儿童血清特异性IgE水平与过敏原皮试及气道反应性之间的关系

为了探讨哮喘儿童血清特异性免疫球蛋白 (SIgE )同过敏原皮试及气道高反应性 (BHR )的关系 ,取 6 4例有症状和 6 0例无症状儿童作为研究对象 ,采用荧光酶联免疫法 (pharmaciaphadiatoptest)测定其血清中吸入性变应原SIgE ,乙酰甲胆碱激发试验测定BHR ,选择尘螨霉菌、猫毛、花粉等 8种常用过敏原做皮试。结果显示 ,SIgE的阳性率在皮试阳性的儿童中占95 6 % ,在皮试阴性的儿童中占 17 9% ;在有高气道反应性和正常气道反应性的儿童中 ,SIgE的阳性率分别为 95 6 %和2 8 8%。两者分别作卡方检验P <0 0 0 1。这说明儿童血清SIgE与过敏原皮试阳性及气道反应性有显著相关 ;吸入性变应原与儿童哮喘气道高反应性具有密切相关。SIgE检测可作为哮喘诊断的重要参考指标 ,特别是那些因各种原因不能完成气道激发试验和过敏原皮试的幼儿     

卡介苗对哮喘小鼠气道炎症、TH细胞分化及血清OVA特异性IgE的影响

目的 探讨卡介苗（BCG）对哮喘小鼠气道炎症、TH细胞分化及血清OVA特异性IgE的影响。方法 动物随机分为阴性对照组、OVA致敏激发组和BCG干预组。检测气管血管旁嗜酸性粒细胞（EOS）数目、气管上皮杯状细胞增生指数和黏液储存指数、小鼠外周血上清液中细胞因子白细胞介素5（IL-5）及γ干扰素（IFN-γ）浓度、小鼠肺组织中T-bet和GATA-3mRNA水平及小鼠血清中OVA特异性IgE表达。结果BCG干预组和OVA致敏激发组中小鼠肺气管血管旁单位面积EOS数目分别为（65．09±32．58）个/mm^2、（941．86±592．03）个/mm^2，两者比较差异有统计学意义（P〈0．05）；BCG干预组和OVA致敏激发组杯状细胞增生指数分别为（19．25±12．27）个／mm、（54．39±24．50）个／mm，BCG干预组和OVA致敏激发组黏液储存指数分别为（6．47±3．94）％、（15．53±11．38）％，两者比较差异有统计学意义（P〈0．001）；BCG干预组和OVA致敏激发组IL-5浓度分别为（83．40±11．33）pg／ml、（192．30±44．30）pg/ml，1FN-γ浓度分别为（28．69±6．05）pg/ml、（18．12±3．78）pg/ml，T-bet／GATA．3mR—NA比值分别为1．02±0．18、0．74±0．07，两者比较均差异有统计学意义（P〈0．01）；BCG干预组和OVA致敏激发组血清中OVA特异性IgE的表达分别为0．61±0．27、1．05±0．45，两者比较差异有统计学意义（P〈0．05）。结论 BCG能抑制哮喘小鼠气道EOS浸润和黏液高分泌状态，影响T-bet／GATA-3表达水平，降低IL-5水平而增高IFN-γ水平，并能抑制哮喘小鼠血清中OVA特异性IgE的表达。     

血清特异性IgE测定在支气管哮喘病因诊断中的价值

本文用ELISA检测了30例支气管哮喘患者及40例健康成人的抗螨、法国梧桐花粉、豚草花粉、葎草花粉过敏原特异性IgE水平。特异性IgE测定和过敏原皮试的总符合率为66％,和嗜碱细胞组胺释放试验的总符合率为83.5％,ELISA测定血清特异性IgE敏感、安全、简便易行,可作为一种支气管哮喘病因诊断的方法。     

32例过敏性哮喘患者血清中总IgE和四种过敏原特异性IgE的检测

３２例过敏性哮喘患者血清中总ＩｇＥ和四种过敏原特异性ＩｇＥ的检测谈丰平，朱翠玉过敏性哮喘的发病机理比较复杂，目前认为与气道变应性炎症有关。它涉及淋巴细胞、嗜硷细胞、肥大细胞和多种介质，其中６０％患者仍与Ⅰ型变态反应，即与ＩｇＥ有关。过敏原初次进入机体...     

