变态反应性疾病患者螨和蟑螂过敏原体外检测分析

目的探讨变态反应性疾病患者血清中螨和蟑螂过敏原特异性免疫球蛋白E(SIgE)的情况以及它们的相互关系分析。方法采用荧光酶联免疫吸附法,对我院2004年10月至2005年10月就诊于呼吸科和变态反应科门诊的199例患者,检测其血清中螨和蟑螂的SIgE。结果在变态反应性疾病的患者中,对于螨类过敏的,包括屋尘螨(d1)、粉尘螨(d2)和热带无爪螨(d201)均为儿童组比成年组的阳性率高,同时具有较高的强阳性率;对于热带无爪螨过敏的患者,一般都是在4级以下,极个别具有强阳性且均为儿童;对于蟑螂过敏的,所有患者均在4级以下;对于同时检测尘螨和蟑螂的患者,其血清中的SIgE值均为各螨类显著高于蟑螂的值(P<0.01)。结论尘螨和蟑螂均为变态反应性疾病的重要过敏原,尤其是尘螨;对于尘螨和蟑螂同时过敏的患者,尘螨的过敏程度均比蟑螂高。     

天门地区变应性鼻炎吸入性变应原皮肤点刺试验结果分析

目的：了解天门地区变应性鼻炎患者的变应原种类、分布情况。方法用11种变应原对天门地区变应性鼻炎疑诊患者行皮肤点刺试验,详细采集病史资料。结果710例（87％）患者变应原呈阳性反应,阳性率相对较高的变应原依次为屋尘螨、粉尘螨、无爪热带螨、德国小蠊及狗毛皮屑,单一的变应原反应阳性者少,多数为2种或2种以上发生变应原阳性反应,其中大多数是螨类,男女差异无统计学意义,儿童组与成人组变应原阳性率有统计学意义。结论天门地区变应性鼻炎的主要变应原为螨类,男女之间阳性率无明显差异,儿童阳性率高于成人。     

过敏性鼻炎血清特异性IgE与皮肤点刺试验的关联性分析

目的评估血清特异性IgE检测与皮肤点刺试验在诊断过敏性鼻炎中的关联性。方法皮肤点刺试验中尘螨阳性的过敏性鼻炎患者82例,采用瑞典法玛西亚公司UniCAP100系统检测血清尘螨特异性IgE,包括屋尘螨及粉尘螨,统计分析二者的关联性。结果82例尘螨过敏患者中,55例尘螨血清特异性IgE检测结果大于或等于1级,特异性IgE水平与皮肤点刺试验结果的等级呈正相关(屋尘螨rs=0.58,粉尘螨rs=0.60)。不同年龄段患者的血清特异性IgE检测结果与皮肤点刺试验的相关系数随年龄的增长而增大,40岁以上患者二者的检测结果无相关性。结论尘螨过敏性鼻炎患者血清特异性IgE水平与皮肤点刺试验结果呈正相关,且随患者年龄变化而有所差异。诊断40岁以上患者时,推荐同时进行2种检测。     

广州市海珠区变态反应体质儿童过敏原调查

目的:获得广州市海珠区儿童的各类过敏原的分布特点,为本区儿童的"免疫照护"提供参考价值的资料。方法:将14岁以下有典型病史的特异性皮炎、荨麻疹、儿童慢性咳嗽、小儿哮喘、过敏性鼻炎等变态反应体质的儿童分成婴幼儿组和少儿组两组,利用荧光酶免法检测45种过敏原。结果:共获得371例阳性过敏原结果,其中户尘螨过敏原阳性128例,占34.5%,粉尘螨过敏原阳性95例,占25.6%,牛奶过敏原阳性75例,占20.2%;鸡蛋白过敏原阳性51例,13.7%。其中婴幼儿组以食入性过敏原牛奶和鸡蛋白为主,少儿组以吸入性过敏原尘螨为主,两组比较,P均<0.05,存在明显差异。结论:广州市海珠区儿童过敏性疾病的主要过敏原是户尘螨、粉尘螨、牛奶和鸡蛋白。婴幼儿是以食入性过敏原牛奶和鸡蛋白致敏为主,少儿以吸入性致敏原尘螨致敏为主。     

