尘螨诱发的变应性鼻炎患者的组分特征  

Characteristics of allergen component in dust mite-induced allergic rhinitis patients

作　　者：陈浩[1] 纪平 杨林 黄南 蒋晴[1] 杨雅琪 祝戎飞 CHEN Hao;JI Ping;YANG Lin;HUANG Nan;JIANG Qing;YANG Yaqi;ZHU Rongfei(Department of Allergy,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430030,China;Department of Allergology,Zhongnan Hospital of Wuhan University)

机构地区：[1]华中科技大学同济医学院附属同济医院过敏反应科,武汉430030 [2]武汉大学中南医院过敏反应科

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第6期442-447,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的探讨尘螨(dust mite,DM)诱发的变应性鼻炎(allergic rhinitis,AR)患者的组分特征,为临床AR的诊断与治疗提供参考。方法纳入2021—2022年就诊于华中科技大学同济医院过敏反应科就诊的由DM诱发的伴或不伴过敏性哮喘(allergic asthma,AA)的AR患者,记录患者年龄、性别以及症状的视觉模拟量表(visual analogue scale,VAS),采用蛋白芯片法检测粉尘螨(Dermatophagoides farinae,Der f)组分Der f1,Der f2及户尘螨(Dermatophagoides pteronyssinus,Der p)组分Der p1,Der p2,Der p7,Der p10,Der p21,Der p23的sIgE与sIgG4,观察患者的组分致敏特征,评估各组分与VAS的相关性以及不同疾病谱之间的组分差别。结果纳入87例DM诱发的AR患者,其中AR伴AA(AR&AA)患者占42.5%,其VAS评分明显高于单独AR患者(6.38±1.95 vs 5.25±1.85,P=0.0098),DM组分致敏率排前的依次为:Der p2(82.8%),Der f2(81.6%),Der p1(74.7%),Der f1(70.1%),Der p23(35.6%);组分sIgG4阳性率排前的依次为:Der p2(21.8%),Der f2(13.8%),Der p21(8.0%),Der p7(6.9%)。组分sIgE、sIgG4浓度以及阳性数量与VAS评分无相关性,但抗体浓度之间分别存在广泛的正相关。与单独AR比较,AR&AA患者Der p[60.5(7.2~91.1)vs 14.0(4.8~45.1),P=0.02],Der f[49.8(15.7~81.6)vs 21.3(7.0~50.2),P=0.04]以及组分Der p1[27.2(0.7~51.5)vs 2.6(0.2~24.9),P=0.02]、Der p2[20.0(1.4~60.6)vs 5.5(0.6~19.1),P=0.004]、Der f2[58.9(16.0~89.2)vs 23.4(0.9~56.8),P=0.009]的sIgE更高,AR&AA患者组分Der p1(70.3%vs 48.0%,P=0.038)与Der p23(27.0%vs 14.0%,P=0.039)的sIgE≥3级的比例更高。结论DM的第1,2及23组分是DM致敏的AR患者的主要组分,多重组分致敏以及各组分sIgE、sIgG4水平与AR的严重程度无相关性,与AR比较,AR&AA患者的第1,2及23组分的sIgE水平更高。Objective To investigate the characteristics of allergen component in dust mite(DM)-induced allergic rhinitis(AR)patients,and provide reference for the diagnosis and treatment of AR.Methods DM-induced AR patients with or without allergic asthma(AA)who visited the Allergy Department of Tongji Hospital,Huazhong University of Science and Technology between 2021 and 2022 were enrolled.Patients'age,gender,and visual analog scale(VAS)for symptoms were recorded.sIgE and sIgG4 levels of allergen components such as Der f1,Der f2,Der p1,Der p2,Der p7,Der p10,Der p21,and Der p23 were detected using a protein chip method.The sensitization characteristics of the allergen components in the patients were observed,and the correlation between sIgE,sIgG of each component and VAS as well as the component differences between AR and AR with AA(AR&AA)were evaluated.Results A total of 87 DM-induced AR patients were enrolled,with 42.5%of them were AR&AA,their VAS scores were significantly higher than those of AR patients(6.38±1.95 vs 5.25±1.85,P=0.0098).The order of sensitization rates for DM components was as follows:Der p2(82.8%),Der f2(81.6%),Der p1(74.7%),Der f1(70.1%),and Der p23(35.6%).The order of positive rates for sIgG4 was:Der p2(21.8%),Der f2(13.8%),Der p21(8.0%),and Der p7(6.9%).There were no correlation between the sIgE,sIgG4 levels or positive numbers of components and VAS scores,but there were positive correlations between sIgE,sIgG4 concentrations of components.Compared with AR patients,AR&AA patients had higher levels of sIgE for Der p(60.5[7.2-91.1]vs 14.0[4.8-45.1],P=0.02),Der f(49.8[15.7-81.6]vs 21.3[7.0-50.2],P=0.04),Der p1(27.2[0.7-51.5]vs 2.6[0.2-24.9],P=0.02),Der p2(20.0[1.4-60.6]vs 5.5[0.6-19.1],P=0.004),and Der f2(58.9[16.0-89.2]vs 23.4[0.9-56.8],P=0.009),and a higher proportion of AR with AA patients had sIgE levels of Der p1(70.3%vs 48.0%,P=0.038)and Der p23(27.0%vs 14.0%,P=0.039)that were≥3 grades.Conclusion Der p1/f1,Der p2/f3,and Der p23 are the major components of DM sensitized AR patients.Multiple co

关 键 词：变应性鼻炎 哮喘 过敏原 尘螨 组分 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]