呼吸道过敏患儿与特异性IgG抗体表达水平的相关研究

Relation between expression of food-specific IgG and respiratory allergic diseases in children

目的探讨食物特异性IgG的表达水平与非IgE介导的呼吸道过敏的关系,以及特异性IgG定量检测能否作为食物引起呼吸道过敏反应的诊断指标之一。方法选取2013年12月-2015年12月在该院儿科哮喘门诊诊治的非IgE介导呼吸道过敏的患儿,共78例,健康对照组27例。在饮食回避后对入组患儿进行疗效判断,其标准为症状消失或明显改善,症状评分为3分;症状有所改善为2分;症状无改善或加重为1分视为无效。然后,对特异性IgG的表达水平与临床症状评分之间的关系进行分析,并通过ROC曲线评估特异性IgG的诊断价值。结果过敏组患儿的临床症状得分以及特异性IgG的表达水平,与对照组比较,均升高,差异有统计学意义(P<0.05)。入组患儿的临床症状得分与特异性IgG水平呈正相关;且特异性IgG的诊断准确性较高,ROC曲线下面积为0.713。结论特异性IgG抗体水平的测定在非IgE介导儿童食物引起呼吸道过敏诊断中有一定的参考价值,可在临床上推广使用。

Objective To explore the correlation between the level of food-specific IgG and the severity of respiratory allergies caused by food, and whether the positive expression of specific IgG can be used as a diagnostic indicator of food-induced respiratory allergies or not. Methods A total of 78 subjects, who were diagnosed with non-IgE- mediated respiratory allergies in the Department of Pediatrics Dahua Hospital of Xuhui District from December 2013 to December 2015, were enrolled into study group. The control group included 27 healthy children. The patients were evaluated for efficacy after diet exclusion. Evaluation criteria were as follows： symptom score was 3 points when the symptoms disappeared or significantly improved; 2 points when the symptoms were improved; 1 points when the symptoms were not improved or even worsened which was considered invalid. Then, the relationships between the expression level of specific IgG and the scores of clinical symptoms were analyzed, and the diagnostic value of specific lgG was evaluated by ROC curve. Results Compared with the control group, the scores of clinical sylnptoms and the expression level of specific IgG were significantly increased （P 〈 0.05）. The scores of clinical symptoms and the expression level of specific IgG was positively correlated （r = 0.488, P = 0.000） in the allergic children. And the diagnostic accuracy of specific IgG was high. The area under the ROC curve was 0.713. Conclusions Determination of food-specific IgG level has certain value in diagnosis of non-IgE-mediated food-induced respiratory allergies in children, and is worth popularizing in clinical practice to prevent misdiagnosis.