本文選題：變應(yīng)性鼻炎 + 皮膚點(diǎn)刺試驗(yàn)　； 參考：《大連醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的:了解大連地區(qū)變應(yīng)性鼻炎患者皮膚點(diǎn)刺試驗(yàn)(SPT)陽性率、變應(yīng)原分布特點(diǎn),為變應(yīng)性鼻炎的防治提供可靠的依據(jù);并對我院78例變應(yīng)性鼻炎患者接受標(biāo)準(zhǔn)化塵螨變應(yīng)原疫苗特異性免疫治療后的療效及安全性進(jìn)行評價。 方法:對2009年3月-2011年3月于大連醫(yī)科大學(xué)附屬第一醫(yī)院耳鼻咽喉頭頸外科門診擬診為變應(yīng)性鼻炎的1035例患者進(jìn)行回顧性分析,對這些患者采用13組標(biāo)準(zhǔn)化變應(yīng)原(Alutard? SQ)進(jìn)行SPT,并按照2004年蘭州會議中變應(yīng)性鼻炎的診斷標(biāo)準(zhǔn)選擇患者,采用自身對照的方法,將78例塵螨引起的變應(yīng)性鼻炎患者他們治療前的癥狀、體征評分及VAS評分分別與接受1年、2年特異性免疫治療后的癥狀、體征評分及VAS評分相比較,并采取秩和等檢驗(yàn)方法進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果:1035例變應(yīng)性鼻炎患者中有802例對變應(yīng)原中至少一組呈陽性反應(yīng)(77.5%)。粉塵螨、屋塵螨及熱帶螨陽性率分別為63.7%、61.2%和39.6%,其它變應(yīng)原陽性率依次是艾蒿(24.2%)、狗毛(22.9%)、美洲大蠊(14.7%)、德國小蠊(10.9%)、豚草(9.7%)、貓毛(7.8%)、霉菌I組(7.3%)、花粉I組(3.6%)、花粉Ⅱ組(3.1%)和霉菌Ⅱ組(2.1%)。男性和女性SPT陽性率分別為77.8%(375/482)和77.2%(427/553),男女之間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。少年兒童組、青年組及中老年組SPT陽性率分別為91.6%、76.7%及62.6%,SPT的總陽性率隨著年齡的增長呈下降趨勢,3組間兩兩比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。大連地區(qū)變應(yīng)性鼻炎患者中并發(fā)哮喘者10.2%。78例接受特異性免疫治療的患者治療前癥狀、體征評分男女之間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),經(jīng)特異性免疫治療1年患者的癥狀、體征評分及VAS評分較治療前均顯著降低,有統(tǒng)計(jì)學(xué)差異(P0.05);堅(jiān)持完成2年治療后患者的癥狀、體征評分及VAS評分較治療前、治療1年時亦有明顯減少,三者之間有顯著性差異(P0.05)。合并哮喘12例,經(jīng)特異性免疫治療后,鼻部癥狀與哮喘癥狀均有不同程度緩解或好轉(zhuǎn),其療效與單純AR患者之間的差異無明顯統(tǒng)計(jì)學(xué)意義(P0.05)。78例患者中40例出現(xiàn)局部過敏反應(yīng),1例全身過敏反應(yīng),未出現(xiàn)致命性不良反應(yīng)。 結(jié)論:大連地區(qū)變應(yīng)性鼻炎患者皮膚點(diǎn)刺試驗(yàn)陽性率較高,且隨年齡的增長而下降。男女之間皮膚點(diǎn)刺試驗(yàn)陽性率無明顯差異。塵螨是大連地區(qū)變應(yīng)性鼻炎的首要的吸入性變應(yīng)原,為本地區(qū)變應(yīng)性鼻炎的防治提供了流行病學(xué)資料和臨床防治依據(jù)。大連地區(qū)變應(yīng)性鼻炎患者合并哮喘者比我國普通人群哮喘發(fā)病率明顯增高。應(yīng)用標(biāo)準(zhǔn)化塵螨變應(yīng)原疫苗治療塵螨引起的變應(yīng)性鼻炎是一種比較安全、有效的方法,為提高療效,建議完成足夠的療程。
[Abstract]:Objective: to investigate the positive rate of skin prick test (SPT) and the distribution of allergens in patients with allergic rhinitis in Dalian area, and to provide a reliable basis for the prevention and treatment of allergic rhinitis.The efficacy and safety of 78 patients with allergic rhinitis treated with standard dust mite allergen vaccine were evaluated.Methods: from March 2009 to March 2011, 1035 patients with allergic rhinitis in the Department of Otorhinolaryngology and neck surgery, first affiliated Hospital of Dalian Medical University, were retrospectively analyzed. 13 groups of patients were treated with standardized allergen Alutard?The patients were selected according to the diagnostic criteria of allergic rhinitis in Lanzhou in 2004. 78 patients with allergic rhinitis caused by dust mite were treated with self-control method.The scores of physical signs and VAS were compared with the scores of symptoms, signs and VAS after 1 year and 2 years of specific immunotherapy, and the results were analyzed statistically by rank sum test.Results 802 out of 1035 cases of allergic rhinitis showed positive reaction to at least one group of allergens (77.5%).The positive rates of SPT in male and female were 77.8% and 77.2%, respectively. There was no significant difference between male and female (P 0.05).The positive rates of SPT in children, youth and middle and old age groups were 91.6% and 62.6%, respectively. The total positive rate of SPT showed a decreasing trend with the increase of age. There were significant differences among the three groups (P 0.05).Among the patients with allergic rhinitis in Dalian area, 10.2.78 patients with asthma received specific immunotherapy before treatment. There was no significant difference in the scores of signs between men and women (P 0.05). The symptoms of patients treated with specific immunotherapy for one year were not significantly different.The scores of physical signs and VAS were significantly lower than those before treatment (P 0.05), and the scores of symptoms, signs and VAS of the patients after 2 years of treatment were significantly lower than those before treatment, and there was a significant difference among the three groups (P 0.05).After specific immunotherapy, nasal symptoms and asthma symptoms were relieved or improved in different degrees.There was no significant difference between the curative effect and the simple AR patients. There was no significant difference between 40 cases of local allergic reaction and 1 case of systemic anaphylaxis, but no fatal side effects.Conclusion: the positive rate of skin prick test in patients with allergic rhinitis in Dalian area was higher and decreased with age.There was no significant difference in the positive rate of skin prick test between male and female.Dust mite is the primary inhalant allergen of allergic rhinitis in Dalian area, which provides epidemiological data and clinical basis for the prevention and treatment of allergic rhinitis in this area.The incidence of asthma in patients with allergic rhinitis in Dalian was significantly higher than that in the general population.The application of standardized dust mite allergen vaccine in the treatment of allergic rhinitis caused by dust mite is a safe and effective method.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R765.21

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 伍慧卿;變應(yīng)性鼻炎患者致敏因素調(diào)查及變應(yīng)原檢測方法分析[D];暨南大學(xué);2013年

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本文編號：1742841