The allergenic specificities of the house dust mite

The most important house dust mites are Dermatophagoides pteronyssinus and in drier areas D. farinae. In subtropical and tropical regions the glycyphagid mite Blomia tropicalis is a major source of allergen, which co-exists with D. pteronyssinus. The group 1 and 2 allergens of Dermatophagoides mites are clearly major specificities and it is likely that these allergens could be the basis of new strategies of immunotherapy for many mite-allergic subjects. About 20% of patients, however, do not have IgE antibody to the group 1 and 2 allergens, and even though this is a minority, it constitutes a large population. There are also many other house dust mite allergens which have high IgE binding activity but these are present in low and variable concentrations in mite extracts, usually at less than 1% of the group 1 and 2 allergens. It must be appreciated that mite extracts are arbitrary preparations that do not accurately represent the relative concentrations of allergens in inhaled air. There is now the opportunity to produce more representative and more balanced formulations of allergens, possibly by mixtures of recombinant allergens. It is likely that the group 3, 5, 7 and 9 allergens will be important along with the high molecular weight group 11, 14, 15 and 18. The tropomyosin group 10 may be an important cross-reacting allergen. B. tropicalis is, because of its distribution in highly populated regions with increasing affluence, a very important allergen. It has low-grade cross-reactivity with Dermatophagoides but most allergens only have 30-40% sequence identity between the different families so they require different allergens for immunotherapy and new diagnostic measures are required to distinguish the sensitivity between the mite families. Studies on B. tropicalis allergens are required to identify the major allergens that do not appear to be the group land 2 specificities. Component resolved diagnosis is a newly developing procedure that uses allergen arrays to provide a diagnostic format to differentiate between cross-reacting allergens and to identify the optimal formulation of allergens for different patients.     

Allergen micro-array detection of specific IgE-reactivity in Chinese allergy patients

Background  Allergen micro-arrays are powerful tools for screening of serum IgE-reactivity. In this study allergen micro-arrays were used to identify dominating IgE-binding allergens and cross-reactivity patterns among selected Chinese allergy patients.

Methods  The study was conducted using patient sera from the cities of Guangzhou, Nanjing, Chengdu and Shenyang. In total 100 sera with Dermatophagoides pteronyssinus (Der p) specific IgE-levels higher than 50 kU/L were selected for testing against 103 individual allergens.

Results  Among 100 selected patients, 95% showed IgE-reactivity towards house-dust mite allergens Dermatophagoides farinae (Der f) 1, Der f 2 and Der p 2 and 94% were IgE positive against Der p 1, and 60% of sera contained IgE reacting against allergen Euroglyphus maynei (Eur m) 2. IgE against cat allergen, Felisdomesticus (Fel d) 1, was seen in 20%. Only 2% showed specific IgE-reactivity to Der p 10, a panallergen belonging to the tropomyosin family. Serum IgE-reactivity towards other allergens was in general low. IgE-reactivity against pollen allergens showed geographic differences.

Conclusions  This study clearly confirms that group 1 and group 2 are major allergens of house dust mites. These selected house-dust mite allergy patients are close to being mono-sensitized. Der p 10 is not an important allergen for cross-reactivity. Specific IgE-sensitization towards pollen allergens is low in southern China compared to other regions. The prevalence of food and stinging insect allergens known to give rise to IgE-mediated cross-reactivity is 2% or less.

