呼吸道过敏性疾病患者血清总抗体E检测及意义

Detection and significance of serum total IgE in patiects with respiratory allergies

目的探讨血清总抗体E（TIgE）水平在呼吸道过敏性疾病诊断中的意义。方法收集呼吸科和变态反应科门诊患者475例,采用荧光酶联免疫吸附法,检测血清TIgE水平,同时测定常见吸入性过敏原的特异性抗体E（SIgE）。结果过敏性疾病患者血清TIgE水平呈非正态分布;0～14岁组TIgE水平高于青壮年和中老年,差异有统计学意义（P=0.001）;TIgE〈113 kU/L的正常参考值时,有38%的患者仍可出现过敏症状或者尘螨SIgE呈阳性;但随着TIgE值增高,其SIgE值不断上升。结论血清TIgE测定不能有效地排除有过敏症状患者对常见吸入性过敏原是否过敏;但高TIgE水平可增加过敏的概率,源于正常人群的TIgE参考值不能用来区分过敏试验阳性和阴性的患者,因为二者有广泛交叉。

Objective To investigate the diagnostic value of serum total immunoglobin E（IgE） test in respiratory allergies.Methods 475 patients registered to department of respirology or allergy clinic in the hospital were evaluated for serum total IgE.The level of specific IgE（SIgE） to common inhalant allergens was also detected.Results The TIgE values in these allergic patients were associated with a nonnormal distribution pattern.Compared with young and older adult groups,0～14 years-old group showed higher TIgE level with markedly statistical significance（P=0.001）.Within the normal reference range（〈113 KU/L）,38% of the subjects were found to be clinically symptomatic,and some of them concurrently demonstrated mite-specific IgE positive.The level of SIgE increased with higher TIgE.Conclusion Serum TIgE test may not be effective to eliminate the involvement of allergies to common inhalant allergens in symptomatic patients,whereas higher TIgE level may be linked to higher risk of allergies.Normal reference value of TIgE originated from normal populations should not be extrapolated to identify individuals with positive or negative results from allergic test due to a wide range of overlapping between the two.