吸入变应原sIgE在不同气道过敏性疾病儿童中的分布特征

Distribution characteristics of serum specific IgE for inhaled allergens in children with different airway allergic diseases

摘要:

目的 了解不同气道过敏性疾病患儿吸入变应原血清特异性IgE（slgE）的分布特征。方法 应用UniCAP250变应原定量IgE检测系统的荧光酶联免疫法，对256例3~14岁气道过敏疾病患儿测定9种常见吸入变应原的血清slgE。256例患儿按临床诊断分为：变应性鼻炎组（简称"鼻炎组"，37例）、支气管哮喘组（简称"哮喘组"，82例）和变应性鼻炎合并支气管哮喘组（简称"鼻炎并哮喘组"，137例）。比较3组患儿9种吸入变应原阳性检出率的分布差异，并比较3组患儿变应原致敏级别和致敏种类数的差异。结果 哮喘组、鼻炎组和鼻炎并哮喘组患儿吸入变应原血清sIgE的阳性检出率分别为57.3%（47/82）、86.5%（32/37）、82.5%（113/137），3组间比较差异有统计学意义（P < 0.05）。哮喘组、鼻炎组、鼻炎并哮喘组患儿常见变应原均依次为霉菌类（32.9%、54.1%、48.9%）、尘螨类（30.5%、45.9%、46.0%）、花粉类（26.8%、35.1%、32.8%）、宠物类（12.2%、27.0%、18.2%）、蟑螂（9.8%、5.4%、5.8%）。鼻炎组和鼻炎并哮喘组患儿霉菌混合的阳性检出率均高于哮喘组，差异有统计学意义（均P < 0.0166）。3组患儿9种变应原的致敏级别和致敏种类数比较差异无统计学意义。结论 支气管哮喘、变应性鼻炎或二者合并患儿前3位吸入变应原均依次是霉菌类、尘螨类、花粉类；与支气管哮喘相比，霉菌致敏可能与变应性鼻炎关系更密切；这3种常见气道过敏性疾病吸入变应原的致敏分布具有相似性。

Abstract:

Objective To investigate the distribution characteristics of serum specific IgE (sIgE) for inhaled allergens in children with different airway allergic diseases. Methods Fluorescent enzyme-linked immunosorbent assay on the UniCAP250 system was performed to measure serum sIgE for 9 common inhaled allergens in 256 children aged 3-14 years with different airway allergic diseases. According to the clinical diagnosis, these children were divided into rhinitis group (37 children with allergic rhinitis), asthma group (82 children with bronchial asthma), and rhinitis-asthma group (137 children with allergic rhinitis complicated by bronchial asthma). The three groups were compared in terms of the detection rates of 9 inhaled allergens, sensitization level, and number of allergens. Results The detection rate of serum sIgE for inhaled allergens was 57.3% (47/82) in the asthma group, 86.5% (32/37) in the rhinitis group, and 82.5% (113/137) in the rhinitis-asthma group (P < 0.05). The most common allergen in the asthma, rhinitis, and the rhinitis-asthma groups was mould fungi (32.9%, 54.1%, and 48.9% respectively), followed by dust mites (30.5%, 45.9%, and 46.0% respectively), pollen (26.8%, 35.1%, and 32.8% respectively), pets (12.2%, 27.0%, and 18.2% respectively), and cockroach (9.8%, 5.4%, and 5.8% respectively). The rhinitis group and the rhinitis-asthma group had a significantly higher detection rate of mould fungi (mx2) than the asthma group (P < 0.0166). There were no significant differences in the sensitization level of 9 allergens and number of allergens between the three groups. Conclusions In children with either bronchial asthma, allergic rhinitis, or bronchial asthma complicated by allergic rhinitis, the three most common inhaled allergens are mould fungi, dust mites, and pollens. Compared with bronchial asthma, allergic rhinitis may be more closely associated with sensitization by mould fungi. The three common airway allergic diseases have similar distribution characteristics of inhaled allergens.