母親孕期至嬰兒出生一年內，居家空氣中塵蟎及其他影響因子之研究

The Impacts of In-house Airborne Dust Mite and Other Factors on Maternities and Neonatals.

賴盈秀(Ying-Siou Lai)

指導教授 ： 陳培詩

高雄醫學大學/健康科學院/公共衛生學系公共衛生學碩士班/碩士(2016年)

摘要

背景：暴露塵蟎過敏原已被證實會引起致敏反應和過敏性疾病的發生，根據世界過敏組織(World Allergy Organization, WAO)估計全球約有40%的人患有過敏性疾病。而臺灣在2005年研究發現兒童患有過敏性疾病的比率是上升的。值得注意的是，研究發現兒童於嬰兒時期暴露塵蟎原會增加致敏比率，因此本研究將於高雄地區針對母親懷孕期間和嬰兒出生六個月進行居家環境採樣評估空氣中塵蟎原濃度分佈及其他影響因子探討。

材料方法：本研究於高雄醫學大學附設中和醫院婦產科招募34位妊娠中的婦女，於婦女懷孕12-40週、嬰兒出生六個月時進行環境採樣。灰塵樣本採樣地點為：客廳、廚房、臥室、母親及嬰兒之枕頭和床墊；空氣樣本主要採樣地點為客廳和臥室，主要檢測塵蟎過敏原(Der p1、Der f 1)，使用ELISA分析。

結果：研究發現灰塵樣本中Der f 1陽性率比Der p1高，但在濃度的部分則是Der p1比Der f 1高；空氣樣本中Der p1陽性率比Der f 1高，濃度亦同。另將塵蟎過敏原(Der p1、Der f 1)與其他環境因子做比較，發現臥室地板打掃頻率與Der f 1濃度有顯著差異(p<0.05)、住宅型態的不同在廚房地板中Der f 1濃度有顯著差異(p<0.05)。相關的部分；Der f 1客廳空氣濃度分別與臥室空氣濃度呈顯著相關(r=0.85, p<0.01)、Der f 1陽台空氣濃度呈顯著相關(r=0.66, p<0.01)、另Der f 1陽台空氣濃度與床墊灰塵濃度呈顯著相關(r=0.70, p<0.05)。

結論：本研究提供高雄地區居家環境中塵蟎過敏原(Der p1、Der f 1)濃度分佈情形，不論是灰塵樣本或是空氣樣本。以及顯示灰塵樣本和空氣樣本之間不同的趨勢，表示過去研究利用灰塵樣本中塵蟎過敏原濃度可能無法代表整體暴露。

關鍵字

Airborne ； 塵蟎過敏原 ； Der p1 ； Der f 1 ； ELISA ； 孕婦 ； 嬰兒

並列摘要

Background: Dust mite allergen has been known that it may cause sensitization and allergic diseases. World Allergy Organization (WAO) estimated there were about 40 percent of whole population suffered from allergic diseases around the world. Studies in Taiwan also indicated that more and more children suffered from allergic diseases in 2005. However, most studies have said that children exposed to dust mite allergen in their infancy may increase the risk of allergy. Thus, this study sampled in house areas which pregnant women and six months old babies lived and then evaluated the concentrations of Dust mite allergens and other effective factors in Kaohsiung city.
Materials and methods: This study recruited 34 pregnant women from the OBGYN department of a medical center in Kaohsiung, and then investigated the concentrations of house dust mite allergen inside the dust and air in their houses while they were at 28-40 weeks of pregnancy or their babies were at six months after childbirth. Dust samplings were conducted at living rooms, kitchens, bedrooms and the mattresses and the pillows on which mothers and babies slept. Air samplings were conducted at living rooms, bedrooms and balconies. The concentrations of Dust mite allergens (Der p1 and Der f1) were investigated by using microplate ELISA reader.
Results: In dust samplings, Der f1 had higher positive rate than Der p1. However, the concentrations of Der f1 were lower than the concentrations of Der p1. In air samplings, whether positive rate or concentrations were Der p1 higher than Der f1. Comparing Dust mite allergens with other environmental factors showed that there were significant differences between sweeping frequency in bedroom and the concentrations of Der f1 (p < 0.05). There were significant differences between the concentrations of Der f1 at floors of kitchens in different household patterns (p < 0.05). There were significant differences between cleaning frequency of beddings and the concentrations of Der p1 (p < 0.05). The correlation comparing of the concentrations of Der f1 in living rooms respectively showed that there were significant differences to bedrooms (r = 0.85, p < 0.01), balconies (r = 0.66, p < 0.01)and the total air samples (r = 0.99, p < 0.01). Furthermore, there were significant differences between the concentration of Der f1 in the air of balconies and the concentrations of Der f1 in the dust of mattresses. (r = 0.70, p < 0.05).
Conclusions: This study applied the concentration distribution of household environmental Dust mite allergens whether dust samples or air samples. And this results showed that there were different trends between dust samples and air samples. Even though previous studies used dust samples as the Dust mite allergens exposure, this results revealed that the concentrations of dust samples might not represent the true exposure of Dust mite allergens.

並列關鍵字

Airborne ； Dust mite allergens ； Der p1 ； Der f1 ； ELISA ； Pregnant women ； Infant

參考文獻

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