食物IgG抗体检测在慢性消化系统疾病中的临床意义

Clinical significance of food allergen-specific IgG antibody detection in chronic gastrointestinal diseases

目的探讨血清中14种食物过敏原特异性IgG与小儿慢性消化系统疾病的关系。方法应用酶联免疫法检测40例慢性消化系统疾病患儿,血清中食物特异性IgG水平,然后按3∶1分别采用微粒子化学发光法和散射比浊法检测血清总IgE和血清IgG4水平。结果40例患儿食物过敏原特异性IgG升高有1到6种不等,总阳性率为100%,2种以上升高者为87.5%。食物特异性IgG升高以鸡蛋(92.5%)和牛奶(72.5%)最多见,其次为小麦、大豆(分别为40.0%、27.5%),鸡肉、猪肉和玉米均为0。根据试验结果调整所有患儿的饮食,病人症状在3周内明显改善者62.5%,症状有所改善者32.5%,无效5.0%,总有效率为95.0%。血清总IgE大于正常值者为17.5%,与食物特异性IgG无相关性(r=-1.132,P=0.268)。血清总IgG4水平变化与食物特异性IgG无相关性(r=0.863,P=0.396),与年龄呈正相关(r=3.317,P=0.003)。结论测定食物过敏原特异性IgG在小儿慢性消化系统疾病诊治中有重要意义。

Objectives To explore the correlation between 14 food allergen-specific IgG antibodies and chronic digestive diseases in children. Methods The food allergen-specific IgG antibodies in serum were measured by enzymelinked immunosorbent assay （ELISA） in 40 children with chronic digestive diseases. Total serum IgE and serum IgG4 levels were analyzed at the ratio of 3 to 1 by chemiluminescent microparticle immunoassay （CMIA） and nephelometry respectively. Results The increased food allergen- specific IgG antibodies ranged from 1 to 6 types in all the children. Total positive rate was 100 % and 87.5 % children showed elevated levels of at least 2 types of antibodies. The most common elevated food allergen-specific IgG detected were that against egg （92.5 %） and cow＇s milk （72.5 %）,followed by wheat （40.0 %） and soybean （27.5 %）. No increase of IgG specific to chicken, pork and corn were detected. All the subjects adjusted their diet according to the assay results. Within 3 weeks, 62.5 % of the cases have significant symptomatic relief,32.5 % had moderate relief and no effect was observed in 5 % of the cases （total efficacy = 95.0 %）. Total serum IgE was 17.5 % above the normal level and had no correlation with food allergen-specific IgG （r = -1.132, P =0.268）. There was also no correlation between serum IgG4 level and food allergen-specific IgG （r = 0.863, P = 0.396）, but a positive correlation between serum IgG4 level and age （r = 3.317, P = 0.003） was detected. Conclusions The measurement of 14 common food allergenspecific IgG might be very useful for diagnosis and treatment of chronic digestive diseases in children.