慢性自发性荨麻疹患者血清特异性IgE抗体与自体血清皮肤试验的关系
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摘要
目的:比较慢性自发性荨麻疹(CSU)患者血清特异性IgE抗体检测结果与自体血清皮肤试验(ASST)的关系,探讨ASST的临床意义。方法:对305例慢性自发性荨麻疹患者同时进行血清特异性IgE抗体检测及自体血清皮肤试验(ASST),对两组的阳性率进行统计分析。结果:305例CSU患者螨虫组合(屋尘螨/粉尘螨)血清特异性IgE抗体与ASST总阳性率分别为47.87%和58.03%,ASST阳性组和阴性组中螨虫组合血清特异性IgE抗体阳性率分别为34.46%和66.41%,两组差异有统计学意义(P<0.05)。ASST阳性程度与对应螨虫、屋尘、狗、大豆、虾血清特异性IgE抗体检测水平呈负相关性(P<0.05)。结论:CSU患者部分常见变应原血清特异性IgE抗体与自体血清皮肤试验结果呈负相关,建议将ASST纳入常规CSU临床检测,ASST阳性的患者可以不进行血清特异性IgE抗体检测。
Objective: To compare the results of serum specific IgE antibody and autologous serum skin test(ASST) in the patients with chronic spontaneous urticaria(CSU), in order to define the clinical significance of ASST. Methods: The serum specific IgE antibody detection and autologous serum skin test(ASST) were conducted in 305 patients with CSU, and the positive rates of the two grougs were compared. Results: The positive rates of serum specific IgE antibody of mites combination(ermatophagoides pteronyssinus/dermatophagoides farinae) and ASST in 305 patients with CSU were 47.87% and 58.03%,respectively. The positive rates of serum specific IgE antibody of mites combination in the ASST positive group and ASST negative group were 34.46% and 66.41%, respectively with statistical significance(P<0.05). There was a negative correlation between the positive of ASST and the serum specific IgE antibody of mites combination, house dust, dog, soybeans, and shrimp, with significant differences(P<0.05). Conclusion: Some serum specific IgE antibodies of common allergens in CSU patients are negatively correlated with the results of ASST. It is suggested that ASST should be included in the routine CSU clinical test and the serum specific IgE antibodied of the patients with ASST positive need not be detected.
Objective: To compare the results of serum specific IgE antibody and autologous serum skin test(ASST) in the patients with chronic spontaneous urticaria(CSU), in order to define the clinical significance of ASST. Methods: The serum specific IgE antibody detection and autologous serum skin test(ASST) were conducted in 305 patients with CSU, and the positive rates of the two grougs were compared. Results: The positive rates of serum specific IgE antibody of mites combination(ermatophagoides pteronyssinus/dermatophagoides farinae) and ASST in 305 patients with CSU were 47.87% and 58.03%,respectively. The positive rates of serum specific IgE antibody of mites combination in the ASST positive group and ASST negative group were 34.46% and 66.41%, respectively with statistical significance(P<0.05). There was a negative correlation between the positive of ASST and the serum specific IgE antibody of mites combination, house dust, dog, soybeans, and shrimp, with significant differences(P<0.05). Conclusion: Some serum specific IgE antibodies of common allergens in CSU patients are negatively correlated with the results of ASST. It is suggested that ASST should be included in the routine CSU clinical test and the serum specific IgE antibodied of the patients with ASST positive need not be detected.
引文
[1] 赵作涛,郝飞.中国荨麻疹诊疗指南(2014版)解读[J].中华皮肤科杂志,2016,49(6):388-390.
[2] Najib U,Sheikh J.The spectrun of chronic urticaria[J].Allergy Asthma Proc,2009,30(1):1-10.
[3] Sabroe RA, Grattan CE, Francis DM,et al.The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria[J]. Br J Dermatol,1999,140(3):446-452.
[4] 木其日,刘玲玲,梁玉华,等.慢性特发性荨麻疹患者自体血清皮肤试验结果分析[J]. 临床皮肤科杂志,2003,32(11):645-647.
