抗组胺耐药慢性荨麻疹与补体C5a、症状评分及风团持续时间的相关性

Correlation between Antihistamine-resistant Chronic Urticarial and C5a Concentration,Symptom Scores and Duration of Wheals

目的探讨抗组胺耐药慢性荨麻疹(chronic urticaria,CU)的相关影响因素。方法检测抗组胺敏感CU及抗组胺耐药CU患者血浆凝血因子[凝血酶原片段F1+2(prothrombin fragment 1+2,F1+2)、组织因子(tissue factor,TF)]、抗凝因子[血栓调节蛋白(thrombomodulin,TM)]、纤溶标志物[高分子量激肽原(high molecular weight kininogen,HMWK)、组织型纤溶酶原激活剂(tissue plasminogen activator,t-PA)]、补体(C5a、C3、C4)、炎性标志物[红细胞沉降率(erythrocyte sedimentation rate,ESR)、抗溶血性链球菌O(anti-streptolysin"O",ASO)、C-反应蛋白(C-reactive protein,CRP)、类风湿因子(rheumatoid factor,RF)]水平,分析上述指标及CU病情等与CU抗组胺药物治疗反应的关系。结果与敏感CU患者[(40.43±10.89)ng/ml]比较,抗组胺药耐受CU患者C5a水平[(50.67±16.83)ng/ml]升高且差异有统计学意义(P<0.05),血浆F1+2、TF、TM、HMWK、t-PA、C3、C4、ESR、ASO、RF及CRP水平差异无统计学意义(均P>0.05)。抗组胺药物敏感与否与症状评分及风团持续时间相关(r=0.42,P<0.01;r=0.57,P<0.01)。结论抗组胺耐药CU患者血浆C5a水平升高、症状评分较高且风团持续时间较长,提示抗组胺耐药CU患者病情更严重且存在更复杂的自身免疫因素。

To investigate the influencing factor for antihistamine-resistant chronic urticaria. Methods The plasma level of prothrombin fragment 1 ＋ 2 （F1 ＋ 2）, tissue factor （TF）, thrombomodulin （TM）, high molecular weight kininogen （HMWK）, tissue-type plasminogen activator （t-PA）, CSa and serum levels of C3, C4, erythrocyte sedimentation rate （ESR）, anti-streptolysin O （ASO）, rheumatoid factors （RF） and C-reactive protein （CRP） were detected in patients with antihistamine-resistant and antihistamine-sensitive chronic urticaria. Results Plasma concentrations of CSa in patients with antihistamines-resistant chronic urticaria [ （50.67 ±16. 83 ） ng/ml] between the higher than in patients with antihistamine-sensitive chronic urticatia [ （40.43 ± 10. 89） ng/ml ] , the difference was statistically significant （P 〈0.05 ）. But there was no significant difference between the plasma level of F1 ＋ 2, TF, TM, HMWK, t-PA and serum levels of C3, C4, ESR, ASO, RF and CRP in two patients groups （P 〉 0. 05）. The responsiveness to antihistamines was correlated with symptom scores and duration of wheals （r = 0. 42, P 〈 0.01 ; r = 0. 57, P 〈 0.01 ）. Conclusion The increased C5a concentration, higher symptom scores and longer duration of wheals was shown in patients with antihistamines-resistant chronic urticarial.