幽门螺杆菌抗体检测对慢性特发性荨麻疹的临床意义

目的探讨幽门螺杆菌（ Helicobacter pylori , HP）检测对慢性特发性荨麻疹（chronic idiopathic urticaria,CIU）的诊疗意义。方法采用ELISA法检测慢性特发性荨麻疹患者与正常对照组血清抗幽门螺杆菌血清抗体,血清阳性的荨麻疹患者随机分为2组,一组给予左旋西替利嗪片（5mg／d）治疗：另一组给予左旋西替利嗪片（5mg／d）、奥美拉唑（20mg,2次／d）、阿莫西林（1g,2次／d）、克拉霉素（500mg,2次／d）联合治疗。两组均连续用药4周,停药4周后观察,观察内容包括瘙痒、风团数量、风团大小、风团持续时间．比较各组治疗效果,分析CIU与HP之间关系。结果127例慢性特发性荨麻疹患者中,57（44．9％）例HPIgG阳性,而100名健康者仅6（6％）例阳性,CIU患者HP阳性率明显高于健康组（χ^2=42．18,P〈0．01）。停药4周后,联合治疗组有效率为92．9％,单一治疗组有效率为55．2％,联合疗法与单纯抗过敏治疗相比,前者的总有效率明显优于后者（χ^2=10．43,P〈0．01）;停药8周后,联合治疗组有效率为92．9％,单一治疗组有效率为44.8％．联合疗法与单纯抗过敏治疗相比,前者的总有效率明显优于后者（χ^2=15．21,P〈0．01）。结论慢性荨麻疹患者的血清HPIgG抗体阳性率显著高于正常人群,针对清除HP的联合疗法治疗HP阳性CIU患者近期（停药4周）以及远期（停药8周）有效率都优于单独抗过敏治疗的方案。结果提示,幽门螺杆菌与部分荨麻疹的发病有一定关系,另外,联合抗幽门螺杆菌的治疗对减少荨麻疹的复发有一定帮助。     

血清抗幽门螺旋杆菌抗体和抗AQP4 抗体在中枢神经系统脱髓鞘病中的相关性研究

目的：探讨血清抗幽门螺旋杆菌抗体（HP-IgG）和抗AQP4抗体在多发性硬化（MS）、视神经脊髓炎（NMO）中的相关性。方法：对33例MS患者、7例NMO患者和35例健康体检者采用间接酶联免疫吸附法（ELISA法）检测血清中抗HP的IgG抗体,采用细胞间接免疫荧光法（CBA）检测血清标本抗AQP4抗体;分析MS、NMO患者中HP-IgG及抗AQP4抗体的阳性率,并对比抗AQP4抗体阳性与抗AQP4抗体阴性患者间HP-IgG阳性率的差别。结果：MS组、NMO组和正常对照组血清中抗血清HP-IgG抗体阳性率分别为69.70%、85.71%、42.86%,差别有统计学意义（P＜0.05）,其中MS组、NMO组与正常对照组血清中抗HP-IgG抗体阳性率差别均有统计学意义（P＜0.05）;但MS组与NMO组血清中抗HP-IgG抗体阳性率差别无统计学意义（P＞0.05）。MS组、NMO组和正常对照组血清中抗AQP4抗体阳性率分别为4.2%、85.71%、0%,差别有统计学意义（P＜0.05）。MS组和NMO患者组中抗AQP4抗体阳性患者与抗AQP4抗体阴性患者抗HP-IgG抗体阳性率分别为72.73%、79.31%,差别无统计学意义（P＞0.05）。结论：HP感染是引起MS及NMO疾病发生的危险因素,而与MS及NMO患者是否含有抗AQP4抗体无关。     

14种食物过敏原特异性IgG抗体与变态反应性皮肤病的关系分析

通过分析变态反应性皮肤病患者血清14种食物过敏原特异性IgG抗体（Ab）水平,探讨检测食物过敏原特异IgG Ab在变态反应性皮肤病诊断与预防中的意义。采用ELISA检测86例荨麻疹、54例异位性皮炎患者和30名健康人血清14种食物特异性IgG Ab水平。结果表明,荨麻疹和异位性皮炎患者中一种或一种以上食物特异性IgG Ab阳性患者112例,阳性率为80.0%,对照组阳性4例,阳性率13.3%,两组相比差异有统计学意义（P〈0.001）;荨麻疹和异位性皮炎患者IgG Ab阳性率排前两位是牛奶和鸡蛋;儿童组牛奶、鸡蛋阳性率和阳性级数均高于成人组,两组相比差异有统计学意义（P〈0.001）。变态反应性皮肤病患者血清中存在食物特异IgG Ab,提示变态反应性皮肤病与食物不耐受有关,并对变态反应性皮肤病的诊断以及预防食物过敏有重要意义。     

