發(fā)布時(shí)間：2018-03-13 19:07

  本文選題：粉塵螨　切入點(diǎn)：交錯(cuò)霉菌　出處：《安徽醫(yī)科大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景從1970年代以來(lái),許多報(bào)告指出,全世界過(guò)敏疾病的發(fā)病率持續(xù)增加,臺(tái)灣地區(qū)過(guò)敏疾病的發(fā)病率也愈來(lái)愈高。一項(xiàng)臺(tái)北市大規(guī)模問(wèn)卷調(diào)查顯示,7-15歲的學(xué)童為對(duì)象,哮喘病發(fā)病率在1974年為1.30%,1985年為5.08%,1991年為5.80%,至1994年已高達(dá)10.79%,在20年間增加8倍之多；過(guò)敏性鼻炎發(fā)病率在1985年為7.84%,1991年為20.67%,至1994年高達(dá)33.53%,在10年間亦增加4倍之多；而異位性皮膚炎和蕁麻疹的發(fā)病率也有類似逐年增高的趨勢(shì).臺(tái)灣中部及南部地區(qū)學(xué)童的過(guò)敏疾病發(fā)病率,雖然較北部為低,但逐年增加的趨勢(shì)則是一致的,非甾體抗炎藥物過(guò)敏亦逐年增加,尤其對(duì)于哮喘和過(guò)敏性鼻炎的患者。臨床醫(yī)師需密切關(guān)注非甾體抗炎藥物的過(guò)敏反應(yīng),對(duì)初診患者須小心問(wèn)診以避免發(fā)生藥物過(guò)敏反應(yīng),發(fā)生過(guò)敏的機(jī)率約為0.6-2.5%。 目的本研究主要調(diào)查臺(tái)灣中部地區(qū)哮喘和過(guò)敏性鼻炎患者的過(guò)敏原檢測(cè)及對(duì)非甾體抗炎藥物產(chǎn)生過(guò)敏的情況。 方法2003-2007年間,收集了臺(tái)灣臺(tái)中縣大雅地區(qū)林釗尚小兒科診所哮喘患者235例,過(guò)敏性鼻炎139例,共計(jì)374位,收集這些患者臨床表現(xiàn)、性別分布、主要的過(guò)敏原、對(duì)非甾體抗炎藥過(guò)敏情況等資料,采用卡方檢驗(yàn)和fisher確切概率的統(tǒng)計(jì)學(xué)方法進(jìn)行統(tǒng)計(jì)分析,總結(jié)兩種過(guò)敏性疾病的過(guò)敏原,調(diào)查其對(duì)非甾體消炎藥過(guò)敏情況。 結(jié)果235例哮喘患者中,男125例,女110例,139例過(guò)敏性鼻炎患者中,男63例,女76例,兩組中性別分布無(wú)差異(X2=2.16,P0.05) 235例哮喘患者中,21例患者對(duì)非甾體抗炎藥物過(guò)敏,產(chǎn)生藥疹,嘴唇黏膜水腫或眼睛充血合并結(jié)膜水腫,約占所有哮喘患者的8.9%,139例過(guò)敏性鼻炎患者中,7例患者對(duì)非甾體抗炎藥物過(guò)敏,產(chǎn)生藥疹或嘴唇黏膜水腫或眼睛充血合并結(jié)膜水腫,約占過(guò)敏性鼻炎患者的5%,哮喘組與過(guò)敏性鼻炎組對(duì)非甾體抗炎藥過(guò)敏無(wú)差異。(x2=1.92,P0.05) 哮喘組對(duì)非甾體抗炎藥過(guò)敏的21例患者中,女性14位,男性7位。過(guò)敏性鼻炎組對(duì)非甾體抗炎藥過(guò)敏的7例患者中,女性6位,男性1位。非甾體抗炎藥過(guò)敏的患者在男女人群中分布無(wú)差異(P0.05)。 230例患者接受特異過(guò)敏原檢測(cè)(MAST),其結(jié)果為粉塵螨189例(82.1%)、屋塵螨177例(77%)、熱帶無(wú)爪螨57例(24.8%)、交錯(cuò)霉菌57例(24.8%)、蝦47例(20.4%)。哮喘最常見(jiàn)的過(guò)敏原依次為粉塵螨、屋塵螨、交錯(cuò)霉菌。過(guò)敏性鼻炎最常見(jiàn)的過(guò)敏原依次為粉塵螨、屋塵螨、熱帶無(wú)爪螨、家塵。哮喘組中交錯(cuò)霉菌、青霉菌、狗毛、白色念珠菌、鮭魚(yú)和煙色曲菌過(guò)敏原檢出率均高于過(guò)敏性鼻炎組,奇異果檢出率低于過(guò)敏性鼻炎組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05) 230例患者有特異過(guò)敏原(MAST)陽(yáng)性患者中對(duì)非甾體抗炎藥物過(guò)敏發(fā)生藥疹的共有20例(9.1%),其余144例無(wú)特異過(guò)敏原患者中有8例(5.5%)對(duì)非甾體抗炎藥物過(guò)敏發(fā)生藥疹。非甾體抗炎藥物在過(guò)敏原陽(yáng)性組與陰性組之間的比較無(wú)差異。(x2=1.26,P0.05)。 結(jié)論 1.哮喘和過(guò)敏性鼻炎是常見(jiàn)的過(guò)敏性疾病,特異過(guò)敏原檢測(cè)能檢出多種過(guò)敏原。 2.哮喘最常見(jiàn)的過(guò)敏原依次為粉塵螨、屋塵螨、交錯(cuò)霉菌。過(guò)敏性鼻炎最常見(jiàn)的過(guò)敏原依次為粉塵螨、屋塵螨、熱帶無(wú)爪螨、家塵。哮喘患者的交錯(cuò)霉菌、青霉菌、狗毛、白色念珠菌、鮭魚(yú)和煙色曲菌過(guò)敏原檢出率高于過(guò)敏性鼻炎的患者,奇異果檢出率低于過(guò)敏性鼻炎的患者。 3.哮喘和過(guò)敏性鼻炎的患者存在過(guò)敏體質(zhì),易發(fā)生對(duì)非甾體抗炎藥的過(guò)敏反應(yīng)。
[Abstract]:Research background since 1970s, many reports pointed out that the incidence of allergic diseases in the world the rate continues to increase, the incidence of allergic diseases in Taiwan area were also more and more high. According to a large-scale Taipei survey, 7-15 students as the object, the incidence of asthma in 1974 1.30%, 1985 5.08%, 1991 5.80%. To 1994 has reached 10.79%, increased by 8 times in 20 years; allergic rhinitis incidence rate in 1985 was 7.84%, 1991 20.67%, 1994 reached 33.53%, in 10 years has increased by 4 times; and the incidence of atopic dermatitis and urticaria have similar rate increased year by year. Students in Taiwan central and southern regions of the allergic disease incidence, although relatively low in the north, but the increasing trend is consistent, non steroidal anti-inflammatory drug allergy has increased year by year, especially for patients with asthma and allergic rhinitis. Clinicians should pay close attention to the anaphylaxis of non steroidal anti-inflammatory drugs. We should be careful to inquiring the first diagnosed patients so as to avoid anaphylaxis and the risk of allergy is about 0.6-2.5%..
Objective the purpose of this study was to investigate the allergen detection of asthma and allergic rhinitis in central Taiwan and the allergy to non steroidal anti-inflammatory drugs.