血清特异性IgE测定在过敏性哮喘病因诊断中的研究

用ＢＳＡ－ＥＬＩＳＡ法检测了４０例过敏性哮喘患者及３０例健康者的抗螨、法国梧桐花粉、藜草花粉和豚草花粉过敏原特异性ＩｇＥ（Ｓ－ＩｇＥ）水平。结果哮喘组Ｓ－ＩｇＥ水平明显高于健康组（Ｐ〈０．０１）；Ｓ－ＩｇＥ和过敏原皮肤挑刺试验（ＳＰＴ）、支气管激发试验（ＢＰＴ）的总符合率分别为８４．５％和８６．６％。提示ＢＳＡ－ＥＬＩＳＡ测定血清Ｓ－ＩｇＥ敏感、安全、简便易行，要作为一种过敏性哮喘病因诊断的方法，     

豚鼠哮喘模型气道重建对气道反应性的影响

目的:通过小剂量致敏原反复致敏建立豚鼠慢性哮喘模型,设定不同时点(4、6、8周)观察气道结构及气道反应性的变化,探讨气道重建对气道反应性的影响。方法:采用低剂量卵白蛋白反复致敏、激发豚鼠,制作哮喘动物模型,应用氯化乙酰胆碱静脉注射进行支气管激发实验,进行支气管肺泡灌洗并计数灌洗液的白细胞总数及分类。应用图像分析系统对豚鼠气道进行形态学测量。结果:哮喘8周组以纤维组织增生及平滑肌厚度增加最为显著。气道高反应性以哮喘4周组增高最明显,而随着与致敏原接触时间的延长,气道高反应性逐渐降低,到哮喘8周组与正常对照组相比已无显著差异。结论:长时间卵白蛋白吸入致敏可以引起哮喘豚鼠气道反应性的变化,这种变化与气道重建的发生相关联。     

哮喘儿童AIT治疗前后血浆ET-1和血清IgE水平变化

目的:观察哮喘儿童变应原免疫治疗(AIT)前后血浆内皮素-1(ET-1)与血清IgE水平变化,以探讨二者在哮喘变应原免疫治疗中的意义和关系.方法:应用放射免疫分析检测46例哮喘儿童变应原免疫治疗前后血浆ET-1与血清IgE水平,并与32例正常对照组进行比较.结果:治疗有效组(35例)治疗前血浆ET-1与血清IgE水平分别为(59.1±11.7)pg/ml和(11.1±3.2)IU/ml,均显著高于正常对照组(P＜0.01),AIT治疗后显著降低,分别为(52.7±11.1)和(8.2±2.4)IU/ml(P＜0.01).治疗无效组(11例)治疗前后ET与IgE水平无显著性变化.结论:治疗后血浆ET-1与血清IgE水平降低可能是哮喘患儿AIT治疗有效的重要机理.     

糖皮质激素对哮喘豚鼠气道高反应性的作用

糖皮质激素（以下简称“激素”）具有广泛的抗炎作用。激素应用后能显著降低哮喘外周血的EOS数量。仅激素对哮喘肺内低密度嗜酸性细胞（HE）作用的观察甚少。本文观察了地塞米松7I豚鼠哮喘模型气道反应性的影响与肺内HE的关联。方法：实验用24只健康豚鼠（重量350～4009），随机分为以下三组。1．哮端组：用卵蛋白（OA）处理豚鼠制作哮喘模型。2．正常对照组：用生理盐水取代OA进行。3．激素治疗。组：用05mg小g－’．day’地塞米松i．P．处理哮喘豚鼠。测定豚鼠对组胺的气道反应后，处死动物，用Hanks液smlX8进行灌洗。回收率应大于5…     

