变应性鼻炎 (AR) 是一种常见疾病,在全球工业化国家,影响多达 30% 的成人和多达 40% 的儿童。[2]European Academy of Allergy and Clinical Immunology. Global atlas of allergic rhinitis and chronic rhinosinusitis. Zurich, Switzerland: EAACI; 2015.http://www.eaaci.org/globalatlas/ENT_Atlas_web.pdf在美国,相关报告显示,医生诊断的 AR 患病率在成人中为 14%,在儿童中为 7%。[3]Meltzer EO, Blaiss MS, Naclerio RM, et al. Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys. Allergy Asthma Proc. 2012 Sep-Oct;33(suppl 1):S113-41.http://www.ncbi.nlm.nih.gov/pubmed/22981425?tool=bestpractice.com 在欧洲,报告的 AR 患病率为 13%。[4]Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004 Nov;24(5):758-64.http://erj.ersjournals.com/content/24/5/758.longhttp://www.ncbi.nlm.nih.gov/pubmed/15516669?tool=bestpractice.com
AR 可影响所有年龄的人群,但诊断为 AR 的患者大约有 80% 在 20 岁之前出现症状。[5]Skoner DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol. 2001;108(suppl 1):S2-8.http://www.ncbi.nlm.nih.gov/pubmed/11449200?tool=bestpractice.com 年长儿童的患病率比年幼儿童的高,13 至 14 岁为发病高峰。[6]Mallol J, Crane J, von Mutius E, et al; ISAAC Phase Three Study Group. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: a global synthesis. Allergol Immunopathol (Madr). 2013 Mar-Apr;41(2):73-85.http://www.ncbi.nlm.nih.gov/pubmed/22771150?tool=bestpractice.com 在儿童早期,男孩比女孩更容易患 AR;[7]Pinart M, Keller T, Reich A, et al. Sex-related allergic rhinitis prevalence switch from childhood to adulthood: a systematic review and meta-analysis. Int Arch Allergy Immunol. 2017;172(4):224-35.https://www.karger.com/Article/FullText/464324http://www.ncbi.nlm.nih.gov/pubmed/28456795?tool=bestpractice.com 从青春期开始,女孩新发 AR 症状的几率较高,到 20 岁后,男性和女性的 AR 患病率相同。[7]Pinart M, Keller T, Reich A, et al. Sex-related allergic rhinitis prevalence switch from childhood to adulthood: a systematic review and meta-analysis. Int Arch Allergy Immunol. 2017;172(4):224-35.https://www.karger.com/Article/FullText/464324http://www.ncbi.nlm.nih.gov/pubmed/28456795?tool=bestpractice.com
正如一项标志性的儿童哮喘与过敏国际研究 (International Study of Asthma and Allergies in Childhood, ISAAC) 表明,AR 的患病率在不同国家之间的差异很大,该研究回顾了 56 个国家 463,801 例 13 至 14 岁儿童中过敏性鼻结膜炎、哮喘和特应性皮炎的自诉症状。[8]International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet. 1998 Apr 25;351(9111):1225-32.http://www.ncbi.nlm.nih.gov/pubmed/9643741?tool=bestpractice.com 在该研究的初始阶段(在 1992 年至 1998 年之间开展)发现,AR 在英国、澳大利亚、新西兰和爱尔兰患病率最高,其次是北美洲、中美洲和南美洲;而在东欧国家、印尼、希腊、中国、乌兹别克斯坦、印度、埃塞俄比亚患病率最低。在 2002 年至 2003 年期间重复开展了 ISAAC 研究,发现大多数国家的 AR 患病率总体上升,尤其是在年幼儿童中。[9]Asher MI, Montefort S, Bjorksten B, et al. ISAAC Phase Three Study Group. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733-43.http://www.ncbi.nlm.nih.gov/pubmed/16935684?tool=bestpractice.com