严重过敏反应常被低估,而且目前仍缺乏非常实用的临床定义和共识标准。[2]Sampson HA, Muñoz-Furlong A, Bock SA, et al. Symposium on the definition and management of anaphylaxis: summary report. J Allergy Clin Immunol. 2005;115:584-591.http://www.ncbi.nlm.nih.gov/pubmed/15753908?tool=bestpractice.com[3]Sampson HA, Muñoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report - second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006;117:391-397.http://www.jacionline.org/article/S0091-6749%2805%2902723-5/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/16461139?tool=bestpractice.com[5]Campbell RL, Hagan JB, Manivannan V, et al. Evaluation of National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria for the diagnosis of anaphylaxis in emergency department patients. J Allergy Clin Immunol. 2012;129:748-752.http://www.ncbi.nlm.nih.gov/pubmed/22051698?tool=bestpractice.com[6]Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis: a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115:341-384.http://www.ncbi.nlm.nih.gov/pubmed/26505932?tool=bestpractice.com鉴于此,很难搜集到严重过敏性反应的发病率和患病率的准确数据。美国总体人群患病率估计为 1% 至 17%,而 0.002% 的人可能死于严重过敏性反应。[7]Neugut AI, Ghatak AT, Miller RL. Anaphylaxis in the United States: an investigation into its epidemiology. Arch Intern Med. 2001;161:15-21.http://archinte.jamanetwork.com/article.aspx?articleid=646961http://www.ncbi.nlm.nih.gov/pubmed/11146694?tool=bestpractice.com也有报告说,终生患病率介于 0.05% 至 2%,报告引用了近期在北美、欧洲和澳洲开展的研究。[8]Lieberman P, Camargo CA Jr, Bohlke K, et al. Epidemiology of anaphylaxis: findings of the American College of Allergy, Asthma and Immunology Epidemiology of Anaphylaxis Working Group. Ann Allergy Asthma Immunol. 2006;97:596-602.http://www.ncbi.nlm.nih.gov/pubmed/17165265?tool=bestpractice.com这些估计值差异很大,原因是人群不同、诊断方法不同和分类标准不同。不同的变应原,其发病率和患病率有差异。在成人中,因青霉素和非甾体抗炎药引起的药物和疫苗诱发反应最为常见。在幼童中,编码为严重过敏反应的食物过敏反应发生率最高。[9]Umasunthar T, Leonardi-Bee J, Turner PJ, et al. Incidence of food anaphylaxis in people with food allergy: a systematic review and meta-analysis. Clin Exp Allergy. 2015;45:1621-1636.http://www.ncbi.nlm.nih.gov/pubmed/25495886?tool=bestpractice.com在儿童中,工业化国家和东南亚新兴经济体最常见的原因是食物过敏,可能同加工食品接触增多有关。食物过敏无明显性别差异。[10]Bock SA, Muñoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001;107:191-193.http://www.ncbi.nlm.nih.gov/pubmed/11150011?tool=bestpractice.com有报告说,香港男性发生食物严重过敏反应的几率略高[11]Smit DV, Cameron PA, Rainer TH. Anaphylaxis presentations to an emergency department in Hong Kong: incidence and predictors of biphasic reactions. J Emerg Med. 2005;28:381-388.http://www.ncbi.nlm.nih.gov/pubmed/15837017?tool=bestpractice.com,而澳大利亚则是女性的发生率更高。[12]Brown AF, McKinnon D, Chu K. Emergency department anaphylaxis: a review of 142 patients in a single year. J Allergy Clin Immunol. 2001;108:861-866.http://www.ncbi.nlm.nih.gov/pubmed/11692116?tool=bestpractice.com