儿童急、慢性荨麻疹IgE及嗜酸性粒细胞检测分析

The analysis of IgE and eosinophil determinations in acute and chronic urticaria children

目的探讨儿童急、慢性荨麻疹Ig E水平和嗜酸性粒细胞变化及其临床意义。方法分别用化学发光法、酶免荧光法和VCS(体积、电导性和散射)原理检测77例急性和46例慢性荨麻疹患儿血清总Ig E水平,食物、螨虫及植物类特异性Ig E和嗜酸性粒细胞比例,比较急、慢性荨麻疹患儿间上述指标的差异。结果伴有其它过敏性疾病的急、慢性荨麻疹患儿间血清总Ig E水平,食物、螨虫及植物类特异性Ig E阳性率差异无统计学意义(P>0.05),但不伴有其它过敏性疾病的慢性荨麻疹患儿总Ig E水平显著高于急性荨麻疹患儿(P<0.05);男性血清Ig E水平显著高于女性;随着年龄增长,总Ig E水平呈一定的增长趋势;螨虫类Ig E阳性率显著高于食物及植物类(P<0.05)。急、慢性荨麻疹患儿嗜酸性粒细胞升高率差异无统计学意义(P>0.05)。结论嗜酸性粒细胞比例不能作为儿童急、慢性荨麻疹鉴别诊断的指标。Ig E在无其它过敏性疾病的儿童急、慢性荨麻疹的鉴别诊断中具有一定的价值,但在其它情况,血清总Ig E水平不能作为儿童急、慢性荨麻疹鉴别诊断的指标,必须结合患儿病史、病程及临床症状方能作出正确的诊断。

Objective To investigate IgE levels,eosinophil change and their clinical significance in acute and chronic urticaria children.Methods Respectively by chemiluminescence,enzyme-linked immunofluorescence and volume,conductivity and scattering （VCS）principle,serum total IgE levels,food,mites and plant-specific IgE levels and eosinophil percentages were determined,and the samples were collected from 77 acute and 46 chronic urticaria children.The differences between acute and chronic urticaria children were analyzed comparatively.Results There was no statistical significance in total IgE levels and positive rates to food,mites and plant-specific IgE levels between acute and chronic urticaria children with other allergic diseases（P ＆gt;0.05）,but there was a significantly higher total IgE level in chronic group than that in acute group in acute and chronic urticaria children without other allergic diseases （P ＆lt;0.05）.Boys had significantly higher serum total IgE levels than girls.The total IgE levels had a trend of increasing with age.There was a higher positive rate to mites-specific IgE than food and plant-specific IgE（P ＆lt;0.05）.The eosinophil percentages of acute and chronic urticaria children had no statistical significance （P ＆gt;0.05）.Conclusions Eosinophil percentage is not a good index for differential diagnosis in acute and chronic urticaria children.IgE has a certain significance for diagnosing acute and chronic urticaria without other allergic diseases.However,in other cases,serum level of total IgE is not a good index for differential diagnosis in acute and chronic urticaria children.Integrating case history,course of disease and clinical symptom can help with making a correct diagnosis.