首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到18条相似文献,搜索用时 187 毫秒
1.
目的 : 探讨慢性荨麻疹患者甲状腺自身抗体及自体血清皮肤试验的意义。方法 : 采用放射免疫法 ,对 6 0例慢性荨麻疹患者的甲状腺激素自身抗体及功能进行检测 ;对甲状腺自身抗体阳性的慢性荨麻疹患者进行自体血清皮肤试验。结果 :  6 0例慢性荨麻疹患者中甲状腺过氧化物酶抗体及促甲状腺受体自身抗体的阳性率分别为 2 1.7% (13 6 0 )和 15 % (9 6 0 ) ,均显著高于正常对照组 (P均 <0 .0 1)。 13例甲状腺自身抗体阳性的慢性荨麻疹患者自体血清皮肤试验 7例 (5 3.8% )阳性 ,显著高于自身抗体阴性对照组 (P <0 .0 1)。结论 : 甲状腺自身抗体的测定及自体血清皮肤试验对自身免疫性慢性荨麻疹有一定的诊断意义  相似文献   

2.
【摘要】 目的 探讨抗高亲和力IgE受体(FcεRI)抗体、抗IgE抗体、抗幽门螺杆菌(HP)抗体和抗甲状腺球蛋白抗体(TGAb)与慢性特发性荨麻疹(CIU)发病的关系。 方法 设(CIU)组、急性荨麻疹(AU)组和健康对照组,每组100例受试者。每例受试者均进行自体血清皮肤试验,荧光酶联免疫吸附法检测过敏原,血清总IgE、抗FcεRI抗体、抗IgE抗体、抗HP抗体、TGAb水平及阳性率,将CIU组与AU组和健康对照组比较。结果 CIU组自体血清皮肤试验阳性率为53%,AU组为12%,健康对照组未发现阳性者。CIU组和健康对照组过敏原检测均为阴性,而AU组能检测到食物或吸入物过敏原,阳性率为86%。 CIU组抗FcεRI抗体和抗IgE抗体水平均高于AU组和健康对照组(P < 0.05); CIU患者IgE水平低于健康对照组(T = 190.00,P < 0.05),而AU组IgE水平高于健康对照组(T = 226.00,P < 0.05); 自体血清皮肤试验阳性CIU患者抗FcεRI抗体水平较阴性患者高(T = 101.73,P < 0.05),抗IgE抗体在自体血清皮肤试验阳性和阴性CIU患者间,差异无统计学意义(T = 312.04,P > 0.05); CIU组、AU组、和健康对照组抗HP抗体阳性率分别为29%、19%和23%,TGAb阳性率分别为18%、15%和11%,抗HP抗体和TGAb阳性率在三组间比较,差异均无统计学意义(P > 0.05); 抗HP抗体阳性的CIU患者中,抗FcεRI抗体阳性率较AU患者和健康人高(P < 0.01);抗IgE抗体阳性率与AU患者和健康人差异无统计学意义(P > 0.05)。TGAb阳性的CIU患者中,抗FcεRI抗体阳性率较AU患者和健康人高(P < 0.01),抗IgE抗体阳性率与AU患者和健康人比较,差异无统计学意义(P > 0.05)。结论 CIU存在抗FcεRI和抗IgE自身抗体,可能在自身免疫性荨麻疹发病中起一定作用。 【关键词】 荨麻疹; 自身抗体; 免疫球蛋白E; 皮肤试验  相似文献   

