摘要
目的 动态监测哮喘患儿家庭内尘螨过敏原含量变化规律,了解其与患儿哮喘控制评估水平、尘螨致敏程度及呼出气一氧化氮浓度的相关性.方法 选取北京地区48例尘螨过敏性哮喘患儿,在1年内4个季节分别收集其家庭内床垫、枕头、卧室地板、客厅地板及沙发处灰尘样本,采用酶联免疫吸附分析方法（ELISA）测定以上灰尘样本中户尘螨过敏原第一组分（Derp 1）和粉尘螨过敏原第一组分（Derf 1）的含量;荧光酶联免疫法测定患儿血清尘螨特异性IgE（sIgE）的浓度及分级;记录各次临床随访期患儿的哮喘控制测试（ACT）或儿童哮喘控制测试（C-ACT）评分值以及根据患儿哮喘症状等指标得到的临床哮喘控制评估水平结果.结果 全部灰尘样本Der f 1平均含量为0.13μg/g,显著高于Der p1平均含量（0.02 μg/g,P＜0.05）,床垫、枕头及沙发灰尘样本Derf1含量分别为0.69 μg/g,0.42μg/g,0.22 μg/g,均显著高于卧室及客厅地板灰尘样本（0.07 μg/g、0.07 μg/g）.发现仅夏季床垫灰尘样本Der f 1含量与患儿哮喘控制评估水平呈负相关关系（r=-0.318,P=0.036）;夏季各区域灰尘样本Der f 1含量和秋季的枕头灰尘样本Der p 1含量分别与ACT/C-ACT评分呈负相关关系.冬季的床垫灰尘样本Der f 1含量与患儿血清粉尘螨sIgE浓度级别呈正相关关系,各季节室内多个区域样本中Der p 1含量与患儿血清户尘螨和粉尘螨sIgE浓度级别呈正相关关系.结论 本地区尘螨过敏性哮喘患儿室内尘螨过敏原类型以Der f 1为主,床垫、枕头及沙发区域是尘螨过敏原的主要来源.室内尘螨过敏原含量对患儿的哮喘控制水平、尘螨致敏程度的影响呈现季节、区域和螨种依赖性.
Objective The prevalence of allergic asthma has been rising continually which is correlated with the increasingly closed living environment.House dust mites are the major sources of indoor aeroallergens which induce asthma in sensitized people.To monitor the seasonal variation of house dust mite （HDM）-allergens exposure level in the asthmatic children,which was evaluated to show its correlation with the level of asthma control,HDM allergic sensitization and fraction of exhaled nitric oxide,and to provide basic data for HDM environmental control.Method A total of 48 HDM-allergic asthmatic children were enrolled from the asthma clinic in the hospital from March 2011 to January 2012 （boys 34 and girls 14,aging from 3 to 14 years,mean age 8 years and 4 months） in the present study.Dust samples from mattresses,pillows,bedroom floor,living room floor and sofas were collected in each season within one year in the household of all the enrolled patients.The concentrations of Der p 1 and Der f 1 were measured by the enzyme-linked immunosorbent assay （ELISA）.To record the Asthma Control Test （ACT） score or Children Asthma Control Test （C-ACT） score for each patient and to collect the data of doctor monitoring asthma control level each time when the patient was clinic visited.The concentration and its classification of the serum specific IgE to HDM was determined by fluoroenzyme-immunometric assay.Result The average concentration of Der f 1 of all dust samples was significantly higher than that of Der p 1 （0.13 μg/g vs 0.02 μg/g,P 〈 0.05）.The concentrations of Der f 1 from mattresses,pillows and sofas dust samples were significantly higher than those from bedroom floor and living room floor dust samples （0.69 μg/g,0.42 μg/ g and 0.22 μg/g vs 0.07 μg/g and 0.07 μg/g,P 〈 0.05）.The Der f 1 exposure level from mattress dusts in summer but no others was negatively correlated with asthma control level （r =-0.318,P =0.036）.The Der f 1 exposure level from any area dusts in summer and the Der p 1 exposure level from pillows dusts in autumn was negatively correlated with ACT/C-ACT score respectively.The Der f 1 from mattress dusts in winter was positively correlated with classification of sIgE to Der f 1.The Der p 1 exposure level from most areas in each season was positively correlated with classification of sIgE to Der f 1 and Der P 1.Conclusion Der f I was the predominant mite allergen in household dust and mainly came from mattresses,pillows and sofas.The role of the HDM allergen exposure level on the asthma control level and HDM allergic sensitization for the asthmatic children were depended on its area,season and HDM species,which suggested that the future assessment of clinical effect by the HDM environmental control should consider these factors.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2014年第3期177-183,共7页
Chinese Journal of Pediatrics
基金
国家自然科学基金（81100022）
北京市教委科技计划重点项目（KZ201110025032）
关键词
哮喘
儿童
尘螨过敏原
控制
Asthma
Child
House dust mite allergens
Control