     

牛奶蛋白过敏婴幼儿常见过敏原sIgE阳性率分析

目的：探讨牛奶蛋白过敏（CMPA）和健康婴幼儿常见过敏原特异性免疫球蛋白E （sIgE）的阳性率差异,明确CMPA婴幼儿常见过敏原sIgE阳性分布特征,为CMPA患儿综合干预提供依据。方法：选择156例CMPA （CMPA组）和318名健康婴幼儿（健康组）作为研究对象,采用酶联免疫吸附法检测2组婴幼儿血清中常见过敏原sIgE和总IgE水平,比较2组婴幼儿常见过敏原sIgE和总IgE阳性率差异。结果：CMPA组和健康组婴幼儿常见过敏原sIgE和总IgE的阳性率比较差异无统计学意义（P>0.05）;CMPA组sIgE阳性率较高的食物过敏原为牛奶（44.2%）、鸡蛋白（10.3%）和腰果（5.1%）,sIgE阳性率较高的吸入性过敏原为猫毛皮屑（21.2%）、狗毛皮屑（9.6%）和户尘螨（4.5%）;健康组sIgE阳性率较高的食物过敏原为牛奶（45.0%）、鸡蛋白（14.2%）和腰果（6.0%）,sIgE阳性率较高的吸入性过敏原为猫毛皮屑（25.8%）、狗毛皮屑（14.5%）和真菌组合（4.5%）。不同年龄段（<1岁与1~2岁）分组分析,CMPA组和健康组婴幼儿常见过敏原sIgE阳性率比较差异无统计学意义（P>0.05）。结论：CMPA和健康婴幼儿常见过敏原血清sIgE阳性率未发现明显差异,提示CMPA婴幼儿行血清sIgE检测的临床指导意义证据尚显不足。     

Indoor Allergen Levels and Household Distributions in Nine Cities Across China

Objective Chinese allergic subjects have high levels of sensitization to house dust mite (HDM) and other indoor allergens. This study quantifies common indoor allergen levels in Chinese households.
Methods Dust samples were collected from nine cities. Major allergens Der p 1 and Der f 1 from Dermatophagoides pteronyssinus and D. farinae, and specific antigens of Blomia tropicalis, Tyrophagus putrescentiae, Acarus siro, and cockroach species Blattella germanica and Periplaneta americana were measured by ELISA.
Results HDM allergens were found in dust samples from bedding in 95% of the Chinese households. The median levels varied from <0.006 to 9.2 μg/g of dust, depending on the city. The percentages of households having HDM allergen levels associated with the risk of developing allergy sensitization and asthma were 65% and 25%, respectively. Specific antigens of the storage mite and cockroach were only found in samples from the southern and tropical regions of China. Levels of mite allergens were generally higher in samples from bedding compared to samples from the living room, even for storage mites, whereas levels of cockroach antigens were higher in the living room samples.
Conclusion HDM allergens are present in bedding dust samples from most Chinese households. Cities in southern and central China have relatively high levels of HDM major allergens compared to cities in northern and western China. Antigens of storage mites and cockroaches are not as common as HDM allergens.     

过敏性鼻炎皮肤点刺试验阳性界值对血清特异性IgE诊断价值的影响

目的对过敏性鼻炎(allergic rhinitis,AR)的客观评估包括体内皮肤点刺试验(skin prick test,SPT)和体外血清特异性IgE(serum specific IgE,sIgE)检测,了解SPT、sIgE试验在诊断AR中的关系对于提高AR的诊断效率至关重要。本研究旨在评估在多过敏原导致的过敏性鼻炎中,不同的SPT阳性界值对血清sIgE诊断价值的影响。方法以SPT结合的阳性结果临床症状和体征作为诊断AR的参考标准,在85例由7种常见过敏原所致的AR患者中,评估SPT阳性界值"+"和"++"对于UniCAP系统检测血清sIgE诊断价值的影响,诊断指标包括灵敏性、特异性、阳性预测值、阴性预测值和诊断效率。结果依据临床症状和体征以及SPT结果"+"作为阳性临界值诊断AR,血清sIgE检测结果良好,其灵敏性在0.50(大豚草)到0.91(屋尘螨、粉尘螨)之间,而特异性在0.93(粉尘螨)到1.00(动物毛、屋尘螨和艾蒿)之间。当SPT阳性临界值调至"++"时,sIgE的整体灵敏性提高,而其余的诊断指标,如特异性、阳性预测值、阴性预测值和诊断效率均明显下降。结论在AR的诊断中,将SPT阳性的临界值设为"+"比"++"更有益于提高血清sIgE的诊断价值。     