3.
自体血清皮肤试验在慢性特发性荨麻疹中的应用研究   总被引:4,自引:0,他引:4  
目的探讨自体血清皮肤试验(autologousserumskintest,ASST)在慢性特发性荨麻疹(chronicidiopathicurticaria,CIU)中的临床应用价值,分析ASST阳性的CIU患者的临床特点。方法采用ASST,对CIU患者组185例、健康对照组20名,过敏性疾病对照组50名患者(湿疹12例,异位性皮炎9例,面部皮炎6例,人工荨麻疹11例,支气管哮喘4例,过敏性鼻炎8例),进行测定,并记录临床症状评分及病史。结果185例CIU患者中ASST阳性率为35.68%(66/185),过敏疾病对照组及健康对照组全部阴性,3组间阳性率差异有显著性(P<0.05)。按ASST阳性结果将CIU组分为ASST阳性组与ASST阴性组。ASST阳性组的组胺风团直径较其他3组大(P<0.05),ASST阳性组在年龄分布、性别、病程等方面与ASST阴性组无统计学差异,ASST阳性的CIU患者皮疹的风团数量较多(P=0.001),风团持续时间较长(P=0.003),具有甲亢病史的患者(6.48%,12/185)出现ASST阳性结果的比例较高(58.3%,7/12)。结论在CIU患者血清是否存在自身抗体的初筛检查中,自体血清皮肤试验具有临床诊断价值及特异性,ASST阳性的慢性荨麻疹患者具有较严重的临床症状。  相似文献   

4.
目的探讨慢性自发性荨麻疹患者自体血清皮肤试验在临床中的应用价值。方法对154例慢性自发性荨麻疹患者及30名健康志愿者做自体血清皮肤试验,并对结果进行分析。结果 154例患者中67例(43.5%)患者检出阳性结果,对照组全部阴性;自体血清皮肤试验阳性与阴性的慢性自发性荨麻疹患者在性别、年龄分布及病程上差异无统计学意义(P0.05),自体血清皮肤试验阳性的慢性自发性荨麻疹患者症状评分及瘙痒持续时间明显高于阴性患者(P0.05),自体血清皮肤试验阳性程度与瘙痒持续时间呈正相关(P0.05)。自体血清皮肤试验阳性的慢性自发性荨麻疹患者伴发过敏史(药物、食物、吸入物)的比例高于阴性的患者(P0.05)。结论自体血清皮肤试验阳性的慢性自发性荨麻疹患者较阴性者病情重,该试验作为慢性荨麻疹功能性自身抗体的筛选试验可在临床上广泛应用。  相似文献   

5.
目的:比较慢性自发性荨麻疹(CSU)患者血清特异性IgE抗体检测结果与自体血清皮肤试验(ASST)的关系,探讨ASST的临床意义。方法:对305例慢性自发性荨麻疹患者同时进行血清特异性IgE抗体检测及自体血清皮肤试验(ASST),对两组的阳性率进行统计分析。结果:305例CSU患者螨虫组合(屋尘螨/粉尘螨)血清特异性IgE抗体与ASST总阳性率分别为47.87%和58.03%,ASST阳性组和阴性组中螨虫组合血清特异性IgE抗体阳性率分别为34.46%和66.41%,两组差异有统计学意义(P<0.05)。ASST阳性程度与对应螨虫、屋尘、狗、大豆、虾血清特异性IgE抗体检测水平呈负相关性(P<0.05)。结论:CSU患者部分常见变应原血清特异性IgE抗体与自体血清皮肤试验结果呈负相关,建议将ASST纳入常规CSU临床检测,ASST阳性的患者可以不进行血清特异性IgE抗体检测。  相似文献   

6.
慢性荨麻疹患者变应原检测及自体血清试验临床分析   总被引:4,自引:0,他引:4  
目的:探讨慢性荨麻疹患者变应原检测和自体血清皮肤试验的临床意义。方法:皮肤点刺试验(SPT)检测30种变应原皮试液(包括吸入性和食物性),以生理盐水作阴性对照,以组胺作阳性对照,注射于前臂屈侧,20-30分钟后观察结果。自体血清试验(ASST)以自体血清注射于一侧前臂,另一侧注射生理盐水作阴性对照,30分钟后观察结果。结果:787例慢性荨麻疹患者中SPT有550例阳性(69.89%),6种以上变应原阳性332例(42.19%),吸入组阳性516例(65.57%)明显高于食物组309例(39.26%);ASST阳性为244例(31.00%),SPT阴性组ASST阳性率明显高于SPT阳性组。结论:SPT可以帮助我们寻找引起慢性荨麻疹的相关变应原。ASST阳性表明患者血清中存在自身抗体,可以作为自身免疫性荨麻疹的筛选试验。  相似文献   

