食物特异性IgG抗体与慢性自发性荨麻疹表型的相关性研究  

Correlation between food-specific IgG antibodies and phenotypes of chronic spontaneous urticaria

作　　者：佟馨 吴剑[1] 张立明[1] 高兴华[1] 连石[2] 张海萍[2] 朱威[2] 郭在培[3] 黎静宜[3] 李萌萌[3] 何黎[4] 农祥[4] 普雄明[5] 于世荣[5] 陈洪铎[1] 肖汀[1] Tong Xin;Wu Jian;Zhang Liming;Gao Xinghua;Lian Shi;Zhang Haiping;Zhu Wei;Guo Zaipei;Li Jingyi;Li Mengmeng;He Li;Nong Xiang;Pu Xiongming;Yu Shirong;Chen Hongduo;Xiao Ting(Department of Dermatology,The First Hospital of China Medical University,National Health Commission Key Laboratory of Immunodermatology,Key Laboratory of Immunodermatology of Ministry of Education,National Joint Engineering Research Center for Theranostics of Immunological Skin Diseases,Shenyang 110001,China;Department of Dermatology,Xuanwu Hospital Capital Medical University,Beijing 100053,China;Department of Dermatology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Dermatology,First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Department of Dermatology,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]中国医科大学附属第一医院皮肤科,卫健委免疫皮肤病学重点实验室、教育部免疫皮肤病学重点实验室,免疫性皮肤病诊治技术国家地方联合工程研究中心,沈阳110001 [2]首都医科大学宣武医院皮肤科,北京100053 [3]四川大学华西医院皮肤科,成都610041 [4]昆明医科大学附属第一医院皮肤科,昆明650032 [5]新疆维吾尔自治区人民医院皮肤科,乌鲁木齐830001

出　　处：《中华皮肤科杂志》2023年第2期130-135,共6页Chinese Journal of Dermatology

基　　金：国家临床重点专科建设项目重点实验室项目《荨麻疹诊治技术的研发与推广》([2012]649)。

摘　　要：目的探讨食物特异性IgG(sIgG)与慢性自发性荨麻疹(CSU)表型的相关性。方法连续收集2014年4月至2015年3月于中国医科大学附属第一医院等5家三级甲等医院皮肤科门诊就诊的活动期CSU、皮肤划痕症(SD)、急性荨麻疹(AU)患者和健康对照血清,酶联免疫吸附法检测90种食物抗原sIgG抗体和总IgE抗体,免疫印迹法检测20种变应原sIgE抗体,化学微粒子发光法检测甲状腺过氧化物酶IgG抗体和甲状腺球蛋白IgG抗体。两组间和多组间正态分布计量数据的比较分别采用t检验和单因素方差分析,两组间非正态分布计量数据的比较采用Mann-Whitney U检验,率的比较采用χ2检验和Fisher精确检验。结果纳入CSU患者248例,SD患者22例,AU患者15例,健康对照13例。以sIgG≥100 IU/ml(2+及以上)为阳性标准,CSU组、SD组和AU组的食物sIgG阳性率(176/248,70.97%;15/22,68.18%;11/15)略高于健康对照组(7/13),但4组差异无统计学意义(χ2=1.80,P=0.615)。248例CSU患者中,sIgG阳性组有过敏性疾病家族史的比例(71/176,40.34%)显著高于sIgG阴性组(19/72,26.39%;χ2=4.30,P=0.042),但两组1 d荨麻疹活动度评分(UASday)差异无统计学意义(Z=0.18,P=0.859)。177例CSU患者完成12~40周的治疗及随访且使用二代抗组胺药物可完全控制病情,sIgG阳性组(128例)与sIgG阴性组(49例)所需剂量差异无统计学意义(Z=-1.06,P=0.298)。结论食物sIgG阳性的CSU患者有过敏性疾病家族史的比例升高,但食物sIgG不能作为反映CSU疾病活动度和治疗反应的指标。Objective To investigate the correlation between food-specific IgG(sIgG)antibodies and phenotypes of chronic spontaneous urticaria(CSU).Methods Serum samples were collected from outpatients with active CSU,symptomatic dermographism(SD),or acute urticaria(AU),and healthy controls from 5 third-grade class-A hospitals such as the First Hospital of China Medical University between April 2014 and March 2015.Enzyme-linked immunosorbent assay was conducted to detect serum levels of 90 food-sIgG antibodies and total IgE,Western blot analysis to detect levels of 20 allergen-specific IgE antibodies,and chemiluminescent microparticle immunoassay to detect levels of anti-thyroid peroxidase IgG antibodies and anti-thyroglobulin IgG antibodies.Comparisons of normally distributed quantitative data between two groups and among several groups were performed by t test and one-way analysis of variance,respectively;comparisons of non-normally distributed quantitative data between two groups were performed by Mann-Whitney U test;for comparisons of proportions,chi-square test and Fisher′s exact test were used.Results A total of 248 patients with CSU,22 with SD,15 with AU and 13 healthy controls were recruited.The cut-off level for sIgG positivity was 100 U/ml(at least 2+),and the positive rate of food-sIgG antibodies was slightly higher in the patients with CSU(176/248,70.97%),SD(15/22,68.18%)and AU(11/15)than in the healthy controls(7/13;χ2=1.80,P=0.615).Among the 248 CSU patients,the proportion of patients with family history of allergic diseases was significantly higher in the sIgG-positive group(71/176,40.34%)than in the sIgG-negative group(19/72,26.39%;χ2=4.30,P=0.042),while no significant difference was observed in the 1-day urticaria activity score(UASday)between the two groups(Z=0.18,P=0.859).Totally,177 CSU patients completed 12-to 40-week treatment;their condition could be completely controlled by second-generation H1-antihistamines,and there was no significant difference in the required dosage of second-generation H1-an

关 键 词：荨麻疹 慢性自发性荨麻疹 皮肤划痕症 急性荨麻疹 食物特异性IGG 甲状腺过氧化物酶 甲状腺球蛋白 总IGE 变应原特异性IgE 

分 类 号：R758.24[医药卫生—皮肤病学与性病学]