IgE在过敏性鼻炎患者鼻黏膜中的表达及意义  

Expression and Significance of IGE in Nasal Mucosa of Patients with Allergic Rhinitis

作　　者：李朝晖 张建辉 陈玉芝[1] 何金萍[1] 马爱民[1] LI Zhaohui;ZHANG Jianhui;CHEN Yuzhi;HE Jinping;MA Aimin(Department of Otolaryngology-Head and Neck Surgery,General Hospital of Norlh China Petroleum Administration,Reiqiu Hebei 062552,China)

机构地区：[1]华北石油管理局总医院耳鼻咽喉头颈外科,河北任丘062552

出　　处：《解放军预防医学杂志》2018年第10期1238-1240,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：华北油田矿区医疗卫生临床诊疗相关研究(No.2017-HB-G0803)

摘　　要：目的了解血清过敏原特异性IgE在过敏性鼻炎患者鼻黏膜中的表达及临床意义,以指导临床防治该病。方法选取我院2016年4月-2017年1月收治的100例过敏性鼻炎患者为研究对象,采用鼻细胞学技术中的鼻粘膜刮片法,以May Grunwald-Giemsa进行染色,观察患者鼻粘膜细胞有无异常。测定患者鼻粘膜细胞中过敏原特异性IgE抗体和IgE总含量,采用国际标准方法进行过敏原皮肤点刺实验。结果 100例患者所采样本中Eos和嗜碱性粒细胞均增加,两者细胞计分>0.5,根据相关标准,诊断为过敏性鼻炎的敏感性达92.4%,特异性为100%。在100例患者中,所有人均对一种或一种以上所列过敏原呈阳性反应,且阳性率为100%,在患者血清的检测结果中,对8种过敏原呈阳性反应者有2例,7种1例,6种4例,5种8例,4种9例,3种23例,2种17例,1种36例。血清总IgE浓度检测有7例<100 IU/ml,16例100～<200 IU/ml之间,25例200～<400 IU/ml之间,52例≥400 IU/ml。100例过敏性鼻炎患者对19种常见过敏原的检测分析显示,尘粉螨及屋内粉尘是导致变应性鼻炎的主要过敏原,可引起患者中度或重度过敏反应,阳性反应与其他过敏原相比较强(P<0.05)。根据阳性反映的强弱顺序依次为动物毛、肉类、奶制品。比较特异性IgE含量,吸入性过敏原明显高于摄入性过敏原,差异有统计学意义(P<0.05)。结论 IgE在过敏性鼻炎的发病机理中具有重要的作用,IgE参与了过敏性鼻炎的免疫发生机理,可作为过敏性鼻炎的有效检测指标,具有重要的临床意义。Objective To investigate the expression and clinical significance of serum allergen specific IgE in nasal mucosa of patients with allergic rhinitis. Methods A total of 100 cases of allergic rhinitis patients treated in our hospital between April2016 and January 2017 were selected as the subjects. The scraping method used in the nasal mucosa nasal cytology was adopted,while May Grunwald-Giemsa staining was used to observe the nasal mucosa in patients with abnormal cells. Allergen specific IgE antibodies and total IgE levels were measured in nasal mucosa cells of patients. Skin prick tests were performed using an international standard method.Results Eos and basophils were increased in 100 patients,and the cells were scored 0.5. According to the relevant criteria,the sensitivity of diagnosis of allergic rhinitis was 92.4%,and the specificity was 100%. All the 100 patients were positive to one or more allergens mentioned above,and the positive rate was 100%. According to the detection results of serum,two cases were positive to eight allergens,one case to seven allergens,four cases to six allergens,eight cases to five allergens,nine cases to four allergens,twenty-three cases to three allergens,seventeen cases to two allergens,and thirty-six cases to one allergen. Serum total IgE concentration was less than 100 IU/ml in seven cases,between 100 IU/ml and 200 IU/ml in sixteen cases,between 200 IU/ml and 400 IU/ml in twenty-five cases,and above 400 IU/ml in fifty-two cases. Analysis of the nineteen common allergens showed that dust mites and house dust were the main cause of allergic rhinitis,which could cause moderate or severe allergic reactions and positive reactions.（ P〈0.05） Positive reactions were the strongest with animal hair,followed by meat and dairy products. When the content of specific IgE was compared,it was found that inhaled allergens far outnumbered ingested ones,and the difference was statistically significant（ P〈0.05）. Conclusion IgE plays an important role in the pathogenesis of allergic

关 键 词：过敏性鼻炎 免疫球蛋白 血清 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]