For 2003-2007 years, Taiwan County, Taichung area Lin Zhaoshang pediatric clinic patients with asthma were collected in the 235 patients, 139 cases of allergic rhinitis, a total of 374, the collection of these clinical manifestations, sex distribution, major allergens of non steroidal anti-inflammatory drugs, allergies and other data, using statistical method of chi square test and Fisher exact probability for statistical analysis, summed up the two kinds of allergens of allergic diseases, the investigation on non steroidal anti-inflammatory drug allergy.
Results among the 235 cases of asthma, there were 125 males, 110 females, 139 cases of allergic rhinitis, 63 males and 76 females. There was no difference in sex distribution in the two groups (X2=2.16, P0.05).
235 cases of patients with asthma, 21 patients of non steroidal anti-inflammatory drugs have allergies, drug eruption, lip mucosa edema or bloodshot eyes with conjunctival edema, accounting for about 8.9% of all patients with asthma, 139 cases of allergic rhinitis patients, 7 patients were allergic to non steroidal anti-inflammatory drugs, or lip mucosal edema or produce drug eruption bloodshot eyes with conjunctival edema, accounting for about 5% of the patients with allergic rhinitis, asthma and allergic rhinitis were allergic to non steroidal anti-inflammatory drugs had no difference (x2=1.92, P0.05).
In asthma group, there were 14 women in the asthma group and 7 men in the 21 patients who were allergic to NSAIDs. Among the 7 cases of allergic rhinitis group, 7 were allergic to NSAIDs, 6 were females and 1 were males. There was no difference in the distribution of the NSAIDs among the men and women (P0.05).
230 patients received specific allergen detection (MAST), the results for the dust mite in 189 cases (82.1%), 177 (77%) cases of house dust mite Blomia tropicalis, 57 cases (24.8%), 57 cases (24.8%) staggered mold, shrimp 47 cases (20.4%). The most common allergens in asthma dust mites, house dust mites, staggered mold. The most common allergens of allergic rhinitis were dust mites, house dust mites, Blomia tropicalis, house dust. Asthma group staggered mold, Penicillium, fur, Candida albicans, salmon and Aspergillus fumigatus allergen detection rate was higher than the allergic rhinitis group, singular the detection rate is lower than the allergic rhinitis group, the difference was statistically significant (P0.05)
230 patients with specific allergen (MAST) positive patients of non steroidal anti-inflammatory drug allergy drug eruption occurred a total of 20 cases (9.1%), 144 cases had no specific allergens in 8 patients (5.5%) of non steroidal anti-inflammatory drug allergy drug eruption. Non steroidal anti-inflammatory drugs in allergy the positive and negative groups were no difference. (x2=1.26, P0.05).
conclusion
1. asthma and allergic rhinitis are common allergic diseases, and a variety of allergens can be detected by specific allergen detection.
The most common allergens of 2. asthma were dust mites, house dust mites, staggered mold. The most common allergens of allergic rhinitis were dust mites, house dust mites, Blomia tropicalis, house dust. Staggered mold, asthma hair, Penicillium, Candida albicans, salmon and Aspergillus fumigatus allergen detection the rate is higher than that of patients with allergic rhinitis, kiwi fruit detection rate was lower than that in patients with allergic rhinitis.
3. patients with asthma and allergic rhinitis have anaphylaxis and are susceptible to anaphylaxis to NSAIDs.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R725.6;R765.21

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 Adrian Wu,Albert Chan,Stanley Chik,Dorothy Wong;HOUSE DUST MITE ALLERGEN (Derp1 AND Blot5) LEVELS IN ASTHMATICS' HOME IN HONGKONG[J];Chinese Medical Sciences Journal;2004年03期

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本文編號(hào)：1607730