摘要
目的观察支气管哮喘儿童的过敏原检测结果,探讨过敏原特异性血清特异性免疫球蛋白E(special immunoglobulin E,SIgE)、血清嗜酸粒细胞阳离子蛋白(eosinophil cationic protein,ECP)、总免疫球蛋白E(total immunoglobulin E,TIgE)在支气管哮喘中的临床意义,并对临床干预效果进行评价。方法选取徐州市儿童医院2012年1月至2017年12月收治的17 479例支气管哮喘儿童为研究对象,统计吸入性过敏原、食入性过敏原、混合型(吸入性+食入性)过敏原检出例次,分析各类过敏原感染种类分布情况,观察过敏原SIgE检出阳性儿童与过敏原SIgE检出阴性儿童的血清ECP和TIgE表达情况,并以第1秒用力呼吸量(forced expiratory volume in the first second,FEV1)、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气量占所有呼气量比例(forced vital capacity rate of one second,FEV1/FVC)为疗效评价指标,简要评价其临床干预效果。结果 17 479例支气管哮喘儿童中,吸入性过敏原检出共13 078人次(49.67%),食入性过敏原检出共8826人次(33.52%),混合型(吸入性+食入性)过敏原检出共4425人次(16.81%)。吸入性过敏原种类以屋尘螨、粉尘螨、屋尘占比最高,分别为3689人次(14.01%)、3474人次(13.19%)和3243人次(12.32%)。食入过敏原种类以牛奶、鸡蛋占比最高,分别为2839人次(10.76%)和2396人次(9.10%)。吸入性、食入性、混合型过敏原感染种类均以两种占比最高(分别为56.02%、47.00%和36.56%)。17 479例支气管哮喘儿童过敏原类型(吸入性、食入性、混合型)在年龄分布特征上差异具有统计学意义(χ^(2)值分别为770.654,17.949和502.403,P值均<0.05),在性别分布特征上差异无统计学意义(P>0.05)。SIgE阳性儿童的血清ECP、血清TIgE显著高于SIgE检出阴性儿童,差异具有统计学意义(t值分别为118.746和83.373,P值均<0.05);经临床干预后,FEV1、FVC、FEV1 /FVC均显著升高,哮喘发作次数明显减少,与临床干预前比较差异具有统计学意义(t值分别为99.144,48.689,364.157和32.256,P值均<0.05)。结论本地区支气管哮喘儿童过敏原以屋尘螨、粉尘螨、屋尘、牛奶、鸡蛋为主,且吸入性过敏原感染明显高于食入性过敏原,SIg可以用来帮助医师进行过敏原判定。另外,过敏原的年龄分布特征差异也应引起重视。
Objective To observe the results of allergen detection in patients with bronchial asthma,and the clinical significance of allergen specific serum special immunoglobulin E(SIgE),eosinophil cationic protein(ECP)and total immunoglobulin E(TIgE)in bronchial asthma,then to evaluate the effect of clinical intervention.Methods Total of 17479 patients with bronchial asthma admitted in Xuzhou Children's Hospital from January 2012 to December 2017 were selected.The cases of inhalation allergens,ingestion allergens and mixed(inhalation+ingestion)allergens were counted.The quantity distribution of allergen infection was analyzed,and the positive cases of allergen SIgE and negative cases of allergen SIgE were observed.The expression of serum ECP and TIgE were evaluated in children with positive allergen SIgE and negative allergen SIgE.The forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and forced vital capacity rate of one second(FEV1/FVC)were used as evaluation indexes.Results Among 17479 children with asthma,13078(49.67%)were detected for inhalational allergens,8826(33.52%)for ingestive allergens,and 4425(16.81%)for mixed(inhalation+ingestion)allergens.House dust mite,Dermatophagoides farinae and house dust accounted for the highest proportion of inhalation allergens,with 3689(14.01%),3474(13.19%)and 3243(12.32%)respectively.Milk and eggs accounted for the highest proportion of allergens,which were 2839(10.76%)and 2396(9.10%)respectively.Inhalation,ingestion,and mixed allergen infections accounted for the highest proportion of two types,which were 56.02%,47.00%and 36.56%respectively.There were significant differences in the age distribution of allergen types(inhalation,ingestion,mixed type)in 17479 children with bronchial asthma(χ^(2) values were 770.654,17.949 and 502.403 respectively,all P values<0.05),and no significant differences were found in gender distribution(P>0.05).The serum ECP and TIgE of SIgE positive children were significantly higher than those of SIgE negative children(t values were 118.746 and 83.373 respectively,all P values<0.05).After clinical intervention,FEV1,FVC,FEV1/FVC increased significantly and the number of asthma attacks decreased significantly compared with before clinical intervention(t values were 99.144,48.689,364.157 and 32.256 respectively,all P values<0.05).Conclusion The main allergens of bronchial asthma patients in this area are house dust mites,Dermatophagoides farinae,house dust,milk and eggs.The inhalation allergen infection is significantly higher than that of food allergens.SIgE can be used to help doctors to determine the allergen.In addition,the difference of age distribution characteristics of allergens is also worthy of attention.
作者
徐佳丽
陈卫伟
张铁英
姜帅
黄宝山
Xu Jiali;Chen Weiwei;Zhang Tieying;Jiang Shuai;Huang Baoshan(Department of Clinical Laboratory,Xuzhou Children's Hospital,Xuzhou 221000,China)
出处
《国际免疫学杂志》
CAS
2021年第1期45-50,共6页
International Journal of Immunology
关键词
支气管哮喘
过敏原
儿童
Bronchial asthma
Allergen
Children
