血清IgE升高在自身免疫性胰腺炎患者中的临床意义

The clinical significance about the increased serum IgE in autoimmune pancreatitis patients

目的探讨血清免疫球蛋白E(IgE)升高在自身免疫性胰腺炎患者(AIP)中的临床意义。方法检测63例AIP患者及30例健康体检者血清IgE、IgG、IgG4、补体、球蛋白、嗜酸性粒细胞百分比(EOS%)及自身抗体水平,评估上述指标与AIP并发过敏性疾病或并发糖尿病的关系。结果在63例AIP患者中,IgE、IgG、IgG4、球蛋白异常的比例分别为58.7%、58.7%、74.6%、61.9%,均超过50.0%;EOS%升高、C3降低、C4降低、自身抗体阳性、并发过敏性疾病和并发糖尿病的患者比例分别为25.4%、31.7%、34.9%、25.4%、15.9%和47.6%。而在37例IgE增高的AIP患者中,其IgG、IgG4、球蛋白异常的比例分别为59.5%、89.2%、62.2%,均超过50.0%;EOS%升高、C3降低、C4降低、自身抗体阳性、并发过敏性疾病和并发糖尿病的患者比例分别为29.7%、35.1%、35.1%、29.7%、18.9%和51.4%。IgE与IgG4呈正相关,与C4呈负相关(r=0.404、-0.294,P<0.05);IgE与EOS%、C3无相关性(r=0.132,P=0.303;r=-0.255,P=0.080);IgE与IgG及IgG4之间无相关性(r=0.021,P=0.873;r=0.089,P=0.490)。IgE在自身抗体阳性或阴性、并发或未并发过敏性疾病,以及并发或未并发糖尿病患者之间差异均无统计学意义(P>0.05)。结论血清IgE可能与过敏机制一起参与了AIP及胰源性糖尿病的发病,是潜在的诊断及监测AIP病情的实验室指标。

Objective To discuss the clinical significance about the increased serum IgE in autoimmune pancreatitis（AIP）.Methods The serum level of IgG,IgG4,complements,globulin（G）,the percent of eosino phils（EOS%） and autoantibodies in 63 AlP patients and 30 healthy controls were tested,and the relationship between IgE with these immunological markers were evaluated. Similarly,the relations between IgE and AIP combined with allergic diseases or combined with diabetes were also evaluated. Results The percent of in creased IgE,IgG,IgG4,G and EOS% were 58.7% ,58.7% ,74.6% ,61.9% and 25.4%,respectively. The per cent of decreased C3 and C4 were 31.7% and 34.9%. Autoantibodies were positive in 25.4% patients. Allergic diseases and diabetes were discovered in 15.9% and 47.6% of AlP patients. There was a positive correlation between IgE and IgG4,and a negative correlation with C4 （r=0. 404, 0. 294,P〈0.05）. There were no cor relations between IgE with G and IgG（r=0. 132,P=0. 303;r= 0. 255,P=0. 080）,a positive correlation with EOS%（r=0. 021,P=0. 873;r=0. 089,P=0. 490）,and a negative correlation with C3,but none of them had statistical significance. There were no significant differences in IgE in the patients with and without au toantibody,diabetes mellitus or allergic diseases （P〉0.05）. Conclusion The serum IgE may be a potential la boratory indicator for the diagnosis and monitoring of AlP and may be involved in the pathogenesis of AlP and pancreatogenic diabete together with allergic mechanisms.