450例婴幼儿喘息患儿特异性IgE的分布特征及意义

Allergens Specific to IgE in 450 Cases of Infant Asthma

目的：探讨婴幼儿喘息患儿特异性IgE的分布特征,为预测婴幼儿喘息的表型及采取二级预防提供依据。方法：应用欧蒙印迹法对2011年3月-2013年11月在本院儿内科住院的450例年龄为2-30个月的婴幼儿喘息患儿进行食入和吸入特异性IgE的测定。结果：450例患儿中检出食入和吸入特异性IgE阳性病例276例,检出率61.33%,特异性IgE阳性检出率前3位从高到低依次为蛋清29.78%（134/450）,螨虫22.89%（103/450）,牛奶22.44%（101/450）;其中2-12个月患儿234例,检出食入和吸入特异性IgE阳性126例,检出率为53.85%,特异性IgE阳性率检出前3位依次为牛奶23.50%（55/234）,蛋清20.09%（47/234）,螨虫16.67%（39/234）;13-30个月患儿216例,检出食入和吸入特异性IgE阳性150例,检出率为69.44%,特异性IgE阳性率检出前3位依次为蛋清40.28%（87/216）,螨虫29.63%（64/216）,牛奶21.30%（46/216）;特异性IgE阳性检出率2-12个月组患儿明显低于13-30个月组（P〈0.005）。牛奶IgE阳性检出率2-12个月组与13-30个月组无差异（P〉0.05）,螨虫IgE阳性检出率2-12个月组明显低于13-30个月组（P〈0.005）。蛋清IgE阳性检出率2-12个月组明显低于13-30个月组（P〈0.005）。450例患儿中仅有34例为单一食入或吸入IgE阳性病例。结论：婴幼儿喘息患儿有食入性和吸入性多种致敏因素,常为牛奶、蛋清、螨虫。过敏原致敏风险和吸入性过敏原机会均随月龄增加而增大。

Objective ：Investigate the allergens specific to IgE in infant asthma ,helping to predict the phenotype of infant asthma and to take appropriate secondary prevention .Methods ：Detection of specific IgE for ingested or inhaled allergens by using Euroimmun blotting in 450 cases with asthma from 2 months old to 30 months old ,who have been hospitalized in the department of pediatrics from March 2011 to November 2013 .Results：276 infants among 450 cases displayed IgE-positive sera ,representing a rate of 61 .33% .Allergens for higer IgE detection rate was shown to be Egg white（29 .78% ,134/450） ,mites （22 .89% ,103/450） and milk （22 .44% ,101/450）;among 234 infants from 2 months old to 12 months old ,126 cases （53 .85% ） had IgE-positive sera ;the most common allergen was milk （23 .50% ,55/234） ,egg white （20 .09% ,47/234） and mites （16 .67% ,39/234） .Among 216 infants from 13 months old to 30 month old ,150 cases（69 .44% ） were found to be IgE positive .Many infants with asthma were allergic to egg white （40 .28% , 87/216） ,mites （29 .63% ,64/216） and milk （21 .30% ,46/216） .IgE detection rate in group from 2 months old to 12 months old was significantly lower than that from 13 months old to 30 months old .When compared to the group of older ,detection rates of IgE specific to mites and egg white was much lower in younger infants .There was no significant difference about IgE detection rate for milk between younger and older group .Additionally ,34 infants among 450 cases displayed that IgE was specific to single ingested allergen or inhaled allergens .Conclusion ：Infants with asthma can be induced by a variety of ingested and inhaled allergens ,such as milk ,egg white and mites .Risk of allergen sensitization is increased with age .