特应性皮炎和湿疹患者血清金黄色葡萄球菌肠毒素B特异性抗体的检测及其意义  

Serum Level and Significance of Specific Antibodies Against Staphyloc occus Aureus Enterotoxin B in Patients with Atopic Dermatitis and Eczema

作　　者：陈艳[1] 郝飞[1] 郭庆[2] 谭国珍[2] 贾虹[3] 杨雪源[3] 毕志刚[4] 杨波[4] 刁庆春[1] 易东[5] 赵辨[4] 

机构地区：[1]第三军医大学西南医院皮肤科,重庆400038 [2]中山大学第二医院皮肤性病科 [3]中国医学科学院,中国协和医科大学皮肤病研究所 [4]江苏省人民医院皮肤科 [5]第三军医大学卫生统计学教研室

出　　处：《中华皮肤科杂志》2005年第6期348-350,共3页Chinese Journal of Dermatology

摘　　要：目的探讨特应性皮炎(AD)和湿疹患者血清金黄色葡萄球菌肠毒素B(SEB)特异性抗体水平及其意义。方法采用多中心、随机双盲、对照法,将118例AD和207例湿疹患者分为莫匹罗星治疗组和对照组,于治疗前和治疗28d取血清行间接酶联免疫吸附测定法测定抗SEB特异性IgG、IgM水平,采用链霉亲和素-生物素法检测抗SEBIgE水平。结果治疗前,抗SEBIgE水平AD组显著高于正常人对照组(P=0.019)和湿疹组(P=0.048),湿疹组与正常人对照组之间差异无统计学意义(P=0.883);抗SEBIgM水平AD组(P=0.012)和湿疹组(P=0.000)均显著高于正常人对照组,AD组与湿疹组之间差异无统计学意义(P=0.088);抗SEBIgG水平各组间均差异无统计学意义(P=0.897)。临床症状评分与抗SEBIgE水平之间AD组(P=0.842)和湿疹组(P=0.134)均无显著相关性。治疗28d后,抗SEBIgM水平AD组显著下降(P=0.003),湿疹组亦显著下降(P=0.000),但治疗组与对照组间AD组(P=0.331)和湿疹组(P=0.815)差异均无统计学意义。结论AD和湿疹患者血中抗SEBIgM、IgE升高,反映皮损处近期金黄色葡萄球菌定植并参与了皮肤变应性炎症性反应。Objective To study serum specific antibodies against stap hylococcal enterotoxin B (SEB) and their significance in the patients with atopi c dermatitis (AD) and eczema.Methods Patients with AD and eczema were enrolle d in a multi-center,randomized,double-blind and controlled study in Nanjin g,Guangzhou and Chongqing.The study group was treated with hydrocortisone buty rate cream and mupirocin,while the control group was treated with hydrocortison e butyrate cream and the matrix of mupirocin,for 28 days in both groups.Sera w ere taken from the patients before and after treatment to detect the antibodies.And enzyme-linked immunosorbent assay(ELISA) was used to detect serum levels of specific IgG and IgM against SEB,and bridged streptavidine-biotin method t o detect serum level of SEB-specific IgE.Results Before treatment,compared w ith the normal controls,levels of SEB-specific IgM were significantly increased in both AD and eczema patients (P < 0.05),and SEB-specific IgE in AD patients were significantly higher than those of the patients with eczema and the contro ls (P < 0.05).However,levels of SEB-specific IgG were similar in both the pati ents and controls.At the end of treatment,levels of SEB-specific IgM were sign ificantly decreased(P < 0.05)in both AD and eczema patients,and not significant ly different between the patients and controls(P > 0.05).Serum level of SEB-spe cific IgE was not correlated with the severity of both ADand eczema (P > 0.05).Conclusions The higher level of SEB-specific IgM and IgE in AD and eczema indi cates the colonization of Staphylococcus aureus,which participates in the exace rbation of allergic inflammation,is involved in the pathogenesis of AD and ecz ema.

关 键 词：金黄色葡萄球菌肠毒素B 特应性皮炎 其意义 湿疹 患者 血清 检测 酶联免疫吸附测定法 特异性抗体水平 特异性IgG SEB 对照组 链霉亲和素 IgE水平 IGG水平 炎症性反应 IgM 统计学 正常人 随机双盲 莫匹罗星 生物素法 症状评分 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]