Characteristics of Anaphylaxis in 907 Chinese Patients Referred to a Tertiary Allergy Center: A Retrospective Study of 1,952 Episodes.
Characteristics of Anaphylaxis in 907 Chinese Patients Referred to a Tertiary Allergy Center: A Retrospective Study of 1,952 Episodes.
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907 例转诊至三级过敏中心的中国患者过敏反应特征：1,952 例病例的回顾性研究
DOI：
10.4168/aair.2016.8.4.353
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发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Li H
中科院分区：
文献类型：
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作者：
Jiang N;Yin J;Wen L;Li H
目的目前国内缺乏对过敏反应的综合评价。在这项研究中，我们描述了儿童和成人患者的临床特征、过敏性触发因素和紧急治疗。方法对2000年1月1日至2014年6月30日北京协和医院变态反应科门诊诊断为“过敏反应”或“严重过敏反应”的患者进行回顾性分析。结果共分析了907例患者的1，952次过敏反应（78%为成人，22%为儿童）。食物是最常见的原因（77%），其次是特发性病因（15%），药物（7%）和昆虫（0.6%）。在食物引起的过敏反应中，62%（13/21）的过敏反应发生在婴幼儿（0-3岁）均由牛奶引发，59%（36/61）的儿童发生过敏反应（4-9岁）由水果/蔬菜引发，而小麦是20%（56/282）的青少年（10-17岁）和42%（429/1，016）的成人（18-50岁）过敏反应的原因。艾蒿花粉致敏在由香料、水果/蔬菜、豆类/花生和树坚果/种子引起的过敏反应患者中常见，患病率分别为75%、67%、61%和51%。36%的药物过敏反应归因于中药。对于接受紧急护理的患者，只有25%的患者接受了肾上腺素治疗。结论成人过敏反应发生率高于婴幼儿和儿童，这与国外过敏反应的发生率不同。特别是，小麦过敏原在引发食物诱导的过敏反应中发挥了突出作用，其次是水果/蔬菜。中药是引起药源性过敏反应的原因之一。此外，运动是最常见的因素加重过敏反应。关于在紧急情况下更积极地使用肾上腺素的教育显然是必要的。
Purpose Comprehensive evaluation of anaphylaxis in China is currently lacking. In this study, we characterized the clinical profiles, anaphylactic triggers, and emergency treatment in pediatric and adult patients. Methods Outpatients diagnosed with "anaphylaxis" or "severe allergic reactions" in the Department of Allergy, Peking Union Medical College Hospital from January 1, 2000 to June 30, 2014 were analyzed retrospectively. Results A total of 1,952 episodes of anaphylaxis in 907 patients were analyzed (78% were adults and 22% were children). Foods are the most common cause (77%), followed by idiopathic etiologies (15%), medications (7%) and insects (0.6%). In food-induced anaphylaxis, 62% (13/21) of anaphylaxis in infants and young children (0-3 years of age) were triggered by milk, 59% (36/61) of anaphylaxis in children (4-9 years of age) were triggered by fruits/vegetables, while wheat was the cause of anaphylaxis in 20% (56/282) of teenagers (10-17 years of age) and 42% (429/1,016) in adults (18-50 years of age). Mugwort pollen sensitization was common in patients with anaphylaxis induced by spices, fruits/vegetables, legume/peanuts, and tree nuts/seeds, with the prevalence rates of 75%, 67%, 61%, and 51%, respectively. Thirty-six percent of drug-induced anaphylaxis was attributed to traditional Chinese Medicine. For patients receiving emergency care, only 25% of patients received epinephrine. Conclusions The present study showed that anaphylaxis appeared to occur more often in adults than in infants and children, which were in contrast to those found in other countries. In particular, wheat allergens played a prominent role in triggering food-induced anaphylaxis, followed by fruits/vegetables. Traditional Chinese medicine was a cause of drug-induced anaphylaxis. Furthermore, exercise was the most common factor aggravating anaphylaxis. Education regarding the more aggressive use of epinephrine in the emergency setting is clearly needed.