广州市儿童个人过敏原与哮喘症状及气道高反应性的相关性研究

目的 探讨广州在校儿童中个人过敏原与哮喘症状及气道高反应性(BHR)间的关系，明确个人过敏原在儿童哮喘进展中的作用．方法 采用整群抽样的方法，对广州市l0岁在校学龄儿童应用ISAAC(the Intemational Study of Asthma and Allergies of Childhood)第二阶段研究方案进行研究，内容包括家长书面问卷(n=3565)，皮肤过敏原点刺试验(n=1094)及乙酰甲胆碱支气管激发试验(n=177)．结果 问卷调查近期喘息率为3．4％，特应性阳性率为30．8％。过敏原阳性率以尘螨最高，其次为蟑螂。第三为猫毛．多因素logistic回归分析显示。特应性(即≥1种过敏原阳性)不是儿童近期喘息及(BHR)独立的危险因素，屋尘螨、粉尘螨与近期喘息及(BHR)显著相关，猫毛与近期喘息也有显著的关联性，蟑螂过敏与近期喘息及(BHR)均无关．结论 广州市儿童特应性并非哮喘症状及BHR独立的危险因素，尘螨仍是当前广州市儿童哮喘的主要病因之一．     

广州市儿童个人过敏原与哮喘症状及气道高反应性的相关性研究

目的探讨广州在校儿童中个人过敏原与哮喘症状及气道高反应性(BHR)间的关系, 明确个人过敏原在儿童哮喘进展中的作用.方法采用整群抽样的方法,对广州市10岁在校学龄儿童应用ISAAC(the International Study of Asthma and Allergies of Childhood)第二阶段研究方案进行研究,内容包括家长书面问卷(n=3565),皮肤过敏原点刺试验(n=1094)及乙酰甲胆碱支气管激发试验(n=177).结果问卷调查近期喘息率为3.4%,特应性阳性率为30.8%,过敏原阳性率以尘螨最高,其次为蟑螂,第三为猫毛.多因素 logistic回归分析显示,特应性(即≥1种过敏原阳性)不是儿童近期喘息及(BHR)独立的危险因素,屋尘螨、粉尘螨与近期喘息及(BHR)显著相关,猫毛与近期喘息也有显著的关联性,蟑螂过敏与近期喘息及(BHR)均无关.结论广州市儿童特应性并非哮喘症状及BHR独立的危险因素,尘螨仍是当前广州市儿童哮喘的主要病因之一.     

学龄儿童的抑郁

３２２名１０～１２岁小学五、六年级学生填写了Ｂｕｌｅｖｕｅ抑郁量表（ＢＩＤ）。抑郁症状的出现率３．４％～１１．５％，有自杀观念者５．９％。自杀观念与总分、心境恶劣、自卑和自杀、攻击性行为和社会交往４个因子的相关程度最高。３２２人中１０人（３．１％）为抑郁症检出者，临床表现与成人抑郁症相似，其中８人有自杀观念。结果提示抑郁情绪、自杀观念、抑郁症在学龄儿童中的出现率较高，应加强预防和治疗。     

患儿鸡蛋、牛奶过敏原体外检测分析

为了解患儿鸡蛋、牛奶过敏原分布情况,采用荧光ELISA法检测患儿血清中鸡蛋和牛奶过敏原SIgE抗体.结果表明:患儿中鸡蛋SIgE和牛奶SIgE阳性检出率分别为31.1%和21.7%.0～1岁组,1～3岁组和3～6岁组鸡蛋SIgE的阳性率显著高于6～14岁组(P＜0.05 ); 0～1岁组和1～3岁组牛奶SIgE的阳性率显著高于3～6岁组和6～14岁组(P＜0.05), 鸡蛋SIgE和牛奶SIgE阳性率都有随着年龄增长而逐渐降低的趋势;鸡蛋SIgE阳性同时牛奶SIgE阳性患儿的阳性率为40.9%,牛奶SIgE阳性同时鸡蛋SIgE阳性患儿的阳性率为44.3%.支气管肺炎患儿鸡蛋和牛奶SIgE阳性率最高,分别为30.3%和29.5%.建议在变态反应性疾病患儿和支气管肺炎患儿中检测鸡蛋SIgE和牛奶SIgE.     

