ) provided by the Danish ALK - ABELLO company , and normal saline was used as a negative control , and the skin prick test was performed on 189 children with chronic cough ( hereinafter referred to as cough group ) with a concentration of 0.01 mg / ml . The positive rate of skin prick test in different age groups was compared .
To compare the positive rate of skin prick test between asthma group and cough group , 42 of 439 patients with asthma were treated with standardized house dust mite . The number of asthma attack , peak expiratory flow rate before and after treatment were compared , and the efficacy and safety of treatment were evaluated .

Results : The positive rate of skin prick in 439 patients with asthma was 35.8 % , and the positive rate of house dust mites was 72.6 % .
The positive rate of skin prick was 23 . 0 % in 0 - 3 year old age group and 72 . 7 % in house dust mite .
The positive rate of skin prick was 40.3 % in the 3 - 6 year old age group and 67.2 % in house dust mite .
The positive rate of 6 - 14 years old was 53.4 % , and the positive rate of house dust mites was 78.2 % . The positive rate of skin prick in the ages of 6 - 14 and 3 - 6 was significantly higher than that in 0 - 3 years old age group ( P0.001 ) .
The positive rate of skin prick in 6 - 14 years old and 3 - 6 years old was significant ( P0.05 ) .
The positive rate of skin prick in cough group was 21.7 % , the positive rate of house dust mites was 41.7 % , which was lower than that in asthma group ( P 0.001 ) .
There were statistically significant differences in the number of asthma attacks before and after treatment ( P0.01 ) . There were a total of 957 desensitizing treatments in 42 children , with a total of 365 patients with local adverse reactions . The incidence rate was 38 . 1 % . Eight times of systemic adverse reactions occurred , and the incidence rate was 0.8 % .

Conclusion : House dust mites are the most common allergens in children ' s asthma in compliance area . The clinical symptoms and PEF of the children with standardized house dust mites were improved . The results suggested that the effect of allergen - specific immunotherapy in house dust mite was obvious , and the incidence of adverse reactions was low , and it was worthy of clinical popularization .

【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.6

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