哮喘儿童597例变应原血清特异性IgE测定的意义  

Significance of Detection of Allergen-Specific Serum Immunoglobulin E in Children with Asthma

作　　者：宋欣[1] 王伟[1] 赵京[1] 曹玲[1] 陈育智[1] 

机构地区：[1]首都儿科研究所,北京100020

出　　处：《实用儿科临床杂志》2008年第9期682-683,685,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的观察哮喘、咳嗽变异性哮喘（CVA）患儿多价食物（fx5）、混合真菌（mx1）及吸入变应原过筛试验（phadiatop）和尘螨（d1）血清特异性IgE（sIgE）阳性率及其年龄分布特征。方法应用全自动体外变应原检测仪UniCAP100系统的荧光酶联免疫方法,对临床诊断为哮喘、CVA的597例（6个月～16岁）患儿同时进行fx5、mx1及phadiatop和d1 sIgE测定,比较哮喘及CVA患儿中各种变应原sIgE阳性情况,并分析各年龄段的不同变应原sIgE阳性率的特点。结果1.fx5、mx1、phadiatop、d1总阳性率分别为34.6%、30.0%、35.2%和23.5%。2.phadiatop、d1的阳性率在6～16岁组最高（总阳性率为67.8%和46.3%）,该年龄组phadiatop显著高于fx5和mxl的阳性率（P〈0.001）,fx5的阳性率在6～16岁组最低（总阳性率24%）,但在〈3岁组显著高于phadiatop和mxl的阳性率（P〈0.001）;mx1的高峰阳性率发生在5岁（总阳性率53.6%）。3.mx1阳性的181例中有90例患儿phadiatop阴性。4.phadiatop阳性的210例中d1阴性率为66.7%。结论哮喘、CVA患儿中有2/3患儿血清中存在sIgE,婴幼儿期儿童以食物性变应原过敏多见,吸入性变应原过敏随年龄增长逐渐增加。在≤5岁的患儿中真菌过敏阳性率随年龄增加而增加,6岁以后阳性率下降。尘螨和真菌是哮喘儿童主要的变应原。Objective To investigate the positive rates of food allergen （ fx5 ）, mixed molds （ mx1 ）, phadiatop and house dust mites （ dl ） allergen- specific serum immunoglobulin E （sIgE） in children with asthma or cough variant asthma （CVA）. Their age distribution characteristics were also compared and analysed. Methods Blood samples of 597 asthmatic children aging from 6 months to 16 years old were applied to fxS, mxl ,pha-dlatop and dl test by using fluoroenzyme - immunometricassay, UniCAP100. The positive rate of fxS, mxl, phadiatop and dl were compared. Age distribution characteristics of children with positive sIgE were analysed. Results 1. The positive rate of fxS, mxl, phadiatop and dl were 34.6% ,30.0% ,35.2% and 23.5% ,respectively. 2. The highest positive rate of phadiatop and dl were highest in children of 6 - 16 age group （67.8 % and 46.3 % ） ;The positive rate of fxS, mxl peaked in children of 2 years and 5 years separately （44.1% and 53.6% ） ;3. Among 181 children with mxl positivity 90 cases manifested phadiatop negativity. 4. Sixty - five percent of children with clinically diagnosed asthma or CVA presented positivity in test in fx5, mxl or phadiatop at least. Conclusions Two thirds asthma and CVA patients exist sIgE. Asthmatic infants mainly manifest food allergen sensitization. The positive of phadiatop increased with age. Positivity of mxl increased with age ≤5 years old in children,and it decreases in older children（ ≥16 years old）. Mxl is one of the main allergens in asthmatic children.

关 键 词：哮喘 咳嗽变异性哮喘 变应原 血清免疫球蛋白E 儿童 

分 类 号：R725.6[医药卫生—儿科]