变态反应性皮肤病患者过敏原特异性IgE与总IgE水平分析

目的探讨张家口地区常见3种变态反应性皮肤病患者血清过敏原特异性IgE与总IgE水平分析。方法选取2014年1月-2015年12月诊断急/慢性荨麻疹、湿疹性皮炎、过敏性紫癜3种变态反应性皮肤病患者620例,采用免疫印迹法检测患者血清总IgE、变应原特异性IgE抗体水平,以血清总IgE100IU/ml,或者以血清变应原特异性IgE水平0.35kU/L为阳性,统计分析3种变态反应性皮肤病患者血清特异性IgE与总IgE水平变化,分析常见过敏原分布特征,比较3种皮肤病患者过敏原分布差异。结果入选研究变态反应性皮肤病患者620例,其中,急/慢性荨麻疹260例,湿疹皮炎210例,过敏性紫癜150例。378例(378/620,60.97%)患者血清总IgE水平升高,急/慢性荨麻疹169例(44.71%)、湿疹性皮炎137例(36.24%)、过敏性紫癜72例(19.05%)。血清过敏原特异性IgE阳性患者412例,检出率66.45%(412/620),急/慢性荨麻疹过敏源阳性194例(194/260,74.62%),湿疹性皮炎过敏原阳性168例(168/210,80.00%)、过敏性紫癜109例(109/150,72.67%)。血清过敏原特异性IgE高于总IgE阳性率[(412/620,66.45%)比(378/620,60.97%),χ~2=9.822,P0.05]。常见16种过敏原组合单项中,户尘螨、粉尘螨、春花粉、狗/猫毛皮屑、牛奶、虾6种变应原特异性IgE抗体阳性率在3种皮肤病中比较差异有统计学意义(P0.05)。吸入性过敏原以户尘/粉尘螨、狗/猫毛皮屑阳性率较高,急/慢性荨麻疹、湿疹性皮炎、过敏性紫癜组中阳性率分别为21.43%、14.90%、8.76%;食物性过敏原中,湿疹性皮炎以牛奶阳性率较高,为5.27%,急/慢性荨麻疹以虾/蟹过敏阳性率高,阳性率为10.90%。结论检测变态反应性皮肤病患者血清过敏原特异性IgE与总IgE水平有助于临床合理寻找过敏原,对其进行针对性预防、治疗。

Analysis of Allergen Specific IgE and Total IgE Levels in Patients with Allergic Skin Disease

Objective To investigate the levels of serum allergen specific IgE and total IgE in patients with any of the three types of allergic skin diseases in Zhangjiakou.Methods A total of 620 patients with allergic skin diseases were selected between January 2014 and December 2015.Western blot was used to detect the serum total IgE and allergen specific IgE antibody levels in serum.Serum total IgE＞100 IU/ml or serum allergen specific IgE level＞ 0.35KU/L was considered a positive diagnostic criterium.The distribution of common allergens was analyzed,and that of allergens was compared between the three types of skin diseases.Results A total of 620 patients with allergic skin diseases were selected,including 260 cases of acute/chronic urticaria,210 cases of eczematous dermatitis and 150 cases of allergic purpura.The total serum IgE level was increased in 378 patients (378/620,60.97％),169 of whom (44.71％) were cases of acute/chronic urticaria,137 eczematous dermatitis (36.24％),and 72 purpura (19.05％).There were 412 serum allergen-specific IgE-positive cases,and the detec6on rate was 66.45％ (412/620).The positive rate of acute/chronic urticaria allergens was 74.62％ (194/260),and that of eczematous dermatitis allergens was 80.00％ (168/210).There were 109 cases of allergic purpura (109/150,72.67％).Serum allergen-specific IgE was higher than the total IgE-positive rate [(412/620,66.45％) vs.(378 / 620,60.97％),x2 =9.822,P＜0.05].The difference in the positive rate of IgE antibody specificity between the six common allergen combinations was statistically significant in the three types of dermatological diseases.The positive rate of inhalation allergens to household dust/dust mite and dog/cat dander was high,the positive rate of acute/chronic urticaria,eczematous dermatitis and allergic purpura was 21.43％ 、14.90％ and 8.76％ respectively.As for food allergens,the positive rate of eczematous dermatitis and allergic purpura was higher(5.27％) for milk.The positive rate of acute / chronic urticaria to shrimp/crab allergy was high (10.90％).Conclusion Detection of serum allergen-specific IgE and total IgE levels in allergic skin diseases can help to find the exact allergens,thus contributing to targeted prevention and treatment.