尘螨过敏可能是斑秃患者早发和重型的危险因素之一

【摘要】 目的 探讨232例斑秃患者的临床特征、伴发过敏性疾病的情况及血清中总IgE和特异性免疫球蛋白E（sIgE）的水平以及它们之间的相互关系。 方法 免疫比浊法和荧光酶联免疫吸附法分别检测232例斑秃患者血清中的总IgE及常见过敏原的sIgE。110例健康对照来自体检中心。 结果 232例斑秃患者中，男127例，女105例，平均（26.4 ± 13.8）岁，平均病程（25.3 ± 42.3）个月，89例（38.4%）为重型斑秃。67例（28.9%）除患斑秃外，还伴发至少1种过敏性疾病，但血清总IgE阳性率（30.6%）与健康对照组（21.8%）相比，差异无统计学意义。斑秃患者sIgE升高以户尘螨（34.1%）、 粉尘螨（31.9%）、蟑螂（22.5%）为主，均为常见过敏原，且三者sIgE的水平分别与总IgE水平呈正相关关系。户尘螨、蟑螂sIgE的阳性率和水平与健康对照组比较，差异无统计学意义。在重型、弥漫型斑秃中，户尘螨、蟑螂sIgE和儿童斑秃户尘螨sIgE的阳性率和水平均比健康对照组高，差异有统计学意义。重型患者户尘螨、蟑螂sIgE或儿童斑秃户尘螨sIgE阳性率和水平，各自比轻型或成人斑秃患者为高，差异有统计学意义。 结论 尘螨过敏是部分斑秃患者（重型、弥漫型及儿童斑秃）的发病因素之一，也是斑秃患者中发病早、脱发范围广的危险因素之一。

Dust mite allergy may be a risk factor for early-onset and severe type of alopecia areata

Li Shuifeng, Zhang Xiaoting, Qi Shiling, Ye Yanting, Cao Hui, Yang Yuqing, Zhang Xingqi. First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China Corresponding author: Zhang Xingqi, Email: xingqi.zhang@aliyun.com 【Abstract】 Objective To analyze the clinical features of, concurrence of allergic diseases in, as well as serum levels of total immunoglobulin E （IgE） and specific IgEs in, 232 patients with alopecia areata （AA）, and to estimate their relationship. Methods Serum samples were obtained from 232 patients with AA and 110 healthy controls from a health check-up center. Turbidimetric immunoassay and fluorescence-based enzyme-linked immunosorbent assay were performed to measure total IgE and specific IgEs to common antigens in these serum samples, respectively. Statistical analysis was carried out by t test, rank sum test, and chi-square test. Results The patients showed a male/female ratio of 127 ∶ 105 with an average age of （26.4 ± 13.8） years and clinical course of （25.3 ± 42.3） months. Among these patients, 89 （38.4%） suffered from severe AA, and 67 （28.9%） reported at least one allergic disease. No significant difference was found in the positive rates of serum total IgE （30.2% vs. 21.8%, P > 0.05）, anti-Dermatophagoides pteronyssinus and -Cockroach specific IgEs or the serum levels of anti-Dermatophagoides pteronyssinus or -Cockroach IgE between the patients and healthy controls. The three most common specific IgEs were anti-Dermatophagoides pteronyssinus IgE（34.1%）, anti-Dermatophagoides farinae IgE （31.9%） and anti-Cockroach IgE（22.5%） in patients with AA, whose serum levels were positively correlated with the level of serum total IgE separately. A significant increase was observed in the positive rates and serum levels of anti-Dermatophagoides pteronyssinus and -Cockroach specific IgEs in patients with severe and diffuse AA compared with the healthy controls and patients with mild AA, as well as in those of anti-Dermatophagoides pteronyssinus specific IgE in child patients with AA compared with the healthy controls and adult patients with AA （P < 0.05 or 0.01）. Conclusions Dust mite allergy may be not only a pathogenic factor for severe, diffuse and childhood AA, but also a risk factor for early onset and severe type of AA.