655例慢性荨麻疹患者血清食物特异性IgG、IgG4检测分析  

Serum food-specific IgG and specific IgG4 in 655 patients with chronic urticaria

作　　者：王新新 吴善东 程浩[3] 朱可建[3] WANG Xinxin;WU Shandong;CHENG Hao;ZHU Kejian(Department of Dermatology,Shulan(Hangzhou)Hospital/Zhejiang University International Hospital,Hangzhou 310006,Zhejiang,China;Hangzhou Zheda Dixun Biolgical Gene Engineering Co.,Ltd.,Hangzhou 310052,Zhejiang,China;Department of Dermatology,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,Zhejiang,China)

机构地区：[1]树兰(杭州)医院(浙江大学国际医院)皮肤科,浙江杭州310006 [2]杭州浙大迪迅生物基因工程有限公司,浙江杭州310052 [3]浙江大学医学院附属邵逸夫医院皮肤科,浙江杭州310016

出　　处：《检验医学》2017年第9期773-778,共6页Laboratory Medicine

摘　　要：目的检测慢性荨麻疹患者血清中20种食物特异性IgG(sIgG)、特异性IgG4(sIgG4)的水平,分析sIgG、sIgG4水平与荨麻疹严重程度及患者生活质量的关系,并观察患者在阳性食物回避6个月后荨麻疹相关参数的变化。方法采用酶联免疫吸附试验(ELISA)定量检测655例慢性荨麻疹患者(患者组)和51名正常者(对照组)血清中20种食物sIgG和sIgG4水平,通过问卷调查其中65例患者(随机抽取)的荨麻疹活动评分(UAS7)、皮肤科生活质量评分(DLQI)、抗组胺药用量,并对26例进行了阳性食物回避6个月的患者再次评估。结果患者组食物sIgG、sIgG4的阳性率分别为74.4%和69.3%,对照组食物sIgG、sIgG4的阳性率分别为13.7%和5.9%,对照组食物sIgG、sIgG4的阳性率明显低于患者组(P<0.01)。患者组阳性率较高的食物为鸡蛋、花生、牛奶、大豆、蟹。65例慢性荨麻疹患者UAS7、DLQI、抗组胺药用量与sIgG、sIgG4水平无相关性。患者食物回避前后UAS7、DLQI、抗组胺药用量差异均有统计学意义(P<0.01)。结论食物sIgG和sIgG4水平对慢性荨麻疹的病因诊断和治疗可能有参考价值。Objective To determine serum food-specific IgG(sIgG)and specific IgG4(sIgG4)in patientswith chronic urticaria,to analyze the correlations of the levels of sIgG and sIgG4with the disease severity of urticariaand life quality,and to evaluate the clinical outcome of dietary avoidance after6months.Methods Enzyme-linkedimmunosorbent assay(ELISA)was used to determine the levels of sIgG and sIgG4against20kinds of food in655patients with chronic urticaria and51healthy subjects(healthy control group).The Weekly Urticaria ActivityScore(UAS7),the Dermatology Life Quality Index(DLQI)and oral antihistamine dosage were evaluated byquestionnaires for65patients selected randomly.The clinical outcome of dietary avoidance was evaluated after6months in26patients.Results The positive rates of sIgG and sIgG4were higher in chronic urticaria patients(74.4%and69.3%)than in healthy control group(13.7%and5.9%)(P<0.01).Egg,peanut,milk,soya bean andcrab were the most common food with high positive rates.There was no correlation of the levels of sIgG and sIgG4with UAS7,DLQI and oral antihistamine dosage.There was statistical significance for UAST,DLQI and oralantihistamine dosage before and after dietary avoidance(P<0.01).Conclusions The determinations of sIgG andsIgG4may be helpful for the etiologic diagnosis and treatment of chronic urticaria.

关 键 词：特异性IGG 特异性IGG4 慢性荨麻疹 食物不良反应 

分 类 号：R446.62[医药卫生—诊断学]