7.
目的 :探讨慢性荨麻疹患者自体血清皮肤试验的意义。方法 :对 4 0例慢性荨麻疹患者以及2 0例正常对照者、1 0例皮肤划痕症、1 0例异位性皮炎患者进行自体血清皮肤试验。结果 :4 0例慢性荨麻疹患者中 1 3例 (32 5 % )自体血清皮肤试验阳性 ,正常对照组和皮肤划痕症及异位性皮炎患者均为阴性 ,慢性荨麻疹患者的自体血清皮肤试验阳性率显著高于正常对照组及皮肤划痕症和异位性皮炎组 (P值均 <0 0 5 )。结论 :自体血清皮肤试验的测定对自身免疫性慢性荨麻疹有一定的诊断意义。  相似文献   

8.
目的 探讨自体血清皮肤试验阳性的慢性荨麻疹患者的临床特点。方法 从82例慢性荨麻疹患者中筛选出29例自体血清皮肤试验阳性患者,对其症状体征及病史等进行分析,并用放免法测定其血清中的抗甲状腺球蛋白抗体(TG-AB)和抗甲状腺微粒体抗体(TM-AB),与自体血清皮肤试验阴性的慢性荨麻疹患者进行对比。结果 自体血清皮肤试验阳性与阴性的慢性荨麻疹患者在年龄分布、病程上差异无统计学意义(P>0.05)。两组患者症状体征评分比较,自体血清皮肤试验阳性患者皮疹发作时风团较大(P<0.05),数量较多(P<0.01),每次发作持续时间较长(P<0.05),瘙痒更剧烈(P<0.05);但风团外观较红,隆起不明显(P<0.01);而两组患者的皮疹发作频次差异无统计学意义(P>0.05)。自体血清皮肤试验阳性的慢性荨麻疹患者伴发血管神经性水肿及系统症状的比例较高,伴随其他自身免疫相关疾病和甲状腺抗体阳性的比例也明显高于自体血清皮肤试验阴性患者(P<0.05)。结论 自体血清皮肤试验阳性的慢性荨麻疹多表现为较严重的慢性荨麻疹。  相似文献   

9.
目的 探讨慢性特发性荨麻疹(CIU)与瘦素水平的相关性。方法 对45例CIU患者做了自体血清皮肤试验(ASST),根据结果分为ASST阳性组及ASST阴性组,对CIU各组与32例正常对照组之间,采用放射免疫技术检测其血清瘦素水平,并进行比较。结果 (1)45例CIU患者中ASST阳性率为37.78%。(2)CIU患者血清瘦素水平(12.51士4.29ng/ml)较正常对照(15.57士4.38ng/ml)显著降低(P<0.01)。(3)与正常对照(15.57士4.38ng/ml)比较,ASST阳性组(11.30士4.41ng/ml)及ASST阴性组(13.23士4.13ng/ml)血清瘦素水平分别显著降低(P值分别为0.002,0.039);而ASST阳性组与ASST阴性组间瘦素水平无显著性差异(P>0.05)。结论 CIU患者瘦素水平下降,瘦素可能在CIU的发生发展中起作用。  相似文献   

10.
荨麻疹患者特异性IgE及过敏原检测与分析   总被引:16,自引:4,他引:16  
目的为进一步了解荨麻疹的致病因素及各种因素之间的相互关系。方法采用过敏原体外检测试剂盒、自体血清皮肤试验及斑贴试验等方法对不同类型荨麻疹患者进行血清特异性IgE、自身抗体及接触性过敏原检测。结果116例患者中有84例(72.4%)至少有一项过敏原阳性。至少一项强阳性的16例,强阳性率为13.8%。各种物质的阳性率差异无显著性(P>0.05)。53例自体血清皮肤试验有20例(37.7%)出现阳性反应。有26例同时进行了上述2项试验。14例自体血清皮肤试验阳性的荨麻疹患者血清特异性IgE均无强阳性反应,而12例自体血清皮肤试验阴性的患者中有4例(33.3%)呈强阳性反应(P<0.05)。对21例慢性荨麻疹患者进行斑贴试验,有19例(90.5%)至少对其中一种物质过敏。20种物质中有15项出现阳性,其中重铬酸钾、硫酸镍、橡胶的阳性率达到了38.1%。结论荨麻疹的病因是多方面的,既有可能对外界物质过敏,又有可能存在自身免疫的问题。同一患者可能同时存在2种不同类型的变态反应;接触性过敏原可引起接触性荨麻疹。  相似文献   

