高雄市孕婦及新生兒居家塵蟎過敏原分布與影響因子之探討

Airborne mite allergens and its influence factors in pregnant women and newborns’ houses in Kaohsiung City, Taiwan

林奐均(Huan-Chun Lin)

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(2017年)

摘要

背景：在台灣，有80%以上的兒童對塵蟎過敏，當暴露於2μg/ g以上塵蟎過敏原的環境之下，會導致哮喘疾病的發生。然而嬰幼兒的中樞免疫系統尚未發展完全，因此嬰幼兒所暴露環境中的塵蟎過敏原對於嬰幼兒的發展相當重要。
目的：本研究評估高雄市孕婦與新生兒家中空氣與灰塵中塵蟎過敏原的濃度分佈，並探討環境因子與塵蟎過敏原之間的相關性。
材料與方法：本研究針對懷孕婦女與新生兒的家中進行環境採樣，分別在客廳、臥室和陽台採集空氣樣本，於地板、寢具和冷氣過濾網採集灰塵樣本，並且評估空氣中塵蟎過敏原的粒徑分佈，使用ELISA分析塵蟎過敏原Der p 1 與Der f 1。
結果：在超過95%的孕婦及新生兒的臥室中檢測到空氣中存在Der p 1與Der f 1，而在超過89%的孕婦及新生兒家戶的地苯及寢具檢測到灰塵中存在Der p 1與Der f 1。其中寢具上的塵蟎過敏原顯著高於地板上的塵蟎過敏原。在粒徑分析的結果發現Der p 1的粒徑小於Der f 1，高相對濕度與溫度顯著增加空氣中塵蟎過敏原的濃度，而打掃頻率低也會顯著增加空氣中塵蟎過敏原的濃度。此外，由於Der p 1的粒徑較小，也適合生活在溫濕度範圍廣的環境中，說明了Der p 1 在空氣中的濃度大於Der f 1。
結論：氣候與環境因子對於塵蟎過敏原濃度有顯著的影響，特別是針對空氣中的塵蟎過敏原的影響最大。由於Der p 1的粒徑小於Der f 1，因此較容易揚起於空氣中，又Der p 1更能適應溫濕度範圍較大的環境，因此應證Der p 1濃度大於Der f 1之原因。

關鍵字

Airborne ； 塵螨過敏原 ； Der p1 ； Der f 1 ； ELISA ； 孕婦 ； 新生兒

並列摘要

Background: More than 80% of children were allergic to mite allergen in Taiwan. People who exposed to more than 2μg / g of dust mite allergens could lead to the occurrence of asthma disease. Because babies' central and immune system was still developing, the concentration of mite allergens for babies might be important.
Objectives: We assessed mite allergen concentration in air and dust samples, and explored the correlation between environmental factors and mite allergens in the households of pregnant women and newborns.
Materials and methods: Air samples were collected for 24 hours from living room, bedroom and balcony in 90 house of pregnant women or newborns. Dust samples were collected from floor, bedding, and air-conditioning filters. In addition, size distribution of airborne mite allergens were also evaluated. Der p 1 and Der f 1allergens were simultaneously analyzed by ELISA kit.
Results: Airborne Der p 1 and Der f 1 mite allergens were found in more than 95% of pregnant women and newborns’ bedrooms. In dust samples, Der p 1 and Der f 1 from floor and bedding samples were found in more than 89% of pregnant women and newborns’ families. Among them, the concentration of mite allergens from bedding was significantly higher than that from floor. We also found the particle size distribution of Der p 1 was smaller than Der f 1. High relative humidity significantly increased the concentration of airborne mite allergens. Low cleaning frequency also increased the concentration of airborne mite allergens. In addition, the concentration of airborne Der p 1 was higher than that of Der f 1 probably because Der p 1 had a smaller particle size distribution and adapted to a wide range of temperature and relative humidity.
Conclusions: Climate and environmental factors had a significant impact on mite allergens, particularly airborne mite allergens. In addition, the concentration of airborne Der p 1 was significantly higher than airborne Der f 1. The smaller size distribution, high relative humidity and temperature of Der p 1 might be the reason.

並列關鍵字

Airborne ； Mite allergen ； Der p 1 ； Der f 1 ； ELISA ； Pregnant women ； Newborns

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