[5] 中华医学会皮肤性病学分会免疫学组. 中国荨麻疹诊疗指南(2014版)[J]. 中华皮肤科杂志,2014,49(7):388-390.
[6] Ghosh SK, Ghosh S. Autologous serum skin test[J]. Indian J Dermatol,2009,54(1):86-87.
[7] 冯林,宋志强,郝飞.自体血清皮肤试验在慢性荨麻疹的应用进展[J].临床皮肤科杂志,2011,40(8):508-510.
[8] 曹永艳, 陈尊义, 陈瑶,等. 武汉及其周边地区慢性自发性荨麻疹2038例常见过敏原分析[J]. 中国皮肤性病学杂志,2013(12):1242-1244.
[9] 王德旭,王瑞芹,于秉伦,等.银屑病和慢性荨麻疹患者自体血清皮肤试验检测[J].中国麻风皮肤病杂志,2014,30(3):174.
[10] 赵辨. 临床皮肤病学[M].南京:江苏凤凰科学技术出版社,2017:783-789.
[11] Kocaturk E,Kavala M,Kural E,et al.Autologous serum skin test vs autologous plasma skin test in patients with chronic urticaria: evaluation of reproducibility, sensitivity and specificity and relationship with disease activity, quality of life and anti-thyroid antibodies[J]. Eur J Dermatol,2011,21(3):339-343.
[12] 孙诗黠, 何文丽.慢性自发性荨麻疹发病机制及治疗研究进展[J].西南国防医药,2017,27(10):1141-1143.
[13] 黄秀英, 周小芳, 冯林,等. 慢性荨麻疹患者粉尘螨变应原皮肤点刺反应与自体血清皮肤反应的关系[J]. 中华皮肤科杂志,2011,44(1):15-17.
[2] Najib U,Sheikh J.The spectrun of chronic urticaria[J].Allergy Asthma Proc,2009,30(1):1-10.
[3] Sabroe RA, Grattan CE, Francis DM,et al.The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria[J]. Br J Dermatol,1999,140(3):446-452.
[4] 木其日,刘玲玲,梁玉华,等.慢性特发性荨麻疹患者自体血清皮肤试验结果分析[J]. 临床皮肤科杂志,2003,32(11):645-647.
[5] 中华医学会皮肤性病学分会免疫学组. 中国荨麻疹诊疗指南(2014版)[J]. 中华皮肤科杂志,2014,49(7):388-390.
[6] Ghosh SK, Ghosh S. Autologous serum skin test[J]. Indian J Dermatol,2009,54(1):86-87.
[7] 冯林,宋志强,郝飞.自体血清皮肤试验在慢性荨麻疹的应用进展[J].临床皮肤科杂志,2011,40(8):508-510.
[8] 曹永艳, 陈尊义, 陈瑶,等. 武汉及其周边地区慢性自发性荨麻疹2038例常见过敏原分析[J]. 中国皮肤性病学杂志,2013(12):1242-1244.
[9] 王德旭,王瑞芹,于秉伦,等.银屑病和慢性荨麻疹患者自体血清皮肤试验检测[J].中国麻风皮肤病杂志,2014,30(3):174.
[10] 赵辨. 临床皮肤病学[M].南京:江苏凤凰科学技术出版社,2017:783-789.
[11] Kocaturk E,Kavala M,Kural E,et al.Autologous serum skin test vs autologous plasma skin test in patients with chronic urticaria: evaluation of reproducibility, sensitivity and specificity and relationship with disease activity, quality of life and anti-thyroid antibodies[J]. Eur J Dermatol,2011,21(3):339-343.
[12] 孙诗黠, 何文丽.慢性自发性荨麻疹发病机制及治疗研究进展[J].西南国防医药,2017,27(10):1141-1143.
[13] 黄秀英, 周小芳, 冯林,等. 慢性荨麻疹患者粉尘螨变应原皮肤点刺反应与自体血清皮肤反应的关系[J]. 中华皮肤科杂志,2011,44(1):15-17.