收稿日期: 2023-09-08
网络出版日期: 2024-01-08
基金资助
广东省南山医药创新研究院项目(编号:横-20211110)
Clinical characteristics of 88 infants or young children with allergic rhinitis and follow⁃up after drug treatment
Received date: 2023-09-08
Online published: 2024-01-08
目的 通过对88例婴幼儿变应性鼻炎(allergic rhinitis, AR)的临床资料进行分析,探讨婴幼儿变应性鼻炎的临床特征和药物治疗后症状改善情况。 方法 对2020年2月1日至8月1日在广州医科大学附属第一医院小儿呼吸科门诊就诊的88例初诊婴幼儿AR患者进行回顾分析,并于就诊后6 ~ 12个月进行电话回访,总结婴幼儿AR的临床特征、合并症和药物治疗效果。 结果 88例3 ~ 36个月婴幼儿AR,其中轻度AR 34例(38.6%),中重度AR 54例(61.4%)。临床症状发生率从高到低依次为流涕87.5%(77/88)、鼻塞87.5%(77/88)、喷嚏47.7%(42/88)和鼻痒37.5%(33/88)。合并症发生率依次为咳嗽56.8%(50/88),打鼾52.3%(46/88),喘息27.3%(24/88),张口呼吸12.5%(11/88)。血清特异性Ig E检测阳性比率排在前3位的是牛奶53.4%(47/88)、尘螨46.6%(41/88)、鸡蛋36.4%(32/88)。药物治疗2~8周后鼻炎症状缓解率在轻度AR中为94.1%(32/34),明显高于中重度AR的75.9%(41/54)(χ 2 = 4.883,P = 0.027)。中重度AR中24.1%在回访时症状仍有反复,明显高于轻度AR组5.9%(2/34)(χ 2 = 4.883,P = 0.027)。 结论 婴幼儿AR症状以流涕、鼻塞突出,合并症主要有咳嗽、打鼾。主要变应原为尘螨、牛奶和鸡蛋。轻度AR治疗后症状缓解比率优于中重度AR,中重度AR症状易反复。
严汝海 , 孙丽红 , 叶映彤 , 张明 . 88例婴幼儿变应性鼻炎临床特征及药物治疗后回访[J]. 实用医学杂志, 2023 , 39(23) : 3101 -3105 . DOI: 10.3969/j.issn.1006-5725.2023.23.013
Objective By analyzing the clinical data from 88 infants or young children with allergic rhinitis (AR), we explore the clinical characteristics of AR in those pediatric patients as well as the improvement in symptoms after drug treatment. Methods A retrospective analysis was conducted on 88 infants or young children initially diagnosed with AR who visited the pediatric respiratory clinic of the first affiliated hospital of Guangzhou medical university from February 1, 2020 to August 1, 2020. Telephone follow-ups were conducted from 6 to 12 months after the first visit. Based on the follow-up results, we summarized the clinical characteristics, complications, and efficacy of therapies of AR in infants and young children. Results Among 88 infants or young children aged 3 to 36 months with AR, 34 (38.6%) had mild AR and 54 (61.4%) had moderate to severe AR. Runny nose and nasal congestion were the most common clinical symptom (87.5%, 77/88), followed by sneezing (47.7%, 42/88) and nasal itching (37.5%, 33/88). Coughing (56.8%, 50/88) was the most common complications, followed by snoring (52.3%, 46/88), wheezing (27.3%, 24/88) and mouth breathing (12.5%, 11/88).The top three positive rates of serum specific IgE testing were 53.4% (47/88) in milk, 46.6% (41/88) in dust mites and 36.4% (32/88) in eggs. After 2 to 8 weeks of medication uses, the remission rate of rhinitis symptoms was significantly higher in mild AR than in moderate to severe AR [94.1% (32/34) vs. 75.9% (41/54), χ 2 = 4.883, P = 0.027]. 24.1% of patients with moderate to severe AR still had recurrent symptoms at follow-up visits, which was significantly higher than 5.9% in the mild AR group (χ 2 = 4.883, P = 0.027). Conclusion The main symptoms of AR in infants and young children are runny nose and nasal congestion, and the main complications include cough and snoring. The main allergens are dust mites, milk, and eggs. The symptom relief rate is better in mild AR than in moderate to severe AR after treatment. The symptoms in moderate to severe AR are prone to relapse.
