健康成人血清总IgE和变应原特异性IgE检测及意义

Detection of serum total IgE and allergen-specific IgE in healthy adults and its significance

目的通过检测健康成人血清总Ig E和变应原特异性Ig E,分析测定值在不同年龄和不同性别人群中的分布情况,探讨其科学意义及应用价值。方法接受健康体检的志愿者536例,其中男347例,女189例,19-60岁（中位数38岁）,均无变态反应性疾病和全身系统性疾病的症状及病史。血清总Ig E检测采用酶联免疫捕获法,总Ig E水平≤100 k U/L为阴性,〉100 k U/L阳性。特异性Ig E检测采用荧光免疫法,以吸入性变应原过筛试验（Phadiatop）为测定指标,Phadiatop 0级为阴性,≥1级为阳性。结果健康成人的血清总Ig E水平为1.14-1 703.70（中位数37.18）k U/L,男性显著高于女性,差异有统计学意义（P=0.001）。血清总Ig E阴性占72.52%,阳性占27.48%。健康成人的Phadiatop测定值为0.01-59.50（中位数0.05）k U/L,男性与女性相比较,差异无统计学意义（P=0.154）。Phadiatop阴性占82.09%,阳性占17.91%。各年龄组之间血清总Ig E水平、特异性Ig E水平进行比较,差异均无统计学意义（P=0.119,P=0.225）。血清总Ig E水平与特异性Ig E水平的Spearman秩相关系数为0.683（正相关）,具有统计学意义（P〈0.001）。血清总Ig E阴性388例中,Phadiatop阴性368例（94.85%）,阳性20例（5.15%）;血清总Ig E阳性147例中,Phadiatop阳性75例（51.02%）,阴性72例（占48.98%）。结论在该健康成年人群中超过1/4者血清总Ig E水平高于100 k U/L,而对吸入性变应原致敏者不到1/5。血清总Ig E与特异性Ig E二者之间有较强的相关性。血清总Ig E水平低于100 k U/L对筛查排除变应原致敏有较大价值,但总Ig E水平高于100 k U/L时无法明确机体是否为致敏状态,需结合病史及临床表现进行合理评价。

Objective To explore the scientific significance and practical application of serum levels of total Ig E（ tIgE）and allergen-specific Ig E（ sIgE） in excluding allergen sensitization. Methods A total of 536 volunteers including 347 males and 189 females,aged 19-60 years with median age of 38 years old received the healthy physical examination were recruited in the study. All the subjects had no history and symptoms of allergic diseases as well as systemic diseases. Serum tIgE was detected by the capture enzyme-linked immunosorbent assay. The tIgE level ≤100 k U / L represented negative while 100 k U / L positive. Serum sIgE was assessed by means of the Phadiatop test using the fluoroimmunoassay. The Phadiatop class 0 means negative and class ≥1 positive. Results Serum level of tIgE among healthy adults was 1. 14-1 703. 70（ median 37. 18） k U / L,and it was significantly higher in males than in females（ P = 0. 001）.The negative and positive rates of serum tIgE were 72. 52% and 27. 48%,respectively. Serum level of sIgE（ Phadiatop） among healthy adults was 0. 01-59. 50（ median 0. 05） k U / L,which had no significant significance betw een the male and the female（ P = 0. 154）. The negative and positive rates of Phadiatop were 82. 09% and 17. 91%,respectively. There were no statistically significant differences in serum tIgE and sIgE levels among different age groups（ P =0. 119 and P = 0. 225,respectively）. The Spearman rank correlation coefficient betw een serum tIgE and sIgE levels was0. 683 with statistical significance（ positive correlation,P 0. 001）. There were 368 subjects（ 94. 85%） with negative Phadiatop and 20 subjects（ 5. 15%） with positive Phadiatop in the serum tIgE negative subjects（ n = 388）,while 75subjects（ 51. 02%） with positive Phadiatop and 72 subjects（ 48. 98 %） with negative Phadiatop in the serum tIgE positive subjects（ n = 147）. Conclusion More than one fourth subjects among healthy adults have a serum tIgE level higher than 100 k U / L,while less than one fifth subjects have a sensitization to inhaled allergens. There is an obvious correlation betw een the serum levels of tIgE and sIgE. The serum tIgE level below 100 k U / L may have a clinical value to exclude allergen sensitization; however,the sensitized status may not be confirmed when the tIgE level is higher than100 k U / L,and case history and clinical manifestations also should be considered.