11.
BACKGROUND: A positive autologous serum skin test (ASST) is considered to reflect the presence of anti-FceRI and/or anti-IgE autoantibodies that are capable of activating mast and basophil cell degranulation. The ASST is regarded as a reliable in vivo test in chronic idiopathic urticaria (CIU) patients, with diagnostic, therapeutic and prognostic implications. However, positive ASST results have also occasionally been demonstrated in patients with other diseases and in healthy subjects. OBJECTIVE: To evaluate the specificity and sensitivity of the ASST in a cohort of CIU patients compared to a cohort of respiratory-allergic patients and a group of normal individuals. METHODS: ASST was performed in a cohort of 116 subjects, 47 subjects with seasonal allergic rhinitis, 32 respiratory-symptom-free CIU patients, and 37 healthy individuals. RESULTS: The results were compared statistically to those of the CIU patients. The intradermal injection of autologous serum induced a weal and flare reaction in 17/32 (53.1%) CIU patients; 14/47 (29.8%) patients with seasonal allergic rhinitis (P=0.06) and in 15/37 (40.5%) of the healthy controls (P=0.34). The sensitivity and specificity of the ASST in the CIU patients and the seasonal allergic rhinitis patients was 53 and 28%, respectively. When comparing the CIU patients with the healthy controls the sensitivity and specificity was 55 and 31%, respectively. The positive and negative predictive values of the ASST when comparing CIU patients with healthy controls were 53 and 59.5%, respectively. The positive and negative predictive values of the ASST in the CIU patients compared to seasonal allergic rhinitis patients were 53 and 70%, respectively. CONCLUSION: The relatively low sensitivity and specificity of the ASST in the CIU patients compared to the seasonal allergic rhinitis patients and healthy controls warrants a more critical interpretation of the ASST in chronic idiopathic urticaria.  相似文献   

12.
Background. Recent data indicate that the autologous serum skin test (ASST) shows a high rate of reactivity not only in chronic idiopathic urticaria (CIU) but also in cases with non‐allergic asthma and rhinitis (NAAR), multiple drug allergy syndrome (MDAS) and even in some healthy people. Aim. To evaluate ASST reactivity in patients with CIU, allergic/non‐allergic asthma or rhinitis and in healthy controls. Methods. We studied 80 patients with CIU, 40 non‐atopic patients with NAAR, 57 patients with allergic rhinitis (AR) and allergic bronchial asthma (ABA), and 45 healthy controls. ASST was performed in all patients and controls, and it was considered positive when a serum‐induced weal with a diameter 1.5 mm greater than the negative (saline) control, surrounded by erythema, was present. Results. In total, 42 patients with CIU showed ASST reactivity (52.5%). ASST was found to be positive in 8 of 40 patients with NAAR (20%). The rate was similar (17.5%) in the AR/ABA patient group. However, 25 healthy controls (55.5%) also had positive ASST. The highest rate was in female controls and in individuals in the 18–30‐year‐old age group. Conclusion. The data indicate that ASST positivity might be a nonspecific phenomenon, influenced by many factors. In the light of the results of this study, we suggest that the significance of ASST reactivity should be re‐evaluated in CIU. In addition, the importance of ASST reactivity in patients with AR/ABA and in patients with NAAR remains unclear, and further controlled studies are needed.  相似文献   

