儿童血清特异性过敏原IgE抗体检测结果分析

目的了解儿童常见过敏性疾病与过敏原的关系及本地区的分布特点,为临床实践提供依据。方法应用欧蒙医学实验诊断股份公司的特应性过敏原（中国组合）检测试剂盒（欧蒙印迹法）对329例患儿进行吸入性和食入性过敏原特异性IgE抗体的检测。结果吸入性过敏原中以猫毛、狗上皮、屋尘、尘螨组合1为主,分别占阳性病例的31.93%、25.21%、16.81%和10.92%,反应级数（ ＋）-（ ＋＋）级;其他依次为树组合中国2（柳树、杨树、榆树）、霉菌组合1（点青霉、分支孢霉、烟曲霉、交链孢霉）、蟑螂、矮豚草、艾蒿、律草等。食入性过敏原中以海鱼组合1（鳕鱼、龙虾、扇贝）、淡水鱼组合1（鲑鱼、鲈鱼、鲤鱼）、牛奶、羊肉为主,分别占阳性病例的22.78%、18.98%、15.12%和12.65%,反应级数为（ ＋＋）-（ ＋＋＋）级,其他依次为虾、蟹、牛肉、鸡蛋白、黄豆、花生等。结论猫毛、狗上皮、屋尘、尘螨组合1是主要的儿童吸入性过敏原,海鱼组合1（鳕鱼、龙虾、扇贝）、淡水鱼组合1（鲑鱼、鲈鱼、鲤鱼）、牛奶、羊肉是主要的儿童食入性过敏原,总体上儿童吸入性过敏原阳性率高于食入性过敏原,反应强度食入性高于吸入性过敏原。儿童特异性过敏原检测的有助于过敏性疾病诊断。     

从过敏原检测与支气管舒张试验相关性看COPD与支气管哮喘的鉴别诊断

目的探讨过敏原检测与支气管舒张试验对COPD与支气管哮喘的鉴别诊断意义。方法随机抽取74例COPD患者作为观察组,再选取同期本院支气管哮喘患者74例作为对照组,均进行过敏原检测与支气管舒张试验。结果有多种过敏原的COPD患者当中舒张试验阳性率明显高于无过敏原的患者,且FEV1改善率、FEV1增加绝对值均高于没有过敏原的患者,差异有统计学意义(P<0.05)。观察组的舒张试验阳性、PEF指标明显高于对照组,其余各项指标均无统计学意义。结论过敏原检测与支气管舒张试验对COPD与支气管哮喘有重要的鉴别诊断价值。     

绍兴地区儿童哮喘过敏原特异性IgE检测结果分析

目的：了解绍兴地区儿童哮喘常见过敏原的分布情况,为儿童哮喘的诊治及预防提供依据。方法对临床诊断的支气管哮喘患儿211例,应用欧蒙印迹法检测总特应性过敏原（中国组合）IgE抗体,吸入性及食入性过敏原特异性IgE抗体。按年龄分为＜5岁组94例和≥5岁组117例,对比分析过敏原状况。结果总IgE抗体阳性率77.7%。吸入性过敏原中户尘螨特异性抗体阳性率最高,其中≥5岁组远高于＜5岁组;食入性过敏原特异性抗体阳性率以鸡蛋白为最高。结论儿童哮喘的发病或急性发作,与过敏原接触密切相关,检测过敏原或其特异性抗体是防治的重要环节。     

正常人群血清过敏原特异性IgE检测分析

目的筛查本地区正常成人过敏原的分布状况，为过敏性疾病的防治提供科学依据。方法采用体外特异性过敏原检测试剂盒对3067例克拉玛依地区部分企业职工进行吸入过敏原和食物过敏原筛检。结果3067例测试者吸入过敏总阳性率30．06％，以矮豚草／蒿／律草组合和动物毛皮屑组合最高，其后依次为尘螨／粉尘螨组合、蟑螂、树花粉组合等；食物过敏原的总阳性率为9．06％，过敏原主要为腰果／花生／黄豆组合，其次为牛、羊肉和牛奶。结论吸入过敏原矮豚草／蒿组合为克拉玛依地区成人最主要的过敏原，食物过敏亦占部分比例。明确过敏原后对过敏性疾病的预防和特异性免疫治疗具有重要的指导意义。     

荨麻疹339例血清过敏原特异性IgE抗体检测结果分析

<正>荨麻疹是皮肤科常见的过敏性疾病,多数患者难以自觉可疑的致敏原因,病情可急性发作,或呈慢性过程,反复发作,迁延不愈,给患者的生活或社会活动带来了一定的影响。本院皮肤科自2005年3月开始进行过敏原检测。特     

