發(fā)布時間：2018-06-26 05:55

  本文選題：鼻炎 + 變應(yīng)性�。� 參考：《天津醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 目的 使用標(biāo)準(zhǔn)化的皮膚點刺原液——阿羅格試劑,對天津地區(qū)變應(yīng)性鼻炎患者的變應(yīng)原進(jìn)行篩查,為變應(yīng)性鼻炎的全國流行病學(xué)調(diào)查提供一定的參考意義；幫助患者盡量避免接觸這些變應(yīng)原以減少發(fā)�。徊楫�(dāng)?shù)刈儜?yīng)性鼻炎患者的特異性免疫治療提供理論依據(jù)；便于國際交流。 方法 選取2009年1月～2009年12月在我院耳鼻喉科門診擬診為變應(yīng)性鼻炎的患者527例為調(diào)查和研究對象,其中男266例,女261例,年齡8-77歲。所有患者均接受阿羅格試劑(共38種試劑,包括吸入性和食物性變應(yīng)原的單一、棍合制劑)和標(biāo)準(zhǔn)的點刺針進(jìn)行的皮膚點刺試驗,并對其進(jìn)行變應(yīng)性鼻炎類型、家族史、是否合并哮喘等相關(guān)病史資料的收集。應(yīng)用SPSS 16.0軟件進(jìn)行分析,采用χ2檢驗,以P0.05具有統(tǒng)計學(xué)意義。 結(jié)果 1、527例受試者中441例患者呈陽性反應(yīng)(83.7%)。 2、吸入性變應(yīng)原篩查顯示前九位排序分別為：粉塵螨(58.7%)、屋塵螨(56.0%)、白色念珠菌(31.7%)、膠乳(23.6%)、煙曲霉(19.5%)、特異青霉(18.8%)、霉菌Ⅰ(17.5%)、艾蒿(17.5%)。 3、食物性變應(yīng)原前九位排序為：小蝦(9.1%)、鯉魚(8.4%)、大鰲蝦(8.2%)、柑橘(5.4%)、核桃(4.8%)、花生(4.5%)、歐芹(4.1%)、桃子(4.1%) 4、本地區(qū)變應(yīng)性鼻炎患者以中青年居多,類型以持續(xù)性中重度為主(59.0%)。陽性等級以“+++”為主(39.9%)。有家族史、哮喘組變應(yīng)原陽性率與各自對照組相比,χ2值分別為9.285、4.917,差異有統(tǒng)計學(xué)意義(P0.05)。在變應(yīng)原陽性強(qiáng)弱方面,前兩者與各自對照組相比,χ2值依次為10.024、19.903,差異有統(tǒng)計學(xué)意義(P0.05),而性別與變應(yīng)原陽性強(qiáng)弱無顯著關(guān)系(χ2=2.361,P0.05)。 結(jié)論 1、天津地區(qū)變應(yīng)性鼻炎吸入性變應(yīng)原篩查結(jié)果顯示：塵螨位居首位,與我國大部分地區(qū)流行病學(xué)調(diào)查結(jié)果一致。其次是真菌,考慮與以下因素有關(guān)：本地區(qū)工商業(yè)發(fā)達(dá),人們居住、工作環(huán)境中使用空調(diào)的頻率很高,霉菌可在通風(fēng)換氣管道(中央供暖和空調(diào)設(shè)備)和水管中生長；生活水平提高,家養(yǎng)觀賞植物增多,霉菌可生長在經(jīng)常澆水的植物上、墻紙、毛絨玩具上、食物和食品添加劑中。當(dāng)?shù)貙儆谘睾３鞘?暖溫帶半濕潤氣候,有明顯由陸到海的過渡特點：冬夏較長,春秋短促；近20年來,天津地區(qū)的歸一化植被指數(shù)總體上呈降低趨勢,植被生長狀況向差的方向發(fā)展,可能與花粉排序靠后有關(guān)。 2、食物性變應(yīng)原陽性率低,說明其在變應(yīng)性鼻炎發(fā)病中不占主要地位。海產(chǎn)品排序靠前,可能與天津位于渤海灣,本地區(qū)海鮮、河鮮非常豐富和居民喜好食海鮮習(xí)慣有關(guān)。由于食物與花粉存在交叉抗原,故更應(yīng)結(jié)合病史做出診斷。 3、本地區(qū)變應(yīng)性鼻炎患者以中青年居多。變應(yīng)原陽性等級以“+++”為主,陽性強(qiáng)弱與家族史、哮喘顯著相關(guān),而與性別無顯著關(guān)系。臨床就診的變應(yīng)性鼻炎患者以持續(xù)性中重度為主,考慮與現(xiàn)在患者工作生活節(jié)奏快、壓力大、就醫(yī)意識差,癥狀嚴(yán)重時才去醫(yī)院就診有關(guān)。
[Abstract]:objective
The standard skin pricking fluid, arrog's reagent, is used to screen allergens in allergic rhinitis patients in Tianjin, providing some reference for the national epidemiological investigation of allergic rhinitis, and helping patients avoid exposure to these allergen to reduce the incidence of disease and to be specific for patients with local allergic rhinitis. It provides theoretical basis for sex immunotherapy and facilitates international exchange.