13.
One-third of patients with chronic idiopathic urticaria (CIU) have circulating functional autoantibodies against the high affinity IgE receptor FcepsilonRI, or IgE. The intradermal injection of autologous serum causes a weal and flare reaction in many patients with CIU, and this reaction forms the basis of the autologous serum skin test (ASST). We have determined the parameters of the ASST which define the optimal sensitivity and specificity for the identification of patients with autoantibodies. Two physicians (R.A. S. and C.E.H.G.) performed ASSTs in a total of 155 patients with CIU, 40 healthy control subjects, 15 patients with dermographism, nine with cholinergic urticaria and 10 with atopic eczema. Patients were classified as having functional autoantibodies by demonstrating in vitro serum-evoked histamine release from the basophils of two healthy donors. There were significant differences (P < 0.001) in the mean weal diameter, weal volume, weal redness and flare area of the intradermal serum-induced cutaneous responses at 30 min between patients with CIU with autoantibodies and either those without autoantibodies or control subjects. The optimum combined sensitivity and specificity of the ASST was obtained if a positive test was defined as a red serum-induced weal with a diameter of >/= 1.5 mm than the saline-induced response at 30 min. For R.A.S. and C.E.H.G., the ASST sensitivity was 65% and 71% and specificity was 81% and 78%, respectively. Using these criteria, the following subjects had positive ASSTs: none of 15 dermographics, none of 10 atopics, one of nine cholinergics and one of 40 controls.  相似文献   

14.
Autologous serum skin test (ASST) reactivity is positive in up to 60% of patients with chronic idiopathic urticaria (CIU). About 21 to 30% of patients with CIU have intolerance to acetyl salicylic acid (ASA) and/or other chemically unrelated non-steroidal anti-inflammatory drugs (NSAIDs). To investigate the relationship between ASA/NSAID intolerance and ASST reactivity, a case-control study was performed in 110 patients with CIU and 60 healthy controls. A positive ASST was defined as an erythematous wheal with a diameter of > 5 mm more than the saline-induced response. Patients were assessed at 10-minute intervals for a minimum of three hours. ASA/NSAID intolerance was ascertained by a placebo controlled-provocation test with offending drug (s). Forty-two patients with CIU (38.2%) had autoreactivity whereas only two of the controls (3.3%) displayed early and weak skin responses (P<.0001). ASA/NSAID intolerance was demonstrated in 30 (27.3%) patients with CIU. The prevalences of autoreactivity were 93.3% (28/30) and 17.5% (14/80) in patients with and without ASA/NSAID intolerance, respectively (P<.001). Thirteen of the 25 ASST-positive patients (52%) who had single (n: 7) or multiple (n: 6) NSAID intolerance showed early (before or at 30 min) and mild autoreactivity of short duration, whereas 15 of the remaining 17 ASST-positive patients (88.2%) who all had multiple NSAID intolerance showed delayed (later than 30 min) and prolonged autoreactivity (P<.05). These findings suggest that a common mechanism may be responsible for the pathogeneses of both delayed autoreactivity and multiple NSAID intolerance in CIU. It might be further speculated that delayed, prolonged, and pronounced autoreactivity may be a possible predictor for multiple NSAID sensitivity in CIU.  相似文献   

15.
Oxidative stress is an important event in lesional skin of patients with chronic idiopathic urticaria (CIU). In the present study, we assessed blood oxidant/antioxidant status of patients suffering from CIU with positive response to autologous serum skin test (ASST) and with negative ASST, to improve our understanding of biological processes and the part of oxidative stress in this disease. Activities of manganese superoxide dismutase (MnSOD), copper–zinc superoxide dismutase (Cu/ZnSOD), glutathione peroxidase (GSH-PX), and catalase (CAT) as indices of enzymatic antioxidant capacity, as well as malondialdehyde (MDA) level as a maker of lipid peroxidation were measured in plasma and erythrocytes from 14 CIU female patients showing positive ASST, 31 CIU female patients with negative ASST and in 19 sex- and age- matched healthy subjects. The antioxidant enzyme activity in plasma and in erythrocytes did not differ significantly among the three groups. Also, the plasma and erythrocytes MDA levels were similar in the three groups. Based on our results, it seems that systemic activity of the enzymatic antioxidants (CuZn/SOD, MnSOD, GSH-Px, and CAT) as well as level of lipid peroxidation determined by MDA may not be increased in the course of immune-inflammatory processes associated with CIU. We also suggest that the systemic oxidant/antioxidant status of CIU patients, showing positive response to ASST, may not be different from that of CIU patients with negative ASST.  相似文献   