Key words: allergic rhinitis; infants and young children; complications
| 1 | WALLACE D V, DYKEWICZ M S, BERNSTEIN D I, et al. The diagnosis and management of rhinitis: an updated practice parameter [J]. J Allergy Clin Immunol, 2008, 122(2 ): S1-84. |
| 2 | ADEGBIJI W A, OLAJDE G T, OLAJUYIN A O, et al. Pattern of allergic rhinitis among children in Ekiti, Nigeria [J]. Int J Pediatr Otorhinolaryngol, 2018, 106: 75-79. |
| 3 | 中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会. 抗组胺药治疗婴幼儿过敏性鼻炎的临床应用专家共识[J]. 中国实用儿科杂志, 2019, 34(9):721-728. |
| 4 | HILL D A, GRUNDMEIER R W, RAM G, et al. The epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in children: a retrospective cohort study [J]. BMC Pediatr, 2016, 16: 133. |
| 5 | MASUDA S, NAGAO M, USUI S, et al. Development of allergic rhinitis in early life: A prospective cohort study in high-risk infants[J]. Pediatr Allergy Immunol, 2022,33(2):e13733. |
| 6 | 中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会. 儿童过敏性鼻炎诊疗——临床实践指南[J]. 中国实用儿科杂志,2019,34(3):169-175. |
| 7 | BROWN T. Diagnosis and Management of Allergic Rhinitis in Children[J]. Pediatr Ann, 2019,48(12):e485-e488. |
| 8 | SMALL P, KEITH P K, KIM H. Allergic rhinitis[J]. Allergy Asthma Clin Immunol, 2018,14():51. |
| 9 | 沙骥超. 儿童变应性鼻炎临床特点分析及相关问题调查[J].中华耳鼻喉头颈外科杂志, 2011,46(1):26-30. |
| 10 | DIVARET-CHAUVEAU A, MAUNY F, HOSE A, et al. Trajectories of cough without a cold in early childhood and associations with atopic diseases[J]. Clin Exp Allergy, 2023,53(4):429-442. |
| 11 | LACK G. Pediatric allergic rhinitis and comorbid disorders [J]. J Allergy Clin Immunol, 2001, 108(1 ): S9-15. |
| 12 | 张亚梅,张星. 儿童变应性鼻炎的特点及其治疗进展[J]. 临床耳鼻喉头颈外科杂志, 2010,12(24):1147-1151. |
| 13 | 黄雨,张睿欣,刘运可,等. 学龄儿童变应性鼻炎和非变应性鼻炎3年后回访的临床特点及发生哮喘情况对比[J]. 实用医学杂志, 2018,34(9):1491-1494. |
| 14 | SEIDMAN M D, GURGEL R K, LIN S Y, et al. Clinical practice guideline: Allergic rhinitis [J]. Otolaryngol Head Neck Surg, 2015, 152(1 ): S1-43. |
| 15 | EGUILUZ-GRACIA I, PEREZ-SANCHEZ N, BOGAS G, et al. How to Diagnose and Treat Local Allergic Rhinitis: A Challenge for Clinicians [J]. J Clin Med, 2019,8(7):1062. |
| 16 | LANDZAAT L J, EMONS J A M, SONNEVELD L J H, et al.Early inhalant allergen sensitization at component level: an analysis in atopic Dutch children[J]. Front Allergy, 2023,4:1173540. |
| 17 | RAZI C, BAKIRTAS A, HARMANCI K, et al. Effect of montelukast on symptoms and exhaled nitric oxide levels in 7- to 14-year-old children with seasonal allergic rhinitis [J]. Ann Allergy Asthma Immunol, 2006,97(6):767-74. |
| 18 | 孙丽红,陈爱欢,秦旭,等. 比较3种不同类药物对儿童持续性变应性鼻炎症状评分的改善作用[J]. 实用医学杂志, 2014,30(2):219-221. |
/
| 〈 |
|
〉 |