炎症因子及凝血因子与慢性荨麻疹发病及预后的相关性

目的：分析慢性荨麻疹患者血液学指标与发病及预后的相关性。方法：检测138例慢性荨麻疹患者及100例正常对照的血清总IgE、CRP、补体C3、补体C4、D2聚体、F1+2片段、FVIIa水平，并进行多因素Logist回归分析。结果：慢性荨麻疹患者血清中总IgE值、补体C3、C4、CRP、F1+2片段、FVIIa 及D2聚体与水平显著高于对照组，差异具有统计学意义( P＜0.05)；87例慢性荨麻疹患者抗组胺药物治疗3个月后有效，其CRP、FVIIa、D2聚体、疾病严重程度评分明显高于治疗有效组，差异具有统计学意义( P＜0.05)。慢性荨麻疹抗组胺治疗无效组进行多因素Logist回归分析示D2聚体为治疗抵抗的主要影响因素（OR：1．63，95％CI 1.102-1.799，P<0.05）。以D2聚体的中位数（5.41 mg/L）分为两组，A组（≥5.41 mg/L）,B组（＜5.41 mg/L），治疗后随访2年显示A组的复发率（23.56%）明显高于B组（12.14%），差异具有统计学意义（P）＜0.001）。结论：多种炎症因子及凝血因子可能参与慢性荨麻疹的发病；D2聚体水平可能与慢性荨麻疹治疗的疗效及复发相关。

Correlation between inflammatory factors or coagulation factors,and onset and prognosis of chronic urticaria

Objective: To analyze the correlation between hematological parameters and chronic urticaria. Methods: The level of serum total IgE, CRP, complement C3, complement C4, D2 mer, F1+2 fragment and FVIIa levels in 138 patients with chronic urticaria and 100 normal controls were detected. Multivariate logist regression analysis was used to detemine the correlation between the risk factors and the disease. Results：The levels of IgE, CRP, complement C3, complement C4, D2 mer, F1+2 fragment and FVIIa were higher in the patients than those in the controls, with significant differences (P<0.05). The antihistamines treatment was effective in 87 patients after treatment for 3 months. The levels of CRP, FVIIa, D2 and disease severity scores were higher in the non-effective patients than those in the sensitive patients to antihistamines, with significant differences (P<0.05). Multivariate logistic regression analysis showed that D2 mer was the main influencing factor for treatment (OR: 1.63, 95% CI 1.102-1.799, P < 0.05). The patients were divided into two groups according to the median D2 mer level (5.41 mg/L): group A with D2 mer level ≥5.41 mg/L and group B with the D2 mer level <5.41 mg/L. The recurrence rate in group A was 23.56% after two years follow-up, which was significantly higher than that in group B (12.14%), with a significant difference (P<0.001). Conclusion: A variety of inflammatory factors and coagulation factors may be involved in the pathogenesis of chronic urticaria and D2 mer may be associated with efficacy of treatment and recurrence.