16.
Background.  A role for complement in autoantibody-mediated histamine release in urticaria has been suggested but not proven in vivo .
Aim.  To study serum complement levels in patients with chronic idiopathic urticaria (CIU) and to determine whether there was a relationship with autologous serum skin test (ASST) reactivity.
Methods.  We recruited 35 patients with CIU. Complement (C3, C4) levels and ASST were measured in all patients; additional investigations were undertaken dependent on history and examination.
Results.  Complement concentrations were outside the population reference intervals in 19/35 patients, with low C3 noted in 3/35 and low C4 in 18/35. Of 12 patients with a positive ASST, 7 had low complement levels, and 12/23 with a negative ASST had low complement levels. Patients with a positive ASST had a median C3 of 1.24 g/L (range 0.35–1.51) compared with a median of 1.25 g/L in those with a negative ASST ( P  = 0.36), and a median C4 of 0.20 g/L (range 0.185–0.452) in those with a positive ASST compared with 0.18 g/L in those with a negative ASST ( P  = 0.88).
Conclusions.  We conclude that both a reduction in C4 and positive ASST are common in CIU and although these immunological abnormalities often coexist, there is no clear relationship between them. Other components of the complement system may be worth exploring.  相似文献   

17.
Autoimmune thyroiditis (AT) is more prevalent in patients with chronic idiopathic urticaria CIU) than in the general population. Previous small studies without any controlled comparison reported that CIU remits in patients with CIU and AT treated with L-thyroxine. To determine whether l-thyroxine treatment can improve the clinical course of CIU in patients with the co-occurrence of AT and CIU. A total of 749 patients with CIU were retrospectively studied. Clinical and laboratory evaluation and classification of chronic urticaria were performed according to the EAACI/GA(2)LEN/EDF/WAO guidelines. After L-thyroxine treatment for 53 ± 19 days, euthyroidism was restored in all subjects. Urticaria activity score (UAS) was evaluated at baseline and after three and six months. The control group consisted of matched 44 euthyroid subjects with CIU. A total of 44 (5.9%) patients were diagnosed to have hypothyroidism related to AT. Autologous serum skin test (ASST) was found to be positive in 17 (38.6%) of them. There was no statistically significant difference in baseline UAS, between the ASST+ (3.94 ± 1.52) and the ASST- (3.63 ± 1.42; P = 0.27) hypothyroid subjects and the euthyroid CIU controls (3.73 ± 1.74). During the L-thyroxine treatment, a significant reduction of UAS was observed in both hypothyroid ASST+ and ASST- subjects. However, the mean UAS after three and six months of L-thyroxine treatment remained not significantly different from that in control euthyroid subjects with CIU. L-Thyroxine treatment has no effect on the course of CIU in patients with CIU and AT.  相似文献   

18.
BACKGROUND: Basophils and mast cells are the main target cells in chronic idiopathic urticaria (CIU). Besides the basopenia, intrinsic defects of the anti-IgE cross-linking signalling pathway of basophils have been described in CIU. OBJECTIVES: We sought to investigate the profile of expression of activation markers on basophils of patients with CIU and to explore the effect of interleukin (IL)-3 priming upon anti-IgE cross-linking stimuli through expression of activation markers and basophil histamine releasability. METHODS: Evaluation of the surface expression of FcepsilonRIalpha, CD63, CD203c and CD123 on whole blood basophils of patients with CIU undergoing autologous serum skin test (ASST) was performed by flow cytometry. The effect of pretreatment with IL-3 in the anti-IgE response was analysed by the expression of basophil activation markers and histamine release using enzyme-linked immunosorbent assay. RESULTS: Blood basophils of patients with CIU were reduced in number and displayed increased surface expression of FcepsilonRIalpha, which was positively correlated with the IgE serum levels. Upregulation of expression of both surface markers CD203c and CD63 was verified on basophils of patients with CIU, regardless of ASST response. High expression of IL-3 receptor on basophils was detected only in ASST+ patients with CIU. Pretreatment with IL-3 upregulated CD203c expression concomitantly with the excreting function of blood basophils and induced a quick hyper-responsiveness to anti-IgE cross-linking on basophils of patients with CIU compared with healthy controls. CONCLUSIONS: Basophils of patients with CIU showed an activated profile, possibly due to an in vivo priming. Functionally, basophils have high responsiveness to IL-3 stimulation, thereby suggesting that defects in the signal transduction pathway after IgE cross-linking stimuli are recoverable in subjects with chronic urticaria.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号