儿童支气管哮喘严重程度与血清IgE关系的研究
摘要
目的:研究不同严重程度的支气管哮喘患儿过敏原状况以指导临床防治。
方法:采用酶联免疫吸附法检测73例3岁～12岁不同严重程度哮喘患儿血清总IgE及过敏原特异性IgE抗体。
结果:所研究患儿总IgE抗体阳性率为65.8%;73例患儿中总IgE阳性者48例,其特异性IgE全部阳性,而总IgE阴性者25例中,特异性IgE阳性者22例;不同过敏原特异性IgE抗体的阳性率以屋尘和螨虫阳性率最高(屋尘74.0%,户尘螨63.0%);各组患儿总IgE抗体阳性结果差异有统计学意义(X~2 =37.7869,P<0.0001);各组患儿检出过敏原种类差异有统计学意义(X~2 =20.8437,P= 0.0001)。
结论:本研究提示支气管哮喘与过敏因素密切相关,特异性IgE作为小儿哮喘过敏性的检测指标更敏感、更直接。屋尘和户尘螨是3岁以上儿童哮喘发作的主要诱因。支气管哮喘患儿的哮喘严重程度与其血清总IgE水平的高低呈正相关。并且对多种抗原表现特异性IgE阳性者往往病情较重。
Objective: To investigate sensibiligen state of different degree of bronchial asthma in children and guide the clinical prevention and cure.
Methods: 73 children (age range, 3～12 years) with different degree of bronchial asthma were included in the study, and all children had their serum total IgE and specific IgE antibody of sensibiligen measured with enzyme linked immunosorbent assay.
Results: The positive rate of general serum IgE antibody in all children were 65.8%; All 48 children who positive in general serum IgE are positive in specific IgE, however, 22 of other 25 children who negative in general serum IgE are positive in specific IgE; The positive rates of house dust and acarid are most high in all specific IgE antibody of different sensibiligen, and their positive rates were 74.0% and 63.0%, respectively; There was statistically significant difference in serum total IgE between different group(X2 =37.7869,P<0.0001); There was statistically significant difference in different sensibiligen between different group (X2 =20.8437,P= 0.0001).
Conclusions: This study indicates that bronchial asthma is very associated with sensibiligen, and specific IgE is more sensitive and direct for the detection of bronchial asthma in children. House dust and acarid are primary motivation of asthmatic attack in children. The degree of bronchial asthma in children is positive correlation with serum total IgE level. Moreove, the patients who had positive in specific IgE antibody of various antigens are common more severe in the pathogenetic condition.
方法:采用酶联免疫吸附法检测73例3岁～12岁不同严重程度哮喘患儿血清总IgE及过敏原特异性IgE抗体。
结果:所研究患儿总IgE抗体阳性率为65.8%;73例患儿中总IgE阳性者48例,其特异性IgE全部阳性,而总IgE阴性者25例中,特异性IgE阳性者22例;不同过敏原特异性IgE抗体的阳性率以屋尘和螨虫阳性率最高(屋尘74.0%,户尘螨63.0%);各组患儿总IgE抗体阳性结果差异有统计学意义(X~2 =37.7869,P<0.0001);各组患儿检出过敏原种类差异有统计学意义(X~2 =20.8437,P= 0.0001)。
结论:本研究提示支气管哮喘与过敏因素密切相关,特异性IgE作为小儿哮喘过敏性的检测指标更敏感、更直接。屋尘和户尘螨是3岁以上儿童哮喘发作的主要诱因。支气管哮喘患儿的哮喘严重程度与其血清总IgE水平的高低呈正相关。并且对多种抗原表现特异性IgE阳性者往往病情较重。
Objective: To investigate sensibiligen state of different degree of bronchial asthma in children and guide the clinical prevention and cure.
Methods: 73 children (age range, 3～12 years) with different degree of bronchial asthma were included in the study, and all children had their serum total IgE and specific IgE antibody of sensibiligen measured with enzyme linked immunosorbent assay.
Results: The positive rate of general serum IgE antibody in all children were 65.8%; All 48 children who positive in general serum IgE are positive in specific IgE, however, 22 of other 25 children who negative in general serum IgE are positive in specific IgE; The positive rates of house dust and acarid are most high in all specific IgE antibody of different sensibiligen, and their positive rates were 74.0% and 63.0%, respectively; There was statistically significant difference in serum total IgE between different group(X2 =37.7869,P<0.0001); There was statistically significant difference in different sensibiligen between different group (X2 =20.8437,P= 0.0001).
Conclusions: This study indicates that bronchial asthma is very associated with sensibiligen, and specific IgE is more sensitive and direct for the detection of bronchial asthma in children. House dust and acarid are primary motivation of asthmatic attack in children. The degree of bronchial asthma in children is positive correlation with serum total IgE level. Moreove, the patients who had positive in specific IgE antibody of various antigens are common more severe in the pathogenetic condition.
引文
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2 Burks AW,Sampson HA. Diagnostic approaches to the patient with suspected food allergies. J Pediatricsa , 1992 ,121 :S64
3 王红玉,孙宝清,郑劲平,等. 儿童哮喘与特应性的关系. 实用医学杂志,2002 ,18 :1163～1165.
4 Host A , Halken S , Jacobsen H P , et al. Clinical course of cow’s milk protein allergy/ intolerance and atopic diseases in childhood. Pediatr Allergy Immunol, 2002 ,13(Suppl 15) :23～28.
5 Spergel J M , Paller A S. Atopic dermatitis and the atopic march. J Allergy Clin Immunol , 2003 , 112 ( 6 Suppl) :118～127.
6 Sasai K, Furukawa S , Muto T , et al. Early detection of specific IgE antibody against house dust mite in children at risk of allergic disease. J Pediatr , 1996 , 128 :834～840.
7 罗海标,颜荣.哮喘患儿 94 例血清总 IgE 水平分析.实用临床医学,2005,6(5):120～123.
8 林娜,刘运广. 小儿支气管哮喘与呼吸道感染关系的研究进展[J ] . 国外医学儿科学分册,2003 ,30 (1):46～48.
9 王雯,哈木拉提·吾甫尔,向阳冰,等.维吾尔族支气管哮喘患者血清总 IgE 及 ECP 水平的研究.新疆医科大学学报,2004,27(1):21～24.
10 张景波, 杨建华, 倪玉美, 等. 支气管哮喘患者血清嗜酸细胞阳离子蛋白的变化[J ]. 细胞与分子免疫学杂志, 2000, 1: 372.
11 邓念强, 王琦筠, 万德胜, 等. 无症状气道高反应性与血清特异性 IgE 及血清嗜酸细胞阳离子蛋白的相关性研究[J ]. 中华结核与呼吸杂志, 2000, 6: 213.
12 全国儿科哮喘防治协作组.儿童哮喘防治常规[试行].中华儿科杂志,1998,36(12):747.
13 胡亚美,江载芳.实用儿科学.第 7 版.北京:人民卫生出版社,2002.635.
14 陈育智,赵京,刘宗翰,等.全国十省市螨皮肤过敏情况调查.实用诊断治疗杂志,1994,8(7):3.
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