食物不耐受在慢性荨麻疹病因诊断中的临床意义

探讨慢性荨麻疹与食物不耐受的相关性,为其病因诊断及防治提供参考依据。采用美国B IOMER ICA公司生产的食物不耐受体外检测试剂盒（ELISA方法）检测慢性荨麻疹患者血清中14种食物特异性IgG抗体,并对结果进行统计分析。结果表明,74例患者中,食物特异性IgG总阳性率为63.5%（47/74）。IgG阳性率在10%以上的食物有六种,阳性率由高至低分别为鸡蛋（24.3%）、牛奶（24.3%）,螃蟹（18.9%）、大豆（18.3%）、小麦（17.6%）、虾（13.5%）。IgG浓度分级结果表明,仅对1种食物不耐受者居多,占全部IgG阳性病例的46.8%（22/47）;男、女患者食物特异性IgG阳性率以及各种食物的IgG阳性率在不同性别间均无显著性差异（P〉0.05）。结论：慢性荨麻疹与食物不耐受密切相关,鸡蛋、牛奶、螃蟹、大豆、小麦、虾是本地区慢性荨麻疹患者食物不耐受最常见的主要致敏源,食物不耐受检测对慢性荨麻疹患者的病因诊断和防治具有重要意义。     

冠心病患者肺炎衣原体感染的研究

目的：探讨肺炎衣原体感染与冠心病之间的关系。方法：采用微量免疫荧光方法检测76例冠心病（包括急性心肌梗塞）患者和76例对照组患者的外周血肺炎衣原体IgG、IgM抗体；采用PCR法检测以上所有病人的鼻咽拭子。结果：两组患者IgG抗体的几何平均滴度差异显著（P<0.05）。IgG、IgM抗体阳性率在冠心病组（包括急性心肌梗塞）分别为75.4%、23.1%，而在对照组分别为52.1%和5.2%，差异显著（P<0.05）。PCR检测冠心病组（包括急性心肌梗塞）20例阳性，阳性率为26.3%（n=76）；对照组4例阳性，阳性率为53%，两组显著差异（P<0.01）。结论：肺炎衣原体感染与冠心病可能有密切的关系。     

幽门螺旋杆菌感染与小儿慢性荨麻疹

目的　探讨幽门螺旋杆菌与慢性荨麻疹之间的关系。方法　应用酶联免疫吸附 (ELISA)法对 2 4例慢性荨麻疹患儿及 30例健康体检儿童进行幽门螺旋杆菌 (Hp -IgG)检测 ,并对抗Hp -IgG抗体阳性的荨麻疹患儿进行了14 C尿素呼吸试验(14 C -UBT) ,2项均阳性患儿采用了根除Hp的治疗。结果　慢性荨麻疹组 2 4例中 11例Hp -IgG阳性 ,阳性率 4 5 .8% ,对照组4例抗Hp -IgG抗体阳性 ,两组比较差异有显著意义 (χ2 =7.0 2 ,P <0 .0 1)。 2 4例荨麻疹患儿Hp -IgG及14 C -UBT均阳性者10例 ,给予根除Hp的治疗后 4周随访 ,所有的患儿皮疹消退 ,复查14 C -UBT均为阴性。继续随访 1年 ,其中 8例未再复发 ,2例再次出现皮疹 ,经再次治疗后皮疹完全消失 ,未再复发。结论　幽门螺旋杆菌感染与慢性荨麻疹的发病有关。     

儿童慢性荨麻疹与幽门螺杆菌感染关系的初探

目的探讨儿童慢性荨麻疹与幽门螺杆菌感染的关系。方法随机选择来我院皮肤科诊治的慢性荨麻疹患儿62例,健康儿童32例,分为两组,分别进行13C-尿素呼气试验检测幽门螺杆菌,并对幽门螺杆菌阳性者给予抗幽门螺杆菌根治性治疗。对幽门螺杆菌阳性率及疗效进行统计学比较。结果慢性荨麻疹患儿组幽门螺杆菌阳性率高于健康对照组（P〈0.05）,而两组幽门螺杆菌转阴率并无统计学差异（P〉0.05）。结论幽门螺杆菌感染对儿童慢性荨麻疹的发生发展起到了一定的作用。     

