内蒙古草原地区藜科花粉诱导的季节性变应性鼻炎特征分析

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目的:分析中国北方内蒙古草原地区藜科花粉诱导的季节性变应性鼻炎(seasonal allergic rhinitis,SAR)的临床特点、藜科花粉的分布和致敏特征。方法:2015年5—8月期间,采用分层、整群、随机抽样的调查方式,对内蒙古草原6个地区(锡林浩特、二连浩特、多伦、通辽、扎旗、开鲁)的人群进行面对面问卷调查和皮肤点刺试验(skin prick test,SPT)。并于2015年1月1日至12月31日期间对上述6个地区进行花粉监测。观察SAR的临床特点、藜科花粉的分布和致敏特征。应用SAS软件9.4进行数据处理。结果:共6 043名受试者完成了问卷调查和SPT,藜科花粉诱导的SAR确诊患病率为13.2%(795/6 043);高发年龄在18~39岁;城市的患病率明显高于农村(61.2%比37.9%,n P<0.001);上述6个地区患病率的差异有统计学意义(锡林浩特21.5%、二连浩特17.8%、多伦8.9%、通辽6.9%、扎旗15.3%、开鲁9.7%,n P<0.001)。藜科花粉诱导的SAR的临床症状以喷嚏(96.5%)、鼻痒(92.2%)为主;眼部症状中眼痒较为明显(69.1%);其他相关症状中,乏力(32.1%)和嗜睡(31.5%)较为突出。藜科花粉诱导的SAR的合并疾病中,变应性结膜炎占71.4%(568/795),食物过敏占86.7%(689/795),支气管哮喘占16.7%(133/795)。藜科花粉播散高峰期为8月;藜科花粉诱导的SAR患病率与藜科花粉浓度呈正相关(n Rn 2=0.78,n P=0.043)。藜科花粉SPT阳性率为21.2%(1 282/6 043),6个地区中以锡林浩特最高(28.0%,236/842)。n 结论:内蒙古草原地区藜科花粉诱导的SAR的患病率较高,临床症状以喷嚏为主,8月为花粉播散高峰期,SAR患病率与藜科花粉浓度呈正相关。“,”Objective:To analyze the clinical characteristics of Chenopodiaceae pollen induced seasonal allergic rhinitis (SAR) as well as the distribution and sensitization characteristics of Chenopodiaceae pollen in Inner Mongolia grassland of northern China.Methods:From May 2015 to August 2015, using stratified, cluster and random sampling, a field interviewer-administered survey study and skin prick test (SPT) were conducted in six areas of Inner Mongolia grassland (Xilinhot, Erenhot, Duolun, Tongliao, Jarud, Kailu), and pollen monitoring was carried out in the above six areas from January 1 to December 31 of 2015. The clinical characteristics of Chenopodiaceae pollen induced SAR, distribution and sensitization characteristics of Chenopodiaceae pollen in these regions were observed. SAS software 9.4 was used for data processing.Results:A total of 6 043 subjects completed the study. The prevalence of Chenopodiaceae pollen induced SAR was 13.2% (795/6 043). The highest prevalence was found in the 18-39 age group. Subjects from urban areas showed higher prevalence of SAR than rural areas (61.2% n vs 37.9%, n P<0.001). There was significant regional difference in the prevalence rate of Chenopodiaceae pollen induced SAR among the above six areas (Xilinhot 21.5%, Erenhot 17.8%, Duolun 8.9%, Tongliao 6.9%, Jarud 15.3%, Kailu 9.7%,n P<0.001). The main clinical symptoms of Chenopodiaceae pollen induced SAR were sneezing (96.5%) and nasal itching (92.2%). Eye itching was more obvious among the ocular symptoms (69.1%), while fatigue (32.1%) and drowsiness (31.5%) were more prominent among other related symptoms. Among comorbidities of Chenopodiaceae pollen induced SAR, allergic conjunctivitis accounted for 71.4% (568/795), food allergy accounted for 86.7% (689/795) and asthma accounted for 16.7% (133/795). The peak of Chenopodiaceae pollen spread was in August. The prevalence of Chenopodiaceae pollen induced SAR was positively correlated with the concentration of Chenopodiaceae pollen (n Rn 2=0.78, n P=0.043). The SPT positive rate of Chenopodiaceae pollen was 21.2% (1 282/6 043), and Xilinhot had the highest rate in six regions (28.0%, 236/842).n Conclusions:The prevalence of Chenopodiaceae pollen induced SAR in Inner Mongolia grassland stays at a high level. Sneezing is the most obvious symptom of SAR. The peak of Chenopodiaceae pollen spread is in August and the prevalence of Chenopodiaceae pollen induced SAR is positively correlated with the pollen concentration.
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