过敏性鼻炎患儿过敏原特异性IgE检测与临床意义

目的 了解过敏性鼻炎儿童主要过敏原分布情况及特点,以指导临床防治.方法 采用免疫印迹法体外定量检测患儿血清中特异性IgE抗体及20种常见过敏原.结果 938例过敏性鼻炎患儿中,100%至少对一种以上的过敏原呈阳性反应,其中487例患儿总IgE〉400IU/Ml,230例患儿总IgE在200IU/ml~400IU/ml之间.在检测20种过敏原中以户尘螨和屋尘的阳性率最高（90.0%,80.8%）.结论 过敏性鼻炎患儿至少有一种特异性IgE抗体显著增加,户尘螨、屋尘、动物皮屑、羊肉和牛奶是引起儿童过敏性鼻炎的主要过敏原.儿童在春秋温暖季节易发过敏性鼻炎.     

Prevalence of Bronchial Asthma and Respiratory Symptoms in Schoolchildren in Oslo

During the school year 1980-81 a survey questionnaire was carried out among schoolchildren aged 7 to 15 years in Oslo. The survey population comprised 39,162 children attending compulsory primary school. The questionnaire was distributed to a random sample of 1772 children in 81 classes, forms 1 to 9, and the response rate was 95%. The prevalence of physician-diagnosis of current and cumulative asthma was 1.6% and 3.1%, respectively. Of those with current asthma 68% used asthma drugs regularly. Occasional wheezing and attacks of breathlessness were reported by 9% and 4%, respectively. Wheezing and breathlessness on exposure to pollen (4.5%), animals (3.1%) and exercise (5.5%) was reported more frequently than physician-diagnosis of asthma. The cumulative prevalence of either hay fever, eczema, urticaria or asthma was 17%. More boys than girls under the age of 12 had a physician-diagnosis of asthma.     

Specific Diagnosis of Exogenous Bronchial Asthma in Children

Twenty-six children with exogenous asthma were studied by case history (CH), skin tests (ST), allergen-specific serum IgE (RAST), basophil histamine release (HR), and bronchial provocation tests (BPT). Nine standardized allergens were used from the following groups: house dust mite, animal dander, pollen, and mould fungi. For each allergen, the same batch was used throughout for all in vivo and in vitro studies, and the tests were carried out in a controlled, double-blinded manner, independent of each other. Different allergen concentrations were used and the results graded on a semi-quantitative scale. Approximately 120 comparable investigations, using in vivo and in vitro tests were carried out, followed by calculations of the sensitivity and specificity for each test alone, as well as for various combinations of tests, at various allergen-concentrations, and compared with the result of BPT, i.e. the true diagnosis. In this way the results could be used to directly compare the diagnostic value of each test, and combinations of tests. In general, a careful CH combined with ST gave the most reliable results. RAST was the most unreliable single analysis. When pollen or mite allergy was suspected, a combination of ST with either RAST or HR gave a further diagnostic reliability. HR as a single analysis did not seem to offer advantages over existing methods. None of the tests, or combinations of tests offered 100% sensitivity and specificity. By altering the concentration of allergen, the sensitivity, or specificity could be increased, but only at the expense of a decrease in the other. BPT is still necessary in many instances when a specific diagnosis is required.     