血管紧张素Ⅱ 1型受体自身抗体在原发性肾小球疾病患者血清中的表达及意义

 目的：探讨原发性肾小球疾病患者血清中血管紧张素Ⅱ 1型受体自身抗体（AT1-AA）的表达及其临床意义。方法：采用ELISA,对326例原发性肾小球疾病患者与同期收集的197例健康对照者进行血清AT1-AA的检测。将原发性肾小球疾病患者分为AT1-AA阴性组和AT1-AA阳性组,比较两组的临床和病理指标。结果：(1)原发性肾小球疾病患者血清中AT1-AA阳性率为35.58%（116/326）,明显高于正常对照组的9.64％（19/197）（P<0.01）;(2)原发性肾小球疾病患者中有免疫抑制剂用药史的患者AT1-AA阳性率明显低于无用药史的患者（P<0.05）;(3)原发性肾小球疾病患者中无高血压组和有高血压组的AT1-AA阳性率均显著高于正常对照组（P<0.01）,但无高血压组和有高血压组之间AT1-AA阳性率的差异并无统计学意义（P>0.05）;(4)AT1-AA阳性组中女性患者所占比例和血清球蛋白水平高于AT1-AA阴性组（P<0.05）。结论: AT1-AA在原发性肾小球疾病患者血清中明显增高,提示与其它经典的自身免疫抗体相似,AT1-AA可能也是肾小球疾病的重要致病因素,抑制AT1-AA的表达可能成为预防和治疗原发性肾小球疾病的新手段。     

胃息肉患者过敏原测定结果分析

目的 分析检查胃息肉病人血清过敏原特异性IgE抗体（sIgE）的结果。方法 选择我院120例胃息肉患者设为患者组,另选择同期120例健康体检者为对照组,均进行血清sIgE检查,对比两组sIgE检测的阳性率。结果 120例胃息肉患者sIgE抗体检测阳性率高达56.67%（68/120）,而对照阳性率为11.67%（14/120）,两者比较差异有统计学意义（P＜0.05）。在吸入性sIgE抗体检测显示,患者组尘螨组合的sIgE阳性比率高于对照组（P＜0.05）。在食入性过敏原sIgE方面,患者组中海鱼组合、淡水鱼组合的sIgE阳性比率较对照组显著升高（P＜0.05）,患者组中食入性过敏原sIgE阳性比率最高的是蟹,占28.33%。结论 胃息肉患者具有较高的血清过敏原sIgE抗体阳性检出率,过敏因素与胃息肉的发病有一定关联,对胃息肉的预防有一定的指导意义。     

穴位埋线治疗慢性荨麻疹的中医护理对策及效果观察

目的 观察穴位埋线治疗慢性荨麻疹的中医护理对策及效果。方法 选取2014年3月~2017年3月本院收治的70例慢性荨麻疹患者,随机分为对照组和观察组各35例。两组患者均给予穴位埋线治疗,对照组给予常规护理,观察组给予中医护理,对比两组患者的复发和护理满意情况。结果 观察组复发率（2.86%）与对照组（17.14%）相比,差异有统计学意义（P＜0.05）;观察组护理满意度（97.14%）与对照组（80.00%）相比,差异有统计学意义（P＜0.05）。结论 对穴位埋线治疗的慢性荨麻疹患者使用中医护理对策,可明显降低复发率,提高护理质量,临床意义重大。     

Chronic idiopathic urticaria: natural course and association with Helicobacter pylori infection.

BACKGROUND: Chronic urticaria is a common disease, though only few data on its natural course are available. In most cases the cause cannot be determined. Recently a relationship of chronic urticaria to infection with Helicobacter pylori (HP) has been postulated, but no controlled study has been performed to prove this association. METHODS: In this prospective study the clinical course and rate of HP infection in 46 patients with chronic 'idiopathic' urticaria were investigated. Infected patients were treated in a double-blind placebo-controlled crossover study with amoxycillin and lansoprazol. Eradication and clinical course were followed up 2 months after each treatment, respectively, 3 and 6 months after the first consultation. RESULTS: In 19/46 (41%) the chronic 'idiopathic' urticaria resolved within 6 months. 12 patients (24%) were infected with HP, which corresponds to the infection rate of the population at comparable ages without urticaria in Switzerland. Eradication of HP was achieved in 3, but only in 1 was the eradication associated with the resolution of urticaria. CONCLUSIONS: Our data show that in young patients with a rather short history of chronic urticaria frequently a rather favourable natural course of chronic idiopathic urticaria can be seen. No association between HP infection and chronic urticaria could be demonstrated.     

