特应性皮炎患儿血清维生素D水平与血清过敏原的相关性  

Study on serum vitamin D levels and serum allergens in children with atopic dermatitis

作　　者：程颖[1] 李梅云 陈戟[1] CHENG Ying;LI Meiyun;CHEN Ji(Department of Dermatology,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心皮肤科,上海200127

出　　处：《上海交通大学学报（医学版）》2022年第11期1569-1575,共7页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的·探索特应性皮炎(atopic dermatitis,AD)患儿血清25-羟维生素D [25-hydroxyvitamin D,25(OH)D]水平与血清过敏原的相关性,为AD的预防和治疗提供理论依据。方法·纳入2017年11月—2019年2月在上海儿童医学中心皮肤科就诊的165例AD患儿,收集患儿基本信息及临床信息,以AD严重程度评分(severity scoring of atopic dermatitis,SCORAD)评估AD严重程度。检测患儿血清总免疫球蛋白E (immunoglobulin E,IgE)以及19种常见过敏原的特异性IgE(specific IgE,sIgE)水平,液相色谱-串联质谱法检测25(OH)D,并进行统计学分析。单因素两两相关性分析采用Spearman相关性分析或点二列相关性分析;定性资料组间比较采用χ^(2)检验;二分类Logistic回归进行危险因素分析。结果·AD患儿SCORAD评分与血清总IgE水平(r=0.213,P=0.009)、嗜酸性粒细胞绝对值(r=0.268,P=0.001)和嗜酸性粒细胞百分比(r=0.249,P=0.003)呈正相关。然而,患儿血清25(OH)D含量与SCORAD评分无相关性;但与其血清总IgE水平(r=-0.212,P=0.011)、嗜酸性粒细胞百分比(r=-0.174,P=0.039)负相关。sIgE分级在Ⅲ级及以上的高致敏性过敏原阳性率从高到低依次为户尘螨、鸡蛋白、腰果、蟹、猫毛皮屑、混合真菌、虾、狗毛皮屑、屋尘、混合树花粉。AD患儿过敏原阳性项数在不同血清25(OH)D含量分组中差异无统计学意义;户尘螨和混合真菌血清sIgE阳性在不同血清25(OH)D含量分组中差异有统计学意义(P=0.000,P=0.043)。单因素Logistic回归分析表明,血清25(OH)D是AD患儿户尘螨过敏的危险因素,血清25(OH)D缺乏患儿对户尘螨过敏的风险是25(OH)D充足患儿的8.196倍(OR=8.196,P=0.000);但血清25(OH)D水平不是AD患儿混合真菌过敏的危险因素。结论·血清25(OH)D含量可能影响AD患儿对户尘螨的致敏性。根据过敏原检测结果,针对性回避致敏物以及补充维生素D,可能在AD的预防和治疗中具有重要意义。Objective·To explore the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and serum allergens in children with atopic dermatitis(AD), and provide a theoretical basis for the prevention and treatment of AD. Methods·From November 2017 to February 2019, a total of 165 pediatric patients with AD who visited the Dermatology Department of Shanghai Children′s Medical Center were enrolled in this study. AD severity was assessed according to the severity scoring of atopic dermatitis(SCORAD). Serum total Ig E and specific IgE(s IgE) levels of 19 common allergens were detected, and serum25(OH)D was determined by liquid chromatography-tandem mass spectrometry. All data were statistically analyzed. Correlation analysis was conducted by spearman’s or point-biserial correlation analysis. Chi-square test was used for comparison of count data between groups.Binary linear regression analysis was used to identify the risk factors. Results·SCORAD score was shown to be positively correlated with serum total IgE level, absolute value and percentage of eosinophils in children with AD(r=0.213, P=0.009;r=0.268, P=0.001;and r=0.249, P=0.003, respectively). However, there was no significant correlation between serum 25(OH)D concentrations and SCORAD score in children with AD, while there was a significant negative correlation between the serum 25(OH)D concentrations and the total IgE levels, and the percentage of eosinophils in children with AD(r=-0.212, P=0.011;and r=-0.174, P=0.039, respectively) was shown. In this study, the most common allergens with s Ig E grade Ⅲ or above were house dust mite, egg white and cashew nut,followed by crab, cat dander, mixed mold, shrimp, dog dander, house dust and mixed tree pollen from high to low. There was no significant correlation between the number of allergen-positive items and serum 25(OH)D concentrations in children with AD(χ^(2)=6.27,P=0.804). However, AD patients with positive house dust mite and mixed mold were statistically significant in different serum [25(OH)D] gro

关 键 词：特应性皮炎 血清25(OH)D 血清总IGE 特异性IGE 户尘螨 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]