Method
527 cases of allergic rhinitis in the Department of ENT of Department of ENT of our hospital from January 2009 to December 2009 were investigated and studied in 527 cases, including 266 males, 261 females and 8-77 years old. All the patients received Arog reagent (a total of 38 reagents, including the single inhalation and food allergen, the stick combination) and the standard punct needles. The skin pricking test was performed and the data of allergic rhinitis, family history, and asthma were collected. The SPSS 16 software was used to analyze the data, and the x 2 test was used to make P0.05 statistically significant.
Result
Of the 1527 subjects, 441 patients were positive (83.7%).
2, inhaled allergens screening showed that the first nine were dusts (58.7%), house dust mites (56%), Candida albicans (31.7%), latex (23.6%), Aspergillus fumigatus (19.5%), Penicillium (18.8%), mould I (17.5%), and Artemisia (17.5%).
3, the top nine food allergens were: Shrimp (9.1%), carp (8.4%), big shrimps (8.2%), orange (5.4%), walnut (4.8%), peanuts (4.5%), parsley (4.1%), peach (4.1%).
4, the majority of the local allergic rhinitis patients were middle-aged and young, and the main type was persistent medium and severe (59%). The positive grade was mainly "+ + +" (39.9%). Family history, the positive rate of allergen in the asthma group was 9.285,4.917 compared with the control group, the difference was statistically significant (P0.05). In the positive and weak of allergens, the former two were Compared with the control group, the chi square value of 10.024,19.903 was 2, the difference was statistically significant (P0.05), while gender had no significant correlation with the positive and negative intensity of allergen (chi 2=2.361, P0.05).
conclusion
1, the screening results of allergic rhinitis inhalation allergen in Tianjin area show that dust mites are the first place, which is in line with the results of epidemiological investigation in most areas of China. Secondly, fungi are considered to be related to the following factors: the industrial and commercial industry in the region is developed, people live, the frequency of air conditioning is very high in the working environment, and the mould can be ventilated and ventilated. (central heating and air conditioning equipment) and water pipe growth; living standards increase, domestic ornamental plants increase, mould can grow on frequently watered plants, wallpaper, plush toys, food and food additives. It belongs to coastal cities, warm temperate and semi humid climate, and has a clear transition from land to sea: long winter and summer, short spring and autumn. In the past 20 years, the normalized vegetation index of Tianjin region has been decreasing in general, and the growth of vegetation is developing towards the poor direction, which may be related to the sorting of pollen.
2, the positive rate of food allergens is low, indicating that it does not occupy the main position in allergic rhinitis. The sequencing of seafood may be related to Tianjin's Bohai Bay, the local seafood, the river fresh is very rich and the residents prefer to eat seafood habits.
3, the majority of the local allergic rhinitis patients are young and middle-aged. The positive grade of allergens is mainly "+ + +". The positive strength is closely related to family history and asthma, but there is no significant relationship with sex. The patients with allergic rhinitis in clinical treatment are mainly with persistent medium and severe, and the patient's working life rhythm is fast, the pressure is great, and the medical consciousness is poor. When the shape is serious, it is related to the hospital.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R765.21

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