233例慢性荨麻疹患者过敏原分布及其临床意义分析

目的 研究分析233例慢性荨麻疹患者过敏原分布及其临床意义.方法 选取2015年7月至2016年9月在我院就诊的慢性荨麻疹患儿233例,根据过敏原分为吸入组和食入组,采用免疫印迹法对患儿血清进行特异性IgE定性检测,观察分析两组患儿过敏原结果和对单一或合并多种过敏原的结果.结果 233例慢性荨麻疹患儿中有140例血清IgE检测为阳性,占比为60.01%,其中吸入组阳性例数为115例,占比为(49.35%),食入组阳性例数为60例,占比为25.76%,总共有35例为两组共同阳性,吸入组过敏原阳性率高于食入组,两组差异具有统计学意义(P<0.05);吸入组过敏原中尘螨组合的占比最高(15.02%),艾蒿和律草的占比最低(0.85%);食入组过敏原中蟹和虾的占比最高(4.72%),鸡蛋白和黄豆的占比最低(1.29%);140例阳性患儿中,对1种过敏原呈阳性的患儿55例,对2种过敏呈阳性的患儿34例,对3种及以上的过敏原呈阳性的患儿51例,单种过敏原阳性患儿例数明显多于多种过敏原阳性患儿例数.结论 对慢性荨麻疹患儿进行过敏原检测,为治疗和预防提供有效依据,具有重要的临床意义.     

The autologous serum skin test in the follow-up of patients with chronic urticaria

BACKGROUND: The presence of anti-FcepsilonRI and anti-IgE autoantibodies in a subset of patients with chronic urticaria suggests their aetiopathogenetic role. In clinical practice, the presence of these antibodies is usually considered when the autologous serum skin test (ASST) is positive. AIMS: To evaluate if the positive ASST follows up the activity of chronic urticaria. METHODS: Autologous serum skin test and thyroid autoantibody detection were performed in 82 patients with chronic urticaria and repeated 1 year later, when the vast majority of patients were symptom-free. Twenty patients with Hashimoto thyroiditis (HT), who had never suffered from urticaria, represented the control group. RESULTS: At the start of the study, the prevalence of positive ASST was 46.6%. The association of HT-urticaria was 29.3%. ASST was positive in 62 and 39% of patients with and without HT, respectively (P > 0.05 ns). One year later, 28 of 34 patients with a positive ASST were symptom-free, but 50% of them were positive for ASST. The ASST was positive in 86.7 and 8% of patients with and without HT, respectively (P < 0.001). In the control group, ASST was always negative. CONCLUSIONS: The co-existence of autoimmune thyroiditis with chronic urticaria seems to induce a significant difference in the persistence of a positive ASST. Consistent with previous reports, a positive ASST correlates with disease exacerbation in chronic urticaria patients without thyroiditis. In patients with thyroiditis and urticaria, positive ASST persists even after the urticaria has disappeared, thus questioning whether a positive ASST to be a surrogate marker of the functional role of anti-FcepsilonRI and anti-IgE autoantibodies.     

桂枝麻黄各半汤治疗慢性荨麻疹的临床疗效

目的 观察桂枝麻黄各半汤治疗慢性荨麻疹的临床效果。方法 选择我院2017年6月~2018年3月收治的慢性荨麻疹患者60例,随机分为对照组和研究组,各30例,对照组接受盐酸西替利嗪片治疗,研究组接受桂枝麻黄各半汤治疗,比较两组治疗后5、10、30 d时症状积分及血清IgE水平,记录两组复发及不良反应情况。结果 研究组治疗总有效率为93.33%,高于对照组的63.33%,差异有统计学意义（P＜0.05）;治疗后5、10、30 d两组症状积分、血清IgE水平均低于治疗前,且研究组低于对照组,差异均有统计学意义（P＜0.05）;研究组复发率、不良反应发生率分别为6.67%、3.33%,低于对照组的36.67%、40.00%,差异有统计学意义（P＜0.05）。结论 桂枝麻黄各半汤治疗慢性荨麻疹疗效优于西药治疗,在缓解症状、降低复发率上作用突出,应用效果较好。     

