Clinical Analysis Of 675 Cases Of Allergic Rhinitis In Children In Jining Are

Background: With the continuous improvement of industrialization and great changes in the natural environment,atopic diseases such as allergic rhinitis,asthma and atopic dermatitis are rapidly increasing in prevalence and have become a serious threat to human health in the global chronic diseases.Allergic Rhinitis(AR)is a type I Allergic disease mediated by IgE after exposure to allergens in atopic individuals.AR is a chronic non-infectious inflammation of nasal mucosa involving immunoactive cells such as mast cells and basophils and cell mediators such as leukotriene and histamine.Its main symptoms are repeated sneezing,runny nose,nasal congestion and nasal itching,long-term delay can cause asthma,cardiovascular and cerebrovascular diseases,diabetes and other multi-system damage,seriously affect the quality of life of patients.Children with allergic rhinitis as a special group,because in the process of chronic recurrent disease,illness can not get effective control for a long time can cause memory loss,insomnia,children can make children personality change,serious when even induce suicide,for children’s daily life,learning and growth were badly hurt,and to the family,society caused a heavy economic burden.Allergens play a crucial role in the occurrence and chronic delay of allergic diseases.In the diagnosis and treatment of allergic diseases,it is important to avoid contact with suspected allergens,so it is very important to identify allergens.To understand the prevalence of the region’s children allergic rhinitis,risk factors and comorbid illness and allergens distribution features,for children,provide clinical basis for the prevention and treatment of allergic rhinitis,the allergic rhinitis in children patients with standardized and personalized treatment,thereby reducing the incidence of children allergic rhinitis and other allergic diseases.Objective: To investigate the clinical characteristics,concomitant diseases and serum-specific allergens of children with AR in Jining area,and to provide information for the prevention,treatment,health education and popularization of AR in children in jining area.Methods: A total of 675 pediatric AR patients treated in the Department of Otorhinolaryngology of Jining First People’s Hospital,Yanzhou District Hospital of Traditional Chinese Medicine,Weishan County People’s Hospital and Sishui County People’s Hospital from July 2017 to September 2019 were selected as the research subjects,and the diagnosis was based on guidelines for the Diagnosis and treatment of allergic rhinitis in Children(2010,Chongqing).Exclusion criteria: previous oral antihistamines,glucocorticoids or other immunosuppressants within the past 1 week,recent history of upper respiratory tract infection,immune deficiency disease,systemic disease and systemic chronic wasting disease,and repeated cases were excluded.Each into the group of children patients with AR(guardian)must be specially designed for the study of filling out a questionnaire,including age,sex,age,to live for a long time,season,food or drug allergy history,also includes the usual physician diagnosis of asthma,allergic conjunctivitis and atopic dermatitis history,family history of allergic disease and serum allergen specific IgE level.The allergen specific IgE antibody detection kit produced by Suzhou Haobo Biomedical Co.LTD was used to detect the level of allergen specific IgE antibody in serum by elisa rapid strip technology.SPSS25.0 statistical software was used to analyze the statistical data.Frequency and percentage were used to represent the count data,and frequency and percentage were used to represent the grade data.χ2 test was used for comparison between groups,and P < 0.05 was considered statistically significant.Result:1.1 Demographic dataIn this study,a total of 675 children diagnosed with AR were enrolled,including 355 males and 320 females,with a male to female ratio of 1.1:1.There were 143 children aged from 2 to 12 years old,143 children aged less than 3 years old in the infant group,319 children aged from 4 to 6 years old in the preschool group,and 213 children aged from 7 to 12 years old in the school group.1.2 Positive rate of allergensAmong 675 children in this study,660 of them received serum s IgE test,of which 564(85.45%)were positive.The detection rate of infant group,preschool group and school-age group was 77.21%,88.75% and 85.92%,respectively,and the preschool group was the highest.The positive rate of allergens in different age groups was significantly different(P< 0.05).The results of serum s IgE test in 660 children showed that inhalational allergens were predominant,including 405(61.36%)positive children in the inhalation group and 240(36.36%)positive children in the food group.The allergen detection rate in the inhalation group was the highest in the preschool group(74.92%),and there was statistically significant difference in the detection rate of inhaled allergen among different age groups(P< 0.05).The detection rate of food allergens in different age groups was significantly different(P< 0.05),and the highest was 60.29% in infant group.403 cases of dust mites/house dust mites(61.06%)were the top 3 inhalation allergens.House dust 324 cases(49.09%);125 absinthe/Mugwort/ragweed(18.94%)were detected,and the top 3 food allergens were egg white/egg yolk(165 cases)(25.00%).Milk 97 cases(14.70%);Shrimp/crab/scallop 49 cases(7.42%).Except dust mite/house dust mite,house dust,cypress/elm/sycamore/willow/poplar,egg white/egg yolk,milk,cod/salmon/perch,there was no significant difference in the detection rates of other allergens(P > 0.05).1.3 Residence and weighting seasonOf the 675 patients,428 lived in urban areas and 247 lived in rural areas,with a ratio of 1.7:1.Among the 675 patients,128 cases(18.96%)had exacerbation in spring,91 cases(13.48%)in summer,163 cases(24.15%)in autumn,118 cases(17.48%)in winter,and 175 cases(25.93%)had no obvious seasonal exacerbation.1.4 History of allergic diseases,personal history and family historyIn the clinical data of this study,a total of 240 patients(35.56%)were associated with asthma,atopic dermatitis and allergic conjunctivitis respectively or simultaneously,including 83 cases of asthma,128 cases of atopic dermatitis and 68 cases of allergic conjunctivitis.There were 153 males and 126 females,and there was no significant difference between male and female patients(P >0.05).There were statistically significant differences in atopic dermatitis in different age groups(P<0.05),but no significant differences in asthma and allergic conjunctivitis(P >0.05).The proportion of atopic dermatitis in infant group was higher than that in other two groups.1.5 Clinical manifestations of AR childrenIn this study,the most common symptoms of AR children were sneezing(72.1%),watery nose(60.6%),nasal obstruction(68.9%),nasal itching(56.6%),eye itching(37.3%),and lacrimal discharge(26.4%).According to the severity and duration of symptoms,they were divided into four subtypes,among which 101 cases(15.0%)were mild intermittent AR.There were 155 cases of mild persistent AR(23.0%),236 cases of moderate to severe intermittent AR(35.0%),and 183 cases of moderate to severe persistent AR(27.1%).Gender differences in the clinical classification,no statistical significance(P > 0.05),and clinical classification comparison among all age groups have no statistical difference(P > 0.05),compared the clinical classification of nasal and ocular symptoms,including sneezing,water cried,the tears overflow statistically significant(P <0.05),stuffy nose,nasal itching,eye itch no statistical difference(P > 0.05).Conclusion:1.The male to female ratio of children with allergic rhinitis in Jining area was 1.1:1,and most of the children lived in cities.2.The main inhalation allergens in Jining area were dust mites/house dust mites;House dust;Wormwood/mugwort/ragweed,the main food allergens are egg white/egg yolk;Milk;Shrimp/crab/scallop,the highest rate of inhalation allergen in preschool group,and the highest rate of food allergen in infant group.3.There was statistical difference in children AR patients with atopic dermatitis in different age groups in Jining area,and the proportion of children AR patients with atopic dermatitis was higher than the other two groups.4.The proportion of AR aggravation in autumn and no obvious season in children in Jining area is high.The most common clinical symptom is sneezing,and the proportion of moderate to severe intermittent and moderate to severe persistent is high.