海口市儿童哮喘变应原流行病学调查研究

目的 了解海口市儿童哮喘常见变应原状况.方法 2012年9~12月本研究采取整群抽样的流行病学方法调查海口市0~14岁儿童10 241名,确诊哮喘患儿324例,对所有哮喘患儿进行过敏史问卷调查及皮肤点刺试验和血清过敏原特异性IgE (SIgE)抗体检测.结果 324例哮喘患儿中224例(69.1%)过敏史阳性,其中湿疹91例(28.1%),食物过敏64例(19.8%),药物过敏28例(8.6%),香烟过敏18例(5.6%),装修气味过敏19例(5.9%),宠物过敏13例(4.0%),油烟过敏11例(3.4%),花粉过敏9例(2.8%).皮肤点刺阳性率为83.0%(269例),其中屋尘螨及粉尘螨阳性率分别为90.1%(292例)及89.2%(289例),热带螨为85.5%(277例),蟑螂19.6%(64例),霉菌3.4%(11例),花粉3.4%(11例),猫毛11.7%(38例),狗毛25.3%(82例).吸入性过敏原IgE阳性率为72.2%(235例),以尘螨为最高(69.8%,226例);食入性过敏原IgE阳性率为28.7%(93例),牛奶占25.3%(82例),鸡蛋白占9.9%(32例),虾蟹占22.8%(74例),热带水果占9.0%(24例),鱼占8.3%(27例).不同年龄组哮喘患儿吸入性过敏原特异性IgE阳性率比较显示,3~7岁组屋尘螨、蟑螂阳性率高于0~3岁组(P<0.05),7~14岁组屋尘螨、蟑螂、狗毛上皮、猫毛上皮阳性率高于0~3岁组(P<0.05).结论 海口市儿童哮喘常见变应原以屋尘螨、粉尘螨和热带螨为主,狗毛、蟑螂及猫毛比例也较高.食入性过敏原以牛奶、鸡蛋白多见,且虾蟹、热带水果致敏对本地区儿童哮喘的影响也不容忽视.     

Analysis of Allergens in 5 473 Patients with Allergic Diseases in Harbin,China

Objective To analyze the allergic status to common inhalant allergens and food allergens in clinical patients in Harbin in northeastern China and provide evidence to develop the prevention strategy of allergic disease. Methods The data were collected from 5 473 patients with clinical suspected allergic diseases seeking medical care in the Second Affiliated Hospital of Harbin Medical University. Among these patients, 2 530 （46.2%） were males aged 0-86 years, the youngest was only 1 month old and 2 579 （47.1%） were young children and teenagers. The serum specific Immunoglobulin E （slgE） to 14 kinds of common allergens and serum total IgE were detected by using AllergyScreen test （Mediwiss Analytic GmbH, Moers, Germany）. Results In 5 473 subjects the positive rate of slgE was 33.1% （n=1 813）. Cow milk （6.9%） and wheat （3.1%） were the most common food allergens, followed by house dust mite mix （12.5%） and mould mix （9.4%） and the age and gender specific differences in the positive rate were significant. For the children aged 〈7 years the positive rates to cow milk, beef-mutton, and egg white/egg yolk were high, but the positive rates to house dust mite mix, ragweed estragon, and mould mix were low （P〈0.05）. For the adults the positive rates to aeroallergens were high while the rates to food allergens were low. Conclusion The results from this study showed that the food allergens in Harbin had geographic characteristics, which support the viewpoint that the environment factors play an important role in the incidence of allergic diseases. Also, the detection of slgE and total IgE are essential to identify relevant allergens for the purpose of early diagnosis, management and prevention of allergic disease.     