哮喘儿童血清特异性IgE检测结果分析

目的 了解本地区哮喘儿童的过敏原，为预防和治疗儿童哮喘提供依据。方法对我院儿科哮喘门诊89例哮喘患儿按年龄分为儿童组和幼儿组，进行了吸入性、食物性过敏原体外血清特异性IgE抗体检测。结果吸入性过敏原以尘螨的所占比例较高，为35．96％，其次是蟑螂、飞蛾、蜜蜂，所占比例为19．11％；食物性过敏原以草菇、冬菇、金针菇和牛奶所占比例较高（17．65％、15．69％），且尘螨所占比例在儿童组最高，为40．54％；牛奶、羊奶所占比例在婴幼儿组最高，为33．34％，两组相比较差异有统计学意义（P〈0．05）。结论尘螨是本地区引起儿童哮喘的主要过敏原，在儿童哮喘组蟑螂、飞蛾、蜜蜂也是主要的过敏原；牛奶、羊奶、草菇、冬菇是婴幼儿哮喘发作不能忽略的重要因素。     

653例过敏性哮喘患者血清特异性IgE抗体检测结果分析

目的通过检测过敏性哮喘患者血清中特异性IgE抗体,确定病变过敏原,为该病预防和临床诊治提供依据。方法采用免疫印迹法定量检测过敏性哮喘患者血清中特异性IgE抗体,发现吸入性和食物性过敏原。结果 653例患者中检出过敏原者521例,血清总IgE阳性率79.8%;1种过敏原阳性者149例（22.8%）,2～4种过敏原阳性者451例（69.1%）,5种及以上过敏原阳性者53例（8.1%）;吸入性过敏原阳性248例（37.9%）,食入性过敏原阳性132例（20.2%）,二者兼有273例（41.9%）;吸入性过敏原8类,阳性率高的是蒿属植物和艾蒿花粉、尘螨和粉螨,食物性过敏原5类,依次是虾蟹、鳕鱼、黄豆和花生、牛奶、鸡蛋。结论过敏原诱导的变态反应是产生过敏性哮喘的重要原因,蒿类花粉和螨类是最常见的过敏原,病变患者呈现低龄化趋势,有明显的季节性特点。     

支气管哮喘患儿139例过敏原检测结果分析

哮喘是儿童常见的慢性疾病,严重影响着儿童健康和生长发育,可分为过敏性和非过敏性。对于过敏性哮喘,目前认为环境因素的危害性较大,其中吸入性及食物性过敏原起着重要作用。     

198例体外过敏原检测结果分析

随着各地自然环境的改变及居民生活习惯的改变,过敏性疾病的发病率日渐增高。临床上很多皮肤病的发生与发展都与产生过敏反应有关。过敏反应是一种对异物的超敏反应。这些异物通常无害,但在过敏反应患者中则产生强烈的反应[1]。临床上对多数过敏性疾病患者通常只给予缓解症状治疗,因未找到引发过敏的真正原因,因而得不到针对性的预防和治疗,导致病情反复加重、迁延不愈。传统的过敏原检测主要采用的是皮试方法,存在受试者疼痛及易发生过敏症的危险。本院从2010年6月始运用体外过敏原检测克服了皮试法     

哮喘患儿过敏原检测及与血清IgE、PPD反应的关系

本对我科过敏原检测的243例患儿进行了分析,并对其中部分患儿进行了血清IgE及PPD反应的检测,以探讨过敏原检测、血清IgE、PPD皮试在小儿哮喘筛查中的意义。     

Association between asthma/chronic obstructive pulmonary disease overlap syndrome and healthcare utilization among the US adult population

Objectives: Asthma/chronic obstructive pulmonary disease (COPD) overlap (ACO) is a recently described phenomenon defined as the coexistence of both asthma and COPD. Both asthma and COPD are known to result in increased emergency department (ED) visits and hospitalizations, but it is unclear how the ACO population utilizes these same healthcare resources. The objective of this study was to compare healthcare utilization in the ACO population versus the general population, the asthma population and the COPD population.

Methods: We conducted a pooled cross-sectional statistical analysis using the 2012–2015 National Health Interview Survey (NHIS) data. We focused on adults 18 years of age and older and excluded pregnant women. We employed an adjusted logit regression model, where the primary outcomes were dichotomous indicators on healthcare utilizations including ED visits and hospital stays. A key covariate was a four-category variable: 1) no asthma or COPD; 2) asthma only; 3) COPD only; and 4) ACO. Other covariates included age, sex, race, education level, marital status, household income level, medical insurance status, smoking status, body mass index (BMI) category, region, year and comorbidities (cancer, diabetes, hypertension, coronary heart disease and ulcer).

