兒童過敏原檢測流行病學研究：一區域教學醫院之報告

Epidemiological Study of Pediatric Allergen Test - Report of A Regional Teaching Hospital

目的：過敏在台灣是兒童常見之問題。本研究在了解一區域教學醫院之兒童過敏原流行病學特徵。方法：研究期間為2008年至2012年，收集有過敏症狀兒童至小兒科門診施作特異性過敏原檢測之報告，將病人分成皮膚症狀組與呼吸道症狀組，也將他們因有無檢測IgE分成IgE組及無IgE組，採用描述性統計或推論性統計分析比較兩組之差異。結果：本研究一共收集了121位兒童，男童有66位，女童有55位。食物方面之過敏原前3名分別為蛋白（56.7％）、牛奶（46.7％）、小麥或杏仁（43.3％）。呼吸道方面過敏原前3名分別為屋塵蟎（98.9％）、粉塵蟎（94.4％）、熱帶無爪蟎（71.9％）。皮膚症狀組的吸入性過敏原篩檢之specific IgE數值明顯比呼吸道症狀組這組之數值低（p=0.024）。IgE組有較多種之過敏原其陽性比率高於無IgE組，而IgE組屋塵蟎及粉塵蟎specific IgE數值比無IgE組高（p=0.000）。無IgE組之吸入性過敏原篩檢specific IgE數值比IgE組較高（p=0.000）。結論：本研究顯示吸入性過敏原陽性以屋塵蟎最高。建議還是先驗IgE後，若數值高於正常值再施作特異性過敏原檢驗。了解引起呼吸道及皮膚過敏反應之過敏原，可預防兒童過敏疾病之再發生。

Purposes: Allergy is a common pediatric problem in Taiwan. The aim of this study was to analyze the epidemiology of pediatric allergens in a regional teaching hospital. Methods: From 2008 to 2012, we collected children receiving specific-allergen test due to allergic symptom. We divided them to patients with skin allergy (skin allergy group) and patients with inhaler allergy (inhaler allergy group), and also divided them to IgE group and non-IgE group. We analyzed and compared both groups by descriptive or inferential statistics. Results: A total of 121 children (66 boys and 55 girls) were enrolled. Skin allergy group: the positive ingestion allergen was 83.3%, and 100% in inhaler allergen respectively. The first three kinds of ingestion allergens are eggs (56.7%), milk (46.7%) and wheat or almond (43.3%). Inhaler allergy group, the positive inhaler allergen was 98.9%, and 79.8% in ingestion allergen respectively. The first three kinds of inhaler allergens are Der. pteronyssinus (98.9%), Der. farinae (94.4%) and Blomia tropicalis (71.9%). The specific IgE values of Der. Pteronyssinus in inhaler allergy group was significantly higher than those in skin allergy group; and specific IgE values of inhaler allergen screen in skin allergy group was significantly lower than those in inhaler allergy group (7.73±9.70 vs. 13.67±17.78, p=0.024); specific IgE values of Bermuda grass and wheat in inhaler allergy group was significantly higher than those in skin allergy group. Most of the allergens showed positive findings in IgE group, but specific IgE values of Der. Pteronyssinus and Der. Farina in non-IgE group was significantly higher than those in IgE group (p=0.000). The specific IgE values of inhaler allergen screen was also significantly higher than those in non-IgE group (p=0.000), but the specific IgE values of ingestion allergen screen was significantly lower than those in IgE group. Conclusions: In our study, the first positive inhaler allergen is Der. Pteronyssinus. We suggest check children's IgE values first, and then check the specific allergen test later if they have high IgE. Realize the inhaler or ingestion allergens which induce allergic reaction can prevent the recurrence of allergic disease in previous symptomatic children.