哮喘青春期自然缓解者血嗜酸粒细胞阳离子蛋白、类胰蛋白酶和吸入性过敏原特异性IgE的变化

Changes of serum ECP, Tryptase and aeroallergen-specific IgE in asthmatics with natural remission at puberty

目的 :对哮喘青春期自然缓解甚而自愈的现象进行探讨 ,为支气管哮喘的防治提供理论依据。方法 :应用Phar maciaUnicap 10 0系统酶免疫荧光检测仪 ,分别对 2 3例哮喘青春期缓解者、15例哮喘患者和 2 9例正常人进行吸入性过敏原的特异性IgE抗体 (phadiatop)、嗜酸粒细胞阳离子蛋白 (ECP)及类胰蛋白酶 (Tryptase)检测。结果 :哮喘青春期缓解组特异性IgE抗体阳性率为 6 6 6 6 %、哮喘组阳性率 71 42 %、正常对照组阳性率为 6 89%。哮喘青春期缓解组与哮喘组特异性IgE抗体阳性率接近 ,几无差别 ,但两组阳性率均明显高于正常对照组 (P <0 0 0 5 )。血清ECP值 ,2 0 %哮喘患者增高 ,而哮喘青春期缓解者和正常人ECP均无一例增高。哮喘组与缓解组比较 ,哮喘组与正常人比较均有差异 (P <0 0 5 )和 (P <0 0 2 5 ) ,而青春期哮喘缓解组与青春期正常人比较 ,无明显差异 (P >0 0 5 )。哮喘青春期缓解组Tryptase增高率为 30 43% ,而哮喘患者的增高率为 5 3 33% ,青春期正常对照组Tryptase增高率为 10 34 %。 3组Tryptase测定结果比较有显著差异 (P <0 0 0 1) ,青春期哮喘缓解组Tryptase增高率明显低于青春期哮喘组 ,但又明显高于正常对照组。结论 :青春期哮喘缓解者虽临床缓解 3年以上 。

Objective:To elucidate the phenomenon of natural remission or even natural recovery of asthma at puberty and put forward the laboratory evidences for the prevention and treatment of asthma Methods:The serum ECP, Tryptase and aeroallergen specific IgE antibody in 23 cases of asthmatics with remission at puberty, 15 cases of asthmatics, 29 cases of normal controls were detected respectively, using Pharmacia Unicap100 Type EIA fluorecent instrument Results: The positive rate of specific IgE antibody in asthmatics with remission at puberty was 66 66%, that in group of asthma was 71 42% and that in normal controls was 6 89% The positive rates of specific IgE in the former two groups were almost the same, and were significantly higher than that in normal controls (P<0 005) As to ECP, 20% of patients were high above normal in group of asthma, whereas no one was above normal in asthmatics with remission at puberty and in normal controls There was significant difference between groups of asthma and asthma with remission at puberty (P<0 05) and significant difference between groups of asthma and normal controls (P<0 025) But no significant difference was found between asthmatic with remission at puberty and normal controls (P<0 05) 30 43% of patients in group of asthma with remission at puberty were found with abnormally high serum Tryptase (content), and 53 33% in group of asthma, 10 34% in group of normal controls were above normal value There were significant differences among these three groups (all P<0 001) Serum tryptase in asthmatic with remission at puberty was significant lower than that in group of asthma, but was significant higher than that in normal controls Conclusion:Even though getting remission more than 3 years at puberty, asthmatics were still found with abnormally high aeroallergen specific IgE antibody , ECP and serum Tryptase , the latter represents the activation of mast cells