急性呼吸衰竭的预后与高碳酸血症、血小板聚集现象的关系

通过对１０８例小儿急性呼吸衰竭血气分析和血液分析资料的观察，发现ＰａＣＯ２越高、血小板聚集现象越明显，且红细胞压积也升高（贫血者例外），小儿预后越差；反之，预后较好。提示：有高碳酸血症，血液“浓度”、“聚”现象时，除了及早机械通气，排除ＣＯ２外，还需要扩容，保证有效循环血量，同时边补边脱，也可用降低血液粘稠度、改善脑循环药物治疗（但慎用血管扩张药物），这才能有效地降低小儿呼吸衰竭死亡率，增加脑复苏率     

Bronchial hyper-responsiveness to hypertonic saline and blood eosinophilic markers in 8–13-year-old schoolchildren

BACKGROUND: In adult asthma, bronchial hyper-responsiveness (BHR) to indirect stimuli reflects eosinophilic activation more closely than BHR to stimuli that directly cause smooth muscle contraction. AIM: To assess the relationship between BHR to the indirect stimulus hypertonic saline (HS), blood eosinophil numbers, and serum eosinophilic cationic protein (ECP) in children with and without current wheeze. METHODS: A cross-sectional survey among 8-13-year-old schoolchildren, using the International Study of Asthma and Allergic disease in Childhood questionnaire, bronchial challenge with HS, skin prick tests, serum IgE, blood eosinophil counts and ECP (in a subset). Based upon the presence of current wheeze (WHE) and BHR, we defined three case groups (WHE+BHR+, WHE-BHR+, WHE+BHR-) and the reference group (WHE-BHR-). By regression analyses, each case group was compared with the reference group for differences in atopic sensitization, blood eosinophil counts and serum ECP. RESULTS: Complete data were obtained for 470 children. BHR was present in 103 children (22%), 66 being asymptomatic and 37 symptomatic. Children of all three case groups were more often atopic. Sensitization to indoor allergens particularly occurred in children with BHR, irrespective of symptoms (P < 0.05). Children with WHE+BHR+ had highest values for blood eosinophils and serum ECP (P < 0.05). Children with WHE-BHR+ had less severe responsiveness. In atopic children with WHE-BHR+, serum ECP was higher than in children with WHE-BHR-(P < 0.05). CONCLUSIONS: BHR to HS is associated with blood markers of eosinophilic activation, particularly in atopic children.     

免疫球蛋白E在儿童呼吸道变态反应性疾病中的作用及分布

目的探讨呼吸道变态反应性疾病儿童特异性免疫球蛋白IgE（SIgE）在各年龄分布及其与总IgE（TIgE）的关系。方法采用荧光酶联免疫检测系统,对73例哮喘、过敏性咳嗽患儿,按年龄分为3组,进行14项SIgE检测,包括食人组和吸入组,同时检测TIgE。结果①患儿TIgE检出率,三组检出率没有显著差异。②患儿SIgE检出率有随年龄增加而增高的趋势。③患儿〈3岁组以食物多价Fmea以及Dx最高,各为5例;而3—6岁组以Fmea最高,为15例;〉6岁组Mxl最高14例。④SIgE和TIgE检测结果有明显相关,但两者检出率无明显差异。如以SIgE阳性和（或）TIgE阳性合并统计,患儿IgE阳性检出率为95．89％。结论①患儿〈3岁组的SIgE和TIgE检出率并不低。②患儿〈3岁婴幼儿最常见的变应原为食入性Fmea、F2、F4。③3～6岁学龄前儿童仍以食人性变应原为主,最高为Fmea,其次为F2,但吸入性变应原开始增多,Dx、Mxl以及wx;④〉6岁组学龄儿童则以室内吸入性变应原为主,Mxl最高,其次为El／E5、Dx,还有食入性Fmea。⑤SIgE与TIgE有很好的相关性,SIgE联合TIgE检测能够提高检出率,更有效地诊断儿童呼吸道变态反应疾病。     

血清IL-10、CRP、IgE与小儿支气管哮喘病情相关性的研究

目的 探讨血清IL-10、CRP、IgE与小儿支气管哮喘病情的相关性.方法 选取2018年9月至2020年10月在我院接受治疗的94例支气管哮喘患儿,另选取50例健康儿童为对照组,测定受试者肺功能及血清IL-10、CRP、IgE水平,分析不同临床时期、不同病情各指标的差异.结果 与对照组比较,支气管哮喘组血清IL-10...