无创呼吸机对慢性阻塞性肺疾病急性加重患者治疗效果的影响

目的探讨飞利浦V60 无创呼吸机对慢阻肺急性加重患者的临床疗效,为慢阻肺急性加重患者的临床治疗提供理论参 考遥方法选取于我院进行治疗的慢阻肺急性加重患者70 例,按随机数字表法平均分成对照组35 例与实验组35 例,对照组采 取常规内科治疗,实验组在对照组的基础上予以无创呼吸机治疗曰观察并分析两组患者临床疗效,利用统计学分析两组患者住 院天数尧使用抗生素药物时间的差异遥结果治疗后,实验组总有效率37 例（92.50%）明显大于对照组总有效率31 例（77.50%）尧 抗生素使用时间及住院天数均显著短于对照组,差异有统计学意义（<0.05）遥结论无创呼吸机治疗能缓解慢阻肺急性加重患 者临床症状,效果显著,还能减少抗生素的使用,提早患者康复出院时间,值得临床推广使用遥     

Effects of a pseudoallergen-free diet on chronic spontaneous urticaria: a prospective trial

Background:  Chronic spontaneous urticaria is a skin disorder that is difficult to manage and can last for years. 'Pseudoallergens' are substances that induce hypersensitive/intolerance reactions that are similar to true allergic reactions. They include food additives, vasoactive substances such as histamine, and some natural substances in fruits, vegetables and spices. Eliminating pseudoallergens from the diet can reduce symptom severity and improve patient quality of life.
Aim:  To assess the effects of a pseudoallergen-free diet on disease activity and quality of life in patient's chronic spontaneous urticaria.
Methods:  Study subjects had moderate or severe chronic spontaneous urticaria that had not responded adequately to treatment in primary care. For 3 weeks, subjects followed a pseudoallergen-free diet. They kept a clinical diary, which recorded their wheal and pruritus severity each day, to yield a clinical rating of chronic spontaneous urticaria severity (the UAS4 score). The subjects also completed the DLQI, a validated quality-of-life instrument. Use of antihistamines and glucocorticoids was minimized, recorded, and analysed. Subjects were classified into nine response categories, according to the changes in symptom severity (UAS4), quality of life (DLQI) and medication usage.
Results:  From the 140 subjects, there were 20 (14%) strong responders and 19 (14%) partial responders. Additionally, there were nine (6%) subjects who made a substantial reduction in their medication without experiencing worse symptoms or quality of life.
Conclusions:  Altogether the pseudoallergen-free diet is beneficial for one in three patients. The pseudoallergen-free diet is a safe, healthy and cost-free measure to identify patients with chronic spontaneous urticaria that will benefit from avoiding pseudoallergens.     

Anti-FcepsilonRIalpha serum autoantibodies in different subtypes of urticaria

BACKGROUND: In recent years, a histamine-releasing anti-FcepsilonRIalpha autoantibody has been demonstrated in about one-third of patients with chronic urticaria. However, its clinical significance is still unclear. The objective was to detect a possible correlation between the occurrence of the anti-FcepsilonRIalpha autoantibody and the clinical type or cause of urticaria. METHODS: Sera from 66 consecutively seen in- and outpatients with various types of urticaria and five healthy controls were examined for the presence of anti-FcepsilonRIalpha autoantibodies with a sandwich ELISA technique. In addition, basophil histamine release was studied in 13 autoantibody-positive sera. RESULTS: Anti-FcepsilonRIalpha autoantibodies were found in 17/48 patients with chronic urticaria, in 2/4 with angioedema, in 1/2 with urticarial vasculitis, and in 2/11 with dermographic urticaria. However, no anti-FcepsilonRIalpha autoantibodies were detected in acute, cold, or delayed-pressure urticaria; in urticaria pigmentosa; or in normal controls. Of all chronic urticaria patients, 22 were classified as idiopathic since no underlying cause could be found. Of this group, seven were seropositive for anti-FcepsilonRIalpha. However, anti-FcepsilonRIalpha was also found in patients who went into remission after treatment of identified causes; namely, in one with type I allergy, one with drug intolerance, one with Helicobacter infection, and six with food intolerance. The autoantibody was also detected in 2/4 patients with associated autoimmune diseases. Functional activity was shown in basophil histamine release in 3/4 autoantibody-positive sera of patients with chronic idiopathic urticaria and in 4/6 autoantibody-positive sera of patients who went into remission after the treatment of underlying causes. CONCLUSIONS: These data confirm that anti-FcepsilonRIalpha autoantibodies in urticaria are mostly found in chronic urticaria. Furthermore, their detection independently of the apparent cause of the urticaria suggests that as yet unidentified mechanisms must be operative, possibly related to the chronic inflammatory process and/or individual predispositions that favor their induction.