2230例变应性疾病患者血清特异性抗体测定分析

目的检测变应性疾病血清特异性抗体筛选相关过敏原,为临床诊断和治疗提供依据。方法采用过敏原检测系统,对2 230例变应性疾病患者的血清特异性免疫球蛋白E(immunoglobulin,IgE)及总IgE水平进行了检测。结果 2230例变应性疾病患者中过敏原以屋尘螨(28.3%)、粉尘螨(26.6%)为最高,其后依次为蒿(14.9%)、猫毛皮屑(9%)、牛羊肉(9%)、蟑螂(8.3%)、鱼虾蟹(8.1%)、霉菌(6.6%)、牛奶(6.1%)、矮豚草(5.6%)、腰果花生(4.6%)、榆、梧桐、柳、三角叶杨(3.8%)、鸡蛋白(3.8%)、黄豆(3.1%);总IgE阳性率为46.9%。结论血清特异性IgE及总IgE的检测分析可以帮助临床寻找相应过敏原,为变应性疾病的预防、诊断和治疗提供依据。     

吕梁地区慢性鼻-鼻窦炎患者吸入变应原谱研究

目的通过对吕梁地区慢性鼻-鼻窦炎患者常见吸入性变应原进行检测,探讨吕梁地区慢性鼻-鼻窦炎患者吸入变应原谱。方法采用瑞典法玛西亚公司的UniCAP自动体外检测过敏原系统,选择北艾、律草、户尘螨、粉尘螨、交链孢霉、烟曲霉、黑曲霉、屋尘作为变应原,以荧光酶联免疫法测定患者血清变应原sIgE含量。结果慢性鼻-鼻窦炎患者变应原特异性IgE阳性率为13．25％（50／400）,依次为北艾（19／50）,户尘螨（12／50）,粉尘螨（10／50）,律草（7／50）,屋尘（2／50）,交链孢霉（1／50）,烟曲霉（1／50）,黑曲霉（1／50）。结论吕梁地区慢性鼻-鼻窦炎患者变应原以北艾为主,且反应最强。     

反复呼吸道感染患儿血清总IgE和特异性IgE水平

目的：测定反复呼吸道感染（RRTI）患儿血清总IgE（tIgE）水平、特异性IgE（sIgE）阳性率,探讨RRTI与血清tIgE、sIgE的关系。方法：RRTI患儿40例,对照组健康儿童35例,采用酶联免疫吸附（ELISA）法检测血清tIgE水平,欧蒙印迹法检测血清吸入与食物组抗原sIgE抗体阳性率。结果：（1）RRTI组血清tIgE水平比对照组显著升高（P〈0.01）;（2）RRTI组血清吸入与食物抗原sIgE类抗体阳性率比对照组明显升高（P〈0.01）;（3）RRTI组血清sIgE类抗体以抗尘螨组合、猫毛、屋尘抗体多见,而食物组sIgE类抗体则以抗海鱼和淡水鱼抗体多见;（4）sIgE阳性率在tIgE水平升高与否的两组间差异不具显著性,血清tIgE水平升高率在sIgE阳性与否的两组间差异亦不具显著性（P〉0.05）。结论：RRTI可能与过敏体质有关,tIgE水平的升高或降低与sIgE阳性率高低并不完全一致。     

肺热型变应性鼻炎过敏原的帕累托图分析

【目的】通过对肺热型变应性鼻炎过敏原的帕累托分析,探讨其规律,寻找肺热型变应性鼻炎发作的主要诱因,为肺热型变应性鼻炎的防治工作提供客观依据。【方法】采用前瞻性调查方法,对137例耳鼻喉科门诊肺热型变应性鼻炎患者进行血清特异性IgE阳性率、食物组及吸入组过敏原测定,并运用帕累托图分析找出最重要的过敏原。【结果】肺热型变应性鼻炎血清特异性IgE总阳性率为94.2%,主要过敏原食物组为鸡蛋(48.1%)、牛奶(24.8%)和虾(15.3%),吸入组为螨(40.9%),男性患者肺热型变应性鼻炎吸入组过敏原和女性患者肺热型变应性鼻炎吸入组过敏原差异无统计学意义(P>0.05);女性患者食物组过敏原鸡蛋阳性率(58.8%)显著高于男性(37.7%),差异有统计学意义(P<0.05),而牛奶和虾过敏男女患者差异无统计学意义(P>0.05)。【结论】总体而言,肺热型变应性鼻炎的主要过敏原是尘螨和鸡蛋,次要过敏原是牛奶和虾,血清特异性IgE是诊断变应性鼻炎的敏感指标。     

