【摘要】 目的 调查凉山地区青少年四种常见变应性疾病——湿疹、荨麻疹、变应性鼻炎（allergic rhinitis，AR）、支气管哮喘（bronchial asthma，BA）的发病情况，及农村与城区患病差异。 方法 采用分层整群抽样方式确定调查点。受调查者填写调查问卷，接受皮肤科、耳鼻喉科、内科专科医师检查。 结果 湿疹调查8 113人，发现患者810例，患病率10.0%，标准化患病率9.3%；男性患病率8.1%，女性患病率11.2%（Plt;0.01）；城区与农村患病率均为10.0%。荨麻疹调查8 113人，发现患者513例，患病率6.3%，标准化患病率6.5%；男性患病率4.6%，女性患病率7.5%（Plt;0.01）；农村患病率6.9%，城区患病率4.9% （Plt;0.01）。AR调查7 977人，发现患者741人，患病率9.3%，标准化患病率9.1%；男性患病率9.4%，女性患病率9.2%（Pgt;0.05）；农村患病率9.0%，城区10.1%（Pgt;0.05）。BA调查7 741人，发现患者296例，患病率3.8%，标准化患病率4.0%；男性患病率3.2%， 女性患病率4.2%（Plt;0.05）；农村患病率4.1%，城区患病率2.9%（Plt;0.05）。 结论 通过调查获得了凉山地区青少年四种变应疾病患病数据。发现女性湿疹、荨麻疹、BA患病率均高于男性，AR患病率相近。农村湿疹、荨麻疹、支气管哮喘患病率均高于城区，AR患病率相近。【Abstract】 Objective To obtain the prevalence rate of four common allergic diseases, including eczema, urticaria, allergic rhinitis, and bronchial asthma, in adolescent of Lianshan district; and to explore the differences of these allergic diseases prevalence rate between rural area and urban area. Methods A survey was conducted in adolescent. The cluster sampling was used. The subjects were required to fulfill the self-report questionnaires and also received physical examinations by doctors. Results A total of 8 113 individuals were included in eczema studis, in whom eczema were present in 810 with a morbidity of eczema of 10.0% (9.3% after standardized). The prevalence rate of eczema in males and females were 8.1% and 11.2%, respectively (Plt;0.01). The prevalence rate of eczema in urban area was the same as that in rural area (10.0%). A total of 8 113 people were included in the urticaria study, in whom urticaria were found in 513. The prevalence rate was 6.3% (6.5% after standardized). The prevalence rate of urticaria in males and females were 4.5% and 7.6%, respectively (Plt;0.01), and were 6.9% and 4.9% respectively in rural area and urban area (Plt;0.01). A total of 7 977 people were included in AR studis. AR was present in 741 people, and the prevalence rate of AR was 9.3% (9.1% after standardized). The prevalence rate of AR in males and females were 9.4% and 9.2% respectively (Pgt;0.05), and were 10.1% and 9.0% respectively in urban area and rural area (Pgt;0.05). A total of 7 741 people were included in BA study, and BA were present in 296 people. The prevalence rate of BA were 3.8% (4.0% after standardized). The prevalence rate in males and females were 3.2% and 4.2% respectively (Plt;0.05), and were 2.9% and 4.1% respectively in urban area and rural area (Plt;0.05). Conclusion The prevalence rate of these commom allergic diseases in adolescent of Liangshan district was obtained. The females have a higher prevalence rate of eczema, urticaria and BA than that in the males; the prevalence rate of AR in males is similar to which in the females. A higher prevalence rate of eczema, urticaria and BA is found in rural area than that in urban area; the prevalence rate of AR in urban area is similar to which in rural area.
ObjectiveTo systematically review the efficacy and safety of dust mite sublingual immunotherapy (SLIT) in the treatment of children with allergic rhinitis. MethodsRandomized controlled trials (RCTs) about SLIT treating allergic rhinitis in pediatric patients was searched in PubMed, EMbase, CBM, Ovid, The Cochrane Library (Issue 5, 2014), CNKI, VIP and WanFang Data from inception to May 2014. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using RevMan 5.3 software. ResultsA total of nine RCTs including 663 patients were finally included. The results of meta-analysis indicated that:the trial group was superior to the control group in reducing the scores of drug use (SMD=-0.61, 95%CI-0.94 to-0.27, P=0.000 4) and mite-specific serum IgE levels (follow-up time > 22 weeks:SMD=0.71, 95%CI 0.31 to 1.12, P=0.000 5). However, no significant difference was found between the two groups in the scores of nasal symptoms (SMD=0.06, 95%CI-0.13 to 0.25, P=0.55) and the incidence of adverse reaction (OR=1.3, 95%CI 0.89 to 1.90, P=0.17). ConclusionSLIT could decrease the use frequency of antihistamine, β-agonist and nasal spray steroids, and it has less adverse reaction and better safety in the treatment of children with allergic rhinitis. But SLIT could neither effectively alleviate nasal symptoms nor reduce mite-specific serum IgE levels of pediatric patients with allergic rhinitis in a short time.
摘要:目的:调查呼和浩特市地区变应性疾病患者常见变应原的分布情况。方法:以720例变应性疾病的患者为研究对象,进行11种吸入性变应原皮肤点刺试验,测定致敏变应原。结果:720例变应性疾病患者中577例(80.1％)变应原测试有阳性反应。577例阳性病例中艾蒿阳性率最高,315例(54.6％),其次是螨虫254例(44.0％)。结论:艾蒿、螨虫是呼和浩特市地区变应性疾病的最常见变应原。Abstract: Objective: To study the distribution of common allergens among patients of allergic diseases in Hohhot area.Method: Seven hundred and twenty cases of allergic disease were selected and 11 items of inhaled allergen skin prick tests were carried out to determine the allergens.Results:Five hundred and seventyseven patients out of the 720 (801％) reacted positively to allergen tests.Three hundreds aned fifty cases (546％) were positive in the mugwort,254 cases (440％) were positive in the mites.Conclusion: Mugwort and mites are the most common allergens in Hohhot area.
