自体血清皮肤试验在慢性特发性荨麻疹自身免疫机制异常诊断中的应用价值

Autologous serum skin test in diagnosis of chronic idiopathic urticaria with autoimmunity

目的探讨自体血清皮肤试验（ASST）在慢性特发性荨麻疹fCIU）患者自身免疫机制异常诊断中的应用价值。方法对90例CIU患者行ASST，分析比较ASST阳性和阴性患者的病史、症状体征及器官特异性自身抗体检查指标的差异。结果ASST阴性者70例，阳性者20例。ASST阳性CIU患者病程明显长于阴性者（P〈0．05），而性别、年龄、发作次数及症状体征积分的差异均无统计学意义（均P〉0．05）。ASST阳性CIU患者伴有自身免疫相关疾病的比例及甲状腺微粒体抗体阳性率、甲状腺过氧化物酶抗体阳性率均明显高于ASST阴性患者（均P〈0．05）．而幽门螺杆菌抗体阳性率及乙肝表面抗原阳性率的差异均无统计学意义（均P〉0．05）。结论ASST阳性提示CIU患者伴有自身免疫机制异常，ASST可以作为CIU患者自身抗体检查的筛选实验。

Objective To assess the autologous serum skin test （ASST） in diagnosis of chronic idiopathic urticaria （CIU） with autoimmunity. Methods ASST was performed in 90 patients with CIU. The clinical features of the patients with ASST＋ were evaluated and compared with those of the patients with ASST-. Results ASST was positive in 20 out of 90 CIU cases with a positive rate of 22.2%. There was no significant difference in age and sex distribution of the disease between the ASST＋ and ASST-CIU patients （P 〉0.05）; and there was also no significant difference in the total score of physical signs and symptoms and eruption frequency between the ASST＋ and ASST- patients （P 〉0.05）. But ASST＋ patients had a significant longer course （P〈0.05） than ASST- patients. ASST＋ patients had more frequent autoimmune conditions than ASST- patients （P〈0.05）. More organ-specific autoantibodies were found in ASST＋ patients than in ASST- patients. Conclusion ASST can be used as a screening test for autoantibodies in CIU.