五岁以下哮喘儿童变应原的检测及临床意义

目的了解年幼儿哮喘常见变应原,为有效避免变应原及早期干预治疗提供依据。方法选择在海南省人民医院儿童哮喘防治中心治疗的5岁以下哮喘儿童468例,使用丹麦爱尔开-阿贝优公司的吸入组点刺试剂进行皮肤点刺试验,对其中251例哮喘患儿定量检测血清中变应原特异性IgE抗体水平。结果 468例哮喘患儿体内过敏原（皮肤点刺试验）阳性率为66%,尘螨皮试阳性率最高且强阳性率（＋＋＋—＋＋＋＋）也最高,其中屋尘螨及粉尘螨分别为87.4%及86.3%,热带螨为66.3%,德国小蠊及美洲大蠊分别为26.7%及19.9%。动物皮毛中,以狗毛为主（20.1%）,猫毛次之（12.4%）。251例体外变应原检测阳性率为57.8%,其中仍以屋尘螨阳性率（63.25%）最高,粉尘螨（58.6%）次之,狗上皮为15.9%。食物组中蛋清为9.3%、花生为4.3%、苹果为3.1%,分居前3。结论哮喘儿童皮肤点刺试验有较高的变应原检出率,屋尘螨、粉尘螨、热带螨是海南儿童哮喘最常见的吸入变应原,蟑螂、狗毛、猫毛等变应原也不容忽视。食入性过敏原检出率低,其对儿童哮喘的影响远低于吸入变应原。     

儿童过敏性疾病血清过敏原特异性IgE检测分析的临床意义

目的:探讨儿童过敏性疾病血清过敏原sIgE检测的临床意义。方法:收集天津市公安医院儿科门诊就诊的过敏性疾病患儿,607例患儿应用酶联免疫吸附实验检测吸入性过敏原sIgE,其中男384例,女223例;629例患儿检测食物性过敏原sIgE,其中男383例,女246例。了解患儿静脉血吸入性和食物性过敏原sIgE的浓度,判断患儿的过敏原以及过敏程度,并进行统计学分析。结果:吸入性过敏原sIgE阳性者562例,阳性率92.6%;食物性过敏原sIgE阳性者506例,阳性率80.4%;吸入过敏原sIgE比食物过敏原sIgE阳性率高（χ2=38.8,P<0.01）。男童的吸入性过敏原包括昆虫混合（蟑螂、蚊子、跳蚤）sIgE阳性率明显高于女童（χ2=5.29,<0.05）;男童的树木混合1（梧桐、桦树、枫树、桑树）sIgE阳性率明显高于女童（χ2=12.14,<0.01）;树木混合2（榆树、柳树、棉白杨）sIgE阳性率明显高于女童（χ2=24.17,<0.01）;各种食物性过敏原sIgE的阳性率男童和女童无差异。检测显示本地区吸入过敏原sIgE霉菌阳性率最高,螨虫第二,树类第三。食物过敏原sIgE鸡蛋阳性率最高,牛奶第二,豆类第三。吸入过敏原sIgE多重阳性率高于食物过敏原sIgE多重阳性率（χ2=25.8,P<0.01）。607例吸入性过敏原sIgE检测阳性率前3名中,霉菌和树木混合1不同年龄阳性率无差别;螨虫6岁以上儿童阳性率大于1～6岁儿童（χ2=5.55,P<0.05）;629例食物性过敏原sIgE检测前3名中,鸡蛋、奶混合、豆类不同年龄阳性率均无差别。结论:对于过敏性疾病患儿检测血清过敏原sIgE可以明确过敏原,为患儿实行特异性免疫治疗提供依据。     