Objective To investigate the effects and mechanisms of lactic acid bacteria on MAPK signaling in immune response of dust mite sensitized mice. Methods Forty C57BL/6 mice in Group M, P and L, were sensitized and challenged with mite extract while then the animals in Group N were treated with saline as control. The mice in Group L and P were fed with Lactococcus lactis or Lactobacillus respectively.Three days after the last challenge, all mice were sacrificed for lung pathological examination. IL-10 level in culture supernatant of splenocytes stimulated with mite extract was detected by ELISA. The expression of IL-4/ IFN-γon CD3 +CD4 + cells was detected by flow cytometry. Western blot were performed for detection of MAPK signaling ( P38, ERK, and JNK) from mice’s spleen cells stimulated with mite extract. Results The mice fed with Lactococcus lactis ( Group L) had lower rate of eosinophilic airway inflammation and higher level of IL-10 in the culture supernatant of splenocytes than Group P. Meanwhile, the number of CD4 + T cell with IL-4 expression was decreased revealed by the analysis of flow cytometry. P38 signaling inspleen cells was activated in the mice of Group M, similarly in the mice of Group P, but not of Group L.Conclusion Oral treatment of Lactococcus lactis can induce an immune tolerance in response to mite by up-regulating the level of Tr cells secreting IL-10, thus inhibiting activation of P38 signaling.
Objective To analyse the clinical characteristics of allergic bronchopulmonary aspergillosis (ABPA). Methods The clinical data of 26 patients diagnosed as ABPA from September 2016 to February 2018 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Results Among 26 patients with ABPA, 15 were female, 11 were male, with a mean age of (47.6±11.7) years. Before the diagnosis of ABPA, 13 cases had been misdiagnosed as bronchial asthma, 8 as bronchiectasis, 8 as pulmonary infection, 3 as tuberculosis. All patients had cough, sputum production, wheeze in 2, fever in 5, hemoptysis in 4, chest pain in 4, dyspnea in 2. The wheezing sound were heard in 20 patients and wet rales were heard in 4 cases. All patients had increased total IgE level ［median 5 000 (654 – 5 337)IU/ml］. The eosinophil counts were increased in 23 patients ［median 0.99 (0.50 – 3.69)×109/L］ and percentages of peripheral blood eosinophil were elevated to (0.36±0.10). Skin prink test was positive in 10 cases. All patients had increased Aspergillus fumigatus specific IgE ［median 15.1 (0.4 – 29.6)kU/L). Chest X-ray showed fleeting consolidation. Chest CT showed multiple pachy, central cylindrical bronchiectasis, mucous plugging, band linear or glover-finger opacities. Sixteen cases underwent bronchoscopy, out of them 5 cases underwent transbronchial lung biopsy, 2 cases underwent CT guided percutaneous lung biopsy. Fourteen cases were treated with oral corticosteroids combined with antifungal therapy. Conclusions ABPA is a relatively rare and without specific clinical manifestations. In the early period, it is mostly misdiagnosed as bronchial asthma, so it is necessary to improve the early diagosis of ABPA and give appropriate treatment. Regular follow-up should be made to prevent the recurrence.
ObjectiveTo investigate the clinical manifestations, diagnosis and treatments of allergic bronchopulmonary aspergillosis (ABPA). MethodsThe clinical data of four cases of ABPA diagnosed in our department between 2009 and 2014 were analyzed. The related literature was also reviewed. ResultsABPA tends to occur in people with chronic lung diseases, such as asthma and cystic fibrosis. The main clinical manifestations are wheezing, fever, cough, and sputum production. Laboratory examinations include immediate Aspergillus skin test reactivity, elevated total serum IgE and Aspergillus specific IgE and IgG antibodies, and peripheral blood eosinophilia. Radiological findings include recurrent chest roentgenographic infiltrates and central bronchiectasis. Treatments involve corticosteroids and antifungal therapy with itraconazole. ConclusionsABPA is easy to misdiagnosis clinically. It should be considered in patients with poor controlled asthma and asthmatic patients with acute pulmonary infiltrates. Early diagnosis and proper treatment can minimize lung injury from ABPA and improve outcomes.
Objective To investigate the effects of FasL gene-modified dendritic cell (DC) on the airway inflammation in mice sensitized/challenged by house dust mite (HDM) allergen.Methods FasL gene-modified DC (FasL-DC) and control DC (nontransfection DC) were administrated into HDM sensitized and challenged mice by intratracheal injection respectively，then HDM sensitized and challenged mice were sacreificed two days later.Total and differentiation cell counts and levels of interleukin-4（IL-4），IL-5 and interferon-γ(IFN-) in bronchoalveolar lavage fluid (BALF) were detected and lung histological features were observed.Results After administration of FasL-DC，lung allergic inflammation was ameliorated while total cell counts，the percentage of eosinophil ,the levels of IL-4 and IL-5 in BALF decreased and the level of IFN- in BALF increased.Conclusion Administrating FasL-DC into HDM sensitized/challenged mice can inhibit Th2 cells activation and ameliorate airway allergic inflammation.