| Background and purpose:Allergic disease is one of the three chronic diseases listed by the World Health Organization that should be studied and prevented in the 21st century.In recent years,with the change of environment,lifestyle and other factors,the prevalence of allergic diseases is increasing worldwide.Allergic rhinitis is mediated by specific allergen stimulation,specific IgE type I allergic diseases,after the body to a specific allergen sensitization over again the same contact allergens,allergen so early diagnosis and treatment can effectively control the occurrence and development of the disease,so as to relieve the suffering of the patients and the economic burden.The Skin Prick Test(SPT)and serum allergen-specific IgE measurement are the most commonly used in vivo tests to identify allergens in allergic rhinitis.The skin prick test involves placing a small amount of highly purified standardized extract of allergen on the skin surface of the patient,and then immerse the extract vertically with a disposable prick needle and puncture the skin with slight force for 15-30 minutes.If the patient is allergic to this allergen,the prickling skin surface will appear red and swollen,the formation of wind mass,may accompany local itching.Specific IgE(sIgE)is an in vitro test,and elevated serum sIgE levels indicate that the patient is sensitized to this allergen.Serum IgE determination is not a dichotomous variable that can only be seen with or without IgE.Whether the quantification of SIGE can be used as an indicator of the severity of some allergic diseases is still under investigation,and the threshold value used to distinguish the normal IgE antibody level from the elevated IgE antibody level caused by allergy has been a long-standing question.At present,there are few studies on patients with allergic rhinitis that carry out the above two tests at the same time and compare and analyze the correlation between the results of these two tests.At the same time,there are few epidemiological studies on the two most common inhalation allergens,house dust mite and dust mite,in Shandong.This study will study the two most common inhalation allergens,house dust mite and dust mite,and explore the correlation between the results of the two tests on dust mite allergens,so as to provide a theoretical basis for the cross-reference between the skin prism test and the quantitative serum IgE detection results.At the same time,through retrospective statistics,the results of serum SIgE test of allergic rhinitis patients from August 2016 to October 2020 were statistically analyzed,so as to understand multiple epidemiological conditions of house dust mite and dust mite allergy in Shandong,and provide reference for the diagnosis,prevention and treatment of dust mite allergy patients in Shandong.Research methods:In this study,serum sIgE was determined among patients with allergic rhinitis who were admitted to the Second Hospital of Shandong University from October 2019 to October 2020.Patients with sIgE of house dust mite and/or dust mite≥0.01KUA/L were selected,and the skin pruning test was carried out according to the principle of informed and voluntary:1.The numerical correlation between the average diameter,area,skin index and SIgE of dust mite and house dust mite SPT sensitized patients was analyzed with different quantities of SIgE as the sensitization threshold(0.10KUA/L,0.35KUA/L,0.7KUA/L,3.5KUA/L).2.The average diameter,area and serum SIgE value of SPT of dust mite and house dust mite(0.10KUA/L was taken as the SIgE positive critical value)were analyzed to analyze the differences and relationships between the two as biological allergens belonging to different suborders.3.Rretrospective statistics were used to collect the patients diagnosed with allergic rhinitis from August 2016 to October 2020 who underwent serum sIgE measurement:0.10KUA/L was taken as the sIgE positive threshold for epidemiological investigation,and the group was divided by gender,age and month to analyze the relationship between the allergy-positive rate of the two species of mites and gender,age and season.All statistical analyses were performed using SPSS24.Pearson method was used to calculate the correlation between wind mass correlation and SIgE level.The population and positive rate of patients were expressed as numbers and percentages,and the chi-square test was used.P values≤0.05 was considered statistically significant.Results:After screening and excluding individual patients with missing information,a total of 204 patients were admitted to the Second Hospital of Shandong University from October 2019 to October 2020 and received skin prick test and serum sIgE test at the same time.In retrospective statistics,a total of 2771 patients with allergic rhinitis were identified from August 2016 to October 2020 and tested for serum sIgE.1.Taking different amounts of SIgE detected by the full quantitative IgE detection system(Thermofisher Phadia)as the sensitization critical values,the numerical correlation between the average diameter,area,skin index of dust mite and house dust mite wind masses and SIgE was analyzed.1.1.With 0.35KUA/L as the positive critical value,Pearson method was used to determine that the correlation coefficients of mean diameter,dust mite cluster area,dust mite skin index and house dust mite IgE were all greater than 0.05,and there was no significant correlation between the values of the three groups.When a scatter plot was used to describe trends in skin index and IgE distribution,no corresponding IgE concentration range was found for grade 4 skin index.Similarly,Pearson’s method was used to obtain the correlation coefficients between the average diameter of dust mite,dust mite wind cluster area,dust mite skin index and dust mite IgE,respectively.Again,there was no significant correlation between the three values.When scatter plots were used to describe trends in skin index and IgE distribution,no corresponding IgE concentration range was found for any of the four skin indices.1.2.When 0.7K UA/L and 3.5KUA/L were used as critical values,there was no correlation between the mean diameter,dust mite cluster area,dust mite skin index and dust mite IgE.Scatter plots of skin index and IgE distribution showed no central trend.Dust mite mean diameter,dust mite cluster area,dust mite skin index and house dust mite IgE were also not correlated.Scatter plots of skin index and IgE distribution showed no central trend.1.3.When 0.10KUA/L was taken as the critical value,the correlation coefficient between the average diameter of dust mite and SIgE was 0.311,and the significant P value was 0.001,indicating a significant positive correlation.The correlation coefficient