化工区变应性鼻炎变应原的特异性分析

目的了解宁波镇海化工区变应性鼻炎（AR）变应原情况,为高污染地区AR防治提供科学依据。方法采用宁波美康医学检验中心变应原体外检测试剂盒,以酶免疫分析法对该地区506例AR患者进行变应原血清总IgE（tIgE）和特异性IgE（sIgE）检测,其中镇海化工区274例、城区232例,并对两区域变应原IgE进行特异性分析。结果两个区域AR患者的变应原sIgE差异主要体现在吸入性变应原方面。化工区AR患者的尘螨、屋尘、霉菌、树类和艾蒿sIgE均显著高于城区患者（P〈0.05）,其中尘螨和屋尘差异最大（P〈0.01）。在两区域中,患者青少年组在尘螨、带鱼、虾蟹、龙虾、食品I和肉类sIgE方面要显著多于成年人组（P〈0.05）,而成年人组在屋尘、树类、蟑螂、艾蒿和皮屑sIgE方面要显著多于青少年组（P〈0.05）。结论受该地区气候潮湿及镇海化工区环境污染的影响,化工区AR变应原tIgE和sIgE较高,表明该地区AR较为严重,患病率可能较高。     

小儿喘息性疾病血清总免疫球蛋白E和特异性免疫球蛋白E变化研究

目的 探讨血清总免疫球蛋白E(tIgE)和特异性免疫球蛋白E(sIgE)在小儿喘息性疾病诊断中的价值.方法 采用酶联免疫吸附法及欧蒙印迹法检测80例喘息性疾病患儿和80例体检健康儿童血清tIgE和sIgE水平,并进行比较.结果 喘息性疾病组患儿tIgE水平和sIgE阳性率较对照组均明显升高,差异有统计学意义(P＜0.05).80例喘息性疾病患儿中,tIgE升高54例,其中有过敏症状的仅38例.结论 喘息性疾病与IgE关系密切,联合检测血清tIgE和sIgE能够提高小儿喘息性疾病的检出率.     

咳嗽变异性哮喘患儿皮肤点刺和血清总IgE检测及其诊断意义

目的检测儿童咳嗽变异性哮喘患儿皮肤点刺情况和血清总IgE水平,探讨其在儿童咳嗽变异性哮喘中的诊断意义。方法分别测定并比较125例咳嗽变异性哮喘(cough variant asthma,CVA)患儿、128例支气管哮喘患儿及同期我院体检的126例健康儿童血清总IgE水平和皮肤点刺结果。结果①CVA组与哮喘组血清总IgE水平比较差异无统计学意义(P=0.802),CVA组、哮喘组患儿血清总IgE水平显著高于健康组(P<0.01)。②CVA组与哮喘组摄入性变应原、吸入性变应原、总变应原阳性率比较差异均无统计学意义(P>0.05);CVA组、哮喘组摄入性、吸入性、总变应原阳性率分别与健康组比较差异均有统计学意义(P<0.01);CVA组、哮喘组、健康组3个组内摄入性变应原与吸入性变应原阳性率比较均有统计学意义(P<0.05)。③125例CVA患儿皮肤点刺试验阳性率为65.6%。吸入变应原总阳性率52.8%,吸入变应原中以粉尘螨和屋尘螨阳性率居高,分别为46.4%和43.2%;摄入变应原总阳性率28.8%,摄入变应原主要为海蟹33.6%,鸡蛋清22.4%。皮肤点刺结果强阳性以粉尘螨和屋尘螨为主,分别为24.0%和21.6%。结论 CVA患儿皮肤点刺试验有较高阳性检出率,血清总IgE水平较健康儿童高,二者对CVA的诊断有重要意义。