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。

Importance of skin prink test and total serum IgE level in diagnosis of cough variant asthma in children

Objective To study the importance of skin prick test(SPT) and total serum IgE level in diagnosis of cough variant asthma(CVA) in children.Methods Total IgE level and SPT findings in 125 patients with CVA(group A),128 with bronchial asthma(group B)and 126 healthy children(control group) were assayed and compared.Results No significant difference was observed in total IgE level between groups A and B(P=0.802).The total IgE level was significantly higher in groups A and B than in control group(P<0.01).The positive rates of inhaled and ingested total allergen in groups A and B were not significantly different from those in control group(P>0.05).However,the positive rates of inhaled and ingested total allergen were significantly higher in groups A and B than in control group(P<0.01).A significant difference was found in positive rates of inhaled and ingested total allergen among the 3 groups(P<0.05).The positive rate of SPT was 65.6%(82/125) in group A.The total positive rate of inhaled allergen was 52.8% with the farinae and dermatophagoides pteronyssinus accounted for 46.4% and 43.2%,respectively.The total positive rate of ingested allergen was 28.8%,with the crab and egg albumen accounted for 33.6% and 22.4%,respectively.SPT showed that the strong positive rate of dermatophagoides farinae and dermatophagoides pteronyssinus was 24.0% and 21.6%,respectively.Conclusion The high positive rates of SPT and total serum IgE level are of great importance in diagnosis of CVA in children.