慢性咳嗽患者吸入性变应原的调查分析

摘要

目的 分析吸入性变应原在不同分组慢性咳嗽患者中的检出率,为临床慢性咳嗽的诊断和治疗提供依据.方法 将460例慢性咳嗽病例按照嗜酸性粒细胞(EOS)计数、诱导痰检查比例、支气管激发试验结果以及临床症状分为咳嗽变异性哮喘(CVA)组、嗜酸性粒细胞性支气管炎(EB)组、上气道咳嗽综合征(UACS)组、胃食管反流性咳嗽(GERC)组和其他病因组,采用印迹法检测吸入性变应原特异性IgE抗体,以120名正常体检者为对照.结果 CVA组和EB组的吸入性变应原检出率明显增加,与其他病因组和对照组比较,差异有统计学意义(P<0.05).在所检测的变应原中,阳性率居前5位的分别为屋尘螨/粉尘螨(71.28%)、蟑螂(25.24%)、狗上皮(15.35%)、屋尘(13.86%)和猫毛(10.89%),存在多重检出现象.结论 在EOS计数和诱导痰检查比例升高的慢性咳嗽患者中,吸入性变应原是其致病的主要因素,尘螨为最常见的吸入性变应原.%Objective To analyze the determination rates of inhalant allergen in patients with chronic cough,and to provide a reference for the diagnosis and treatment of chronic cough.Methods A total of 460 patients with chronic cough were classified into groups with cough variant asthma(CVA),eosinophil(EOS)bronchitis(EB), upper airway cough syndrome(UACS),gastroesophageal reflux-induced chronic cough(GERC)and other causes,according to EOS count,induced sputum examination,bronchial provocation test and clinical symptoms. Imprinting method was used to determine specific IgE antibody for inhalant allergen. Totally,120 healthy subjects were enrolled as healthy control group.Results In CVA and EB groups,the determination rates of inhalant allergen increased. Compared with other groups and healthy control group,there was statistical significance(P<0.05). Among the tested allergens,the top 5 positive rates were for house dust mites/dust mites(71.28%),cockroaches (25.24%),dog epithelia(15.35%),house dust(13.86%)and cat hair(10.89%).Conclusions In chronic cough patients with increasing EOS count and induced sputum examination,inhalant allergens are main causes for pathogenesis. Dust mites is a dominant inhalant allergen.