过敏性疾病患儿外周血嗜碱性粒细胞百分比及活化率检测觹

The clinical values of peripheral blood basophil activation test in children with allergic diseases

目的探讨嗜碱性粒细胞在儿童过敏性疾病中的临床参考价值。方法应用流式细胞仪,采用识别CRTH2/CD63/CD4组合抗体,检测过敏性疾病患儿与正常儿童外周血中CRTH2阳性细胞和嗜碱性粒细胞百分比及其活化率,并将检测结果与血清总IgE、特异性IgE、皮肤点刺试验结果作比较,分析其内在联系。结果 68例过敏性疾病患儿外周血CRTH2阳性细胞百分比较25例正常儿童升高(P<0.05),嗜碱性粒细胞百分比及活化率均较正常儿童显著升高(P均<0.01)。Pearson直线相关分析显示嗜碱性粒细胞百分比与血清总IgE无相关性(r=0.085,P=0.493),嗜碱性粒细胞活化率与血清总IgE之间有轻度相关性(r=0.247,P=0.043)。Spearman等级相关分析显示嗜碱性粒细胞百分比与特异性IgE无相关性(r=0.259,P=0.192),嗜碱性粒细胞活化率与特异性IgE间也存在相关性(r=0.455,P=0.017)。SPT等级结果与嗜碱性粒细胞百分比作Spearman等级相关分析显示两者间无相关性(r=0.231,P=0.058),而嗜碱性粒细胞活化率与SPT等级间存在相关性(r=0.481,P<0.01)。结论过敏性疾病患儿外周血CRTH2阳性细胞百分比显著增高,提示过敏性疾病患儿体内存在Th2型免疫反应的亢进;嗜碱性粒细胞参与了过敏性炎症反应的启动和维持;嗜碱性粒细胞活化率与特异性IgE、皮肤点刺试验存在相关性,对过敏性炎症性疾病的临床筛查和诊断有一定的参考价值。

Objective To explore the clinical values of basophil activation test in childhood allergic diseases by the analysis of CRTH2＋ cells,percent of basophil,and activation of basophil in peripheral blood.Methods The peripheral basophils activation in healthy children and allergic patients（asthma and/or rhinitis and/or dermatitis）were analyzed with a combination of CD3/CRTH2/CD63 antibodies by flow cytometric.Results Ninty-three subjects（25 in control group,68 in allergy group）completed the study.The peripheral CRTH2＋ cell level in the allergy group（0.53% ± 0.22%）was significantly higher than that in control group（0.44% ± 0.14%）（P 0.05）.The peripheral basophil level of the allergy group（0.39% ± 0.19%）was significantly higher than that of control group（0.130% ± 0.073%）（P 0.01）.The basophil activation ratio was higher in allergic patients（85.77% ± 10.63%）than that in control group（31.62% ± 17.41%）.In addition,Spearman correlation coefficients indicated a moderate positive correlation between basophil activation ratio and sIgE calss categorized by Unicap calss.Moreover,Spearman correlation coefficients indicated medium positive correlation between basophil activation ratio and standardized skin prick test.Conclusions The peripheral CRTH2＋ cell level and basophil level increase in allergic children.It suggests that basophils play an important role in the pathogenesis of allergic diseases.Moreover,basophil activation test may have some values in the diagnosis and screening of allergic diseases in children.