CAP检测系统在儿童变态反应性及免疫性疾病的应用

目的 了解变应原过筛试验作为筛查吸入物抗原及常见食物抗原血清中特异性IrE(stsE)和嗜酸细胞阳离子蛋白(ECP)在儿童常见变态反应性及免疫相关性疾病中的差异及意义.方法 检测26例特异性皮炎、33例喘息性支气管炎(简称喘支)或哮喘症、20例过敏性紫癜、15例川崎病惠儿及20名健康同龄儿童血总IgE抗体、吸入过敏原特异抗体、食物过敏原特异抗体、ECP等并进行比较.结果 26例特异性皮炎、33例喘支或哮喘、20例过敏性紫癜、15例川崎病患儿混合食物过筛试验(Fx5E)阳性率分别为73.1%、24.2%、25.0%、13.3%,吸入过敏原过筛试验(Phadiatop)阳性率分别为23.1%、69.7%、10.0%、6.6%.特异性皮炎组与喘支或哮喘组比较,Fx5E、Phadiatop阳性率差异均有统计学意义(χ~2值分别13.973、12.646,P均<0.01);与过敏性紫癜组比较,Fx5E阳性率差异有统计学意义(χ~2=10.471,P<0.01),Phadiatop差异无统计学意义(χ~2=1.346,P>0.05);与川崎病组比较,Fx5E阳性率差异有统计学意义(χ~2=13.589,P<0.01),Phadiatop阳性率差异无统计学意义(χ~2=1.809,P>0.05).喘支或哮喘组与过敏性紫癜组比较,Fx5E阳性率差异无统计学意义(χ~2=0.004,P>0.05),Phadiatop差异有统计学意义(χ~2=17.808,P<0.01);与川崎病组比较,FxSE阳性率差异无统计学意义(χ~2=0.744,P>0.05),Phadiatop差异有统计学意义(χ~2:16.388,P<0.01).过敏性紫癜组与川崎病组比较,FxSE、Phadiatop阳性率差异均无统计学意义(χ~2值分别为0.729、0.122,P均>0.05);与正常对照组比较,Fx5E阳性率差异有统计学意义(χ~2=5.714,P<0.05),Phadiatop差异无统计学意义(χ~2=0.00,P>0.05).川崎病组与正常组比较,Fx5E、Phadiatop阳性率差异均无统计学意义(χ~2值分别2.828、0.122,P均>0.05).各疾病组血清ECP、TIgE水平均高于正常对照组(P均<0.05),从高到低分别为喘支或哮喘、特异性皮炎、过敏性紫癜、川崎病,各组间差异有统计学意义(P<0.05).结论 吸入性过敏原及食物过敏原在喘支或哮喘症、特异性皮炎发病中起重要作用,而在川崎病、过敏性紫癜起一定作用.喘支或哮喘症以吸入性过敏为主,特异性皮炎以食物性过敏原为主.

Application of Phadiatop UniCAP in detection in children with allergic diseases

Objective To evaluate a blood test,UniCAP system(screening IgE to food or inhalant allergens,eosinophil cationic protein,ECP)in differentiation the capability of lgE-mediated allergic diseases in children. Methods 26 atopic dermatitis,33 asthma/bronchiolitis,20 allergic purpura, 15 Kawasaki disease patients and 20 normal children were tested total lgE,lgE to food or inhalant allergens,ECP by UniCAP system and compared.Resuits Fx5E positive rate are 73.1%,24.2%,25.0%,13.3%in atopic dermatitis,asthma,allergic purpura,Kawasaki disease respectively,and the Phadiatop positive rate are 23.1%、69.7%、10.0%、6.6%.The serum levels of ECP、TIgE of patients were higher than the mormal controls,with the highest level in asthma, and lowest in Kawasaki disease,the differences were significant(P<0.05).Conclusions Food orinhalant allergens plays an important role in the inflammatory process of asthma,atopic dermatitis,and some role in allergic purpura,Kawasaki disease.Food allergens are more important to atopic dermatitis.and inhalant allergens are more important to asthma.