Results: Adults with ACO were 134%, 53% and 21% more likely to have ED visits than the general population, asthma group and COPD group, respectively. For hospital stay, the ACO group was 120% and 86% more likely to be hospitalized than the general population and the asthma group respectively. In addition, adults with ACO were 61% and 130% more likely to have asthma exacerbations and asthma-related ED visits than the asthma group.

Conclusions: ACO is a considerable risk factor for healthcare utilization versus the general population, the asthma population and the COPD population. Future focus should be placed on the ACO population to identify ways to reduce their healthcare utilization.     

Oxidants in asthma and in chronic obstructive pulmonary disease (COPD)

Experimental and clinical evidences suggest that oxidants play a role in the pathogenesis of respiratory disorders characterised by chronic airway inflammation such as asthma and chronic obstructive pulmonary disease (COPD). The respiratory system is chronically exposed to environmental pollutants, including oxidants. Exogenous sources of oxidants are particularly relevant to the pathogenesis of COPD, being cigarette smoke an extremely rich source of oxidants. In addition, the inflammatory cells recruited to the airways of patients with asthma and COPD, have an exceptional capacity to produce oxidants. Many decades of research have produced a significant amount of data indicating pro-oxidative molecular mechanisms putatively relevant in the pathogenesis of the oxidative stress which characterises these diseases, both locally and systemically. As a consequence, a drug therapy able to restore the redox imbalance in asthma and COPD would probably exert clinical and functional benefits. Indeed, currently available therapies for asthma and COPD can exert an inhibitory effect on oxidant production in the airways. However, it is unknown whether the efficacy of the treatment is somehow linked to the pharmacological modulation of the oxidant/antioxidant balance. So far, it appears that the potential role of antioxidant compounds in the treatment of asthma and COPD has not been fully explored.     

慢性阻塞性肺疾病患者合并侵袭性肺曲霉菌感染危险因素的Meta分析

目的 系统评价慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者并发侵袭性肺曲霉菌(invasive pulmonary aspergillosis,IPA)感染的危险因素。方法 检索PubMed、Embase、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库从建库至2019年12月发表的有关COPD患者并发IPA感染危险因素的病例对照研究,2名研究员独立按照纳入与排除标准筛选文献、提取资料及质量评价后,采用RevMan 5.3软件进行Meta分析。结果 共纳入16篇文献,4篇为外文,12篇为中文。Meta分析结果显示,吸烟史(OR=1.89,95%CI：1.44~2.47)、COPD分级≥3级(OR=2.56,95%CI：2.02~3.24)、入住ICU(OR=3.29,95%CI：2.44~4.44)、低蛋白血症(OR=2.66,95%CI：1.93~3.66)、糖尿病(OR=3.10,95%CI：2.49~3.86)、肾功能不全(OR=2.59,95%CI：1.49~4.49)、呼吸衰竭(OR=4.32,95%CI：3.24~5.75)、有创机械通气(OR=4.59,95%CI：3.76~5.61)、侵袭性操作(OR=4.59,95%CI：3.60~5.84)、糖皮质激素全身给药(OR=2.17,95%CI：1.28~3.70)、糖皮质激素日剂量≥20mg(OR=3.92,95%CI：2.38~6.45)、糖皮质激素累积剂量≥700mg(OR=9.61,95%CI：5.80~15.94)、糖皮质激素用药≥14d(OR=4.64,95%CI：3.63~5.94)、广谱抗生素用药≥14d(OR=4.29,95%CI：2.43~7.58)、抗生素联用(OR=6.61,95%CI：3.03~11.58)和碳青霉烯类(OR=9.83,95%CI：4.02~24.06)是COPD患者并发IPA的危险因素(P<0.05)。患者年龄、性别、COPD病程、肝功能不全、心功能不全、糖皮质激素雾化吸入与IPA 感染未见明显关联(P>0.05)。敏感度分析提示Meta分析结果稳定。结论 COPD患者并发IPA感染危险因素较多,临床应采取针对性预防措施,以降低其感染风险。     

Emerging oligonucleotide therapies for asthma and chronic obstructive pulmonary disease

Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) are disorders of the airways largely related to the presence of persistent inflammation. The approval of inhaled corticosteroids in the early 1970s pioneered a new age of therapy in treating chronic inflammatory airway diseases. This was the first time that an anti-inflammatory product was available to reduce the characteristic lung inflammation in airways and the associated obstruction, inflammation and hyper-responsiveness. Fast forward 40 years: corticosteroids are still an important therapeutic intervention; however, they exhibit limited use in moderate to severe asthma and COPD. Oligonucleotide therapies are an emerging class which include the antisense, the RNAi (siRNA and miRNA), the immunomodulatory, the aptamer and the decoy approaches. As these approaches are rather recent in the respiratory field, most are still early in development. Nevertheless, with limitations of current small molecule therapies and the hurdles faced with biologics, the use of oligonucleotides is relevant and the door is open to the development of this category of therapeutics. This review focuses on the major classes of oligonucleotides that are currently in late stage preclinical or clinical development for the treatment of asthma and COPD, and discusses the implications for their use as therapies for respiratory diseases.     

哮喘、慢性阻塞性肺病患者血清IL-18和总IgE水平的相关性

目的 探讨IL-18、总IgE、Th1和Th2类细胞因子在哮喘、慢性阻塞性肺病(COPD)发病时血清水平的变化及其相关性.方法 随机收集哮喘急性发作期患者50例(哮喘组),老年COPD急性加重期患者80例(COPD组),健康者50例(对照组)血清,采用双抗体夹心酶联免疫吸附试验检测血清IL-18、总IgE、IL-8、IL-4、IFN-γ水平.结果 CDPD组急性期IL-18、IL-8、IL-4、IFN-γ水平分别高于对照组1.8、25.2、116、150.8倍.哮喘组IL-18、IL-8、IL-4分别高于对照组29.9、3.4、5.2倍.哮喘组血清总IgE水平高于对照组223.2倍,而COPD组血清总IgE水平与对照组相比无显著性差异.COPD血清中IL-18与IL-8、IFN-γ,IL-8与IL-4呈正相关;哮喘组IL-18与IL-8、IL-4、总IgE,IL-4与总IgE呈正相关.结论 高血清IL-18提示细胞闪子参与哮喘及COPD的发病过程.哮喘发作时IL-18与总IgE正相关,而在COPD急性加重期无相关性,表明COPD和哮喘是两类有不同发生机制的气道炎症.     

生脉注射液治疗慢性阻塞性肺病急性加重期的临床疗效

目的:探讨生脉注射液治疗慢性阻塞性肺病(COPD)急性加重期的临床疗效。方法:60例COPD患者随机分为两组,对照组(n=28)患者给予氧疗、抗炎、平喘、解痉、止咳化痰等常规治疗,试验组(n=32)在对照组治疗的基础上给予生脉注射液60mL 5%葡萄糖溶液(GS)或0.9%氯化钠溶液(NS)250mL中静脉滴注,qd,连用2周。结果:与对照组比较,治疗后试验组HR,RR,PaCO2均明显下降,白细胞、中性粒细胞明显降低,住院天数缩短,PaO2和SaO2明显上升。试验组与对照组总有效率分别为93·8%(30/32)和75·0%(21/28)(P<0·05)。结论:生脉注射液治疗COPD疗效确切。     

吸入制剂在哮喘和慢性阻塞性肺疾病治疗中的作用及地位

在欧美等发达国家哮喘与慢性阻塞性肺疾病(COPD)患者普遍使用吸入制剂,我国大陆地区吸入制剂的应用尚未得到广泛推广,同时还面临着定量吸入气雾剂抛射剂氟利昂淘汰的困境。本文综述哮喘与COPD治疗中常用的吸入制剂,及其与非吸入制剂相比不可替代的临床地位。     

Exacerbations of asthma and chronic obstructive pulmonary disease (COPD): focus on virus induced exacerbations

Asthma and chronic obstructive pulmonary disease (COPD) are the 2 most prevalent chronic airway diseases. Much of the morbidity, mortality and health care costs of the diseases are associated with acute exacerbations, which are episodes of increased symptoms and airflow obstruction. Over the last decade evidence has emerged implicating virus respiratory tract infections as a major cause of exacerbations of both asthma and COPD. Current therapies are not very effective in the prevention or treatment of virus-induced exacerbations and exacerbations are therefore a major unmet medical need. The development of new and novel treatments requires a better understanding of the molecular and cellular mechanisms linking virus infection with exacerbations of asthma and COPD. This article provides an overview of current knowledge regarding the mechanisms of virus-induced exacerbations in both asthma and COPD. It will also review existing treatments and future treatments that are in advanced stages of development.