between the area of dust mite wind cluster and the SIgE correlation coefficient was 0.194,and the significant P value was 0.025,which was less than 0.05,indicating a significant positive correlation.The correlation coefficient between the dust mite skin index and SIgE was 0.307,and the significance P value was only 0.004,indicating that the two variables were significantly positively correlated.In addition,there was no central trend in the scatter plots of grade 4 skin index and IgE distribution.The correlation coefficient between the average diameter of house dust mites and SIgE was 0.324,and the significant P value was 0.000,far less than 0.05,indicating a significant positive correlation.The correlation coefficient between the area of house dust mite wind cluster and SIgE was 0.291,and the significant P value was 0.001,which was less than 0.05,showing a significant positive correlation.The correlation coefficient between the skin index of house dust mite and SIgE was 0.219,and the significant P value was 0.032,indicating that the two variables were significantly positively correlated.In addition,there was no central trend in the scatter plots of grade 4 skin index and IgE distribution.Only at the critical value of 0.10KUA/L,the correlation value of dust mite SPT cluster was correlated with serum SIgE value,and the correlation was significantly positive.2.The difference between the wind head diameter and the negative control group was≥3mm as the positive criterion for the results of the skin pruning test.The wind group results showed that 142 patients were allergic to at least one of the allergens of dust mite and house dust mite,134 patients had double allergy,and the double allergy rate was 94.37%.Taking 0.10KUA/L as the sIgE positive cut-off value,the serum results showed that 133 patients were allergic to at least one of the allergens of dust mite and house dust mite,127 patients were double allergic,and the double allergic rate was 95.49%.The average diameter,area and serum SIgE values of dust mite and house dust mite were analyzed.The correlation coefficients of average diameter of wind mass,area of wind mass and serum SIgE values were 0.780,0.758 and 0.89,respectively.The significant P values were all 0.000,which were less than 0.05.The correlation was significant and positive.In addition,since the correlation coefficients of the three items were all above 0.75,it can be said that the results of dust mites and house dust mites were significantly positively correlated no matter in the positive rate,the size of SPT wind cluster or the serological detection.3.In the retrospective statistics of 2771 patients,0.10KUA/L was taken as the critical value of sIgE positive,grouped by gender,age and month,and the relationship between the allergy positive rate of two species of mites and gender,age and season was analyzed3.1.Grouped by gender,the positive rate of house dust mite allergy was 43.49%(752/1729)in males and 43.09%(449/1042)in females.43.38%(750/1729)of the males were allergic to dust mites,and 43.28%(451/1042)of the females.There was no significant difference in the positive rates of house dust mite and dust mite allergy between men and women.In this study,the rates of house dust mite and dust mite allergy were not related to gender.3.2.Grouping patients of different ages,it was found that there were differences in dust mite allergy rates among patients of different ages.Among the allergic rates of house dust mites,the highest positive rates were in the adolescent group(13-18 years old)and the school-age group(7-12 years old),with 62.24%(300/482)and 66.34%(136/205),respectively,and there was no statistical difference between the two groups.Secondly,the allergy rate of people aged 19-40 years old was 46.48%(370/796).The allergic rate was 37.52%(239/637)in the preschooler group(1-6 years old).People aged 41-60 years and over 60 years had the lowest rate of dust mite allergy,with 24.95%(127/509)and 20.42%(29/142),respectively,and there was no statistically significant difference between the two groups.The same pattern also appeared in the dust mite allergens,with the highest positive rate in the adolescent group and the school-age group,61.83%(298/482)and 63.41%(130/205),respectively,and there was no statistical difference in the allergic rate between the two groups.Secondly,in people aged 19-40,the allergy rate was 47.74%(380/796).The allergy rate was 35.01%(223/637)in the preschoolers group.People aged 41-60 and over 60 had the lowest rates of dust mite allergy,with 26.92%(137/509)and 23.24%(33/142),respectively,and there was no statistically significant difference between the two groups.3.3.The year in Shandong was divided into four seasons according to the long-term tracking temperature and humidity,and patients were divided according to the visiting seasons.Although the positive rate of house dust mites was slightly different in different seasons,there was no statistical difference in the positive rate of house dust mites among different seasons.Similarly,no statistical difference was found between seasons in the positive rate of dust mite.Conclusions:1.Only when 0.10KUA/L was used as the positive critical value of SIgE,the average diameter of dust mite wind mass,the area of dust mass and the skin index of the skin sting test showed significant positive consistency with the specific value of serum SIgE,while when the traditional threshold value of 0.35KUA/L or higher was used as the critical value,The positive correlation is no longer evident,and there is even a negative correlation between the two(although none of these correlations are reliable).In addition,when the skin index is used as the measurement standard,no matter what value is used as the critical value,the sIgE concentration range corresponding to the skin index of all levels of allergen positive can not be obtained.This suggests that the idea of using SPT or serum SIGE test as a direct substitute for each other and inferring a test result or even clinical symptoms from only one test is currently difficult to achieve.2.Dermatophagoides farinae and Dermatophagoides pteronyssinus have a wide cross-reaction in allergic diseases,and are positively correlated in the mean diameter and area of the skin prickle test positive wind masses as well as in the serological tests.3.1.Gender has no effect on the allergic rate of house dust mites and dust mites.3.2.In minors,the rates of both house dust mite and dust mite allergy increased with age,and the highest positive rate was found in 7-18 year olds,and then the positive rate decreased with age.3.3.Seasons have no effect on the allergic rate of house dust mites and dust mites. |
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