伴有器官特异性自身抗体的荨麻疹170例临床分析

Clinical Analysis of 170 Cases Urticaria with Organ Specific Autoantibodies

目的了解自身免疫性荨麻疹的临床及免疫学特征。方法回顾性分析170例血清中具有器官特异性自身抗体的慢性荨麻疹患者的临床资料。结果女性130例(76.47%),男性40例(23.53%);平均年龄35.79±8.49岁;皮损位于躯干部者152例,皮损持续时间大于12h者101例,伴重度瘙痒者132例,其中64例伴发关节痛、胃肠道或呼吸道症状;所有患者血清中均检测出器官特异性自身抗体,其中抗甲状腺相关自身抗体109例,抗幽门螺杆菌抗体85例;9例患者合并结缔组织病,1例患者合并白癜风,45例患者合并桥本甲状腺炎或甲亢;患者中ASST阳性者110例(64.70%),ASST阴性者60例(35.30%)。结论自身免疫性荨麻疹的皮损特点与普通慢性荨麻疹无明显差异,但症状更重,皮损持续时间较长,瘙痒剧烈,好发于躯干部,颜色多为鲜红色,容易伴发其它自身免疫性疾病。

Objective To analyze the clinical and immunologic features of autoimmune urticaria （AU）.Methods The clinical data of 170 cases of chronic urticaria patients with organ specific autoantibodies were analyzed retrospectively.Results One hundred and seventy patients with AU were studied including 130 females （76.47%） and 40 males （23.53%）,with a mean age of （35.79±8.49）years.Among them,152 cases had wheal on the trunk,101 patients showed duration of wheal 〉12h,and severe itching occurred in 132 cases.Arthralgia,gastrointestinal or respiratory symptoms had been experienced during urticarial episodes in 64 cases.The organ specific autoantibodies were found in all patients,including anti-thyroid autobodies in 109 patients and anti-helicobacter pylori antibody in 85 patients.Associated diseases comprised connective tissue disease （9 cases）,vitiligo （1 case） and Hashimoto′s thyroiditis or hyperthyroidosis （45 cases）.Out of 170 patients,110 patients （64.70%） showed positive results by autologous serum skin test （ASST）,and 60 patients （35.30%） showed negative results.Conclusion The results presented in this study revealed that AU has more severe clinical manifestations,such as longer duration,severe itching,areas of predilection for trunk,bright red lesions,often concomitant with autoimmune diseases,though its clinical features are similar with that of ordinary chronic urticaria.