Ⅰ型变态反应疾病中特异性IgE变应原引起的单一致敏和多重致敏的变应原分布特征研究

Study on the Allergens Distributional Characteristic of Monosensitization and Polysensitization Induced by Specific IgE Allergens in Ⅰ Type Hypersensitivity Disease

目的研究Ⅰ型变态反应疾病中特异性IgE(specific IgE,sIgE)变应原在单一致敏和多重致敏中的分布特征。方法选取2014年10月~2017年9月徐州市医学科学研究所确诊的Ⅰ型变态反应疾病患者767例作为研究对象,免疫印迹法检测患者血清中19种变应原sIgE,分析单一致敏和多重致敏比例、sIgE变应原在单一致敏和多重致敏中的阳性率及分布。结果 sIgE变应原引起的单一致敏和多重致敏分别为414例(53.98%)和353例(46.02%),户尘螨和混合霉菌在单一致敏和多重致敏中的分布接近(49.0%vs 51.0%和43.4%vs 56.6%),并且在不同数量变应原致敏的多重致敏中阳性率相对稳定,其他17种变应原75%~100%分布在多重致敏中,阳性率随致敏变应原种类增加而增高。单一致敏中最主要变应原为户尘螨(64.8%)和混合霉菌(19.0%),其次是牛奶(3.9%)和蟑螂(2.2%)。多重致敏中各变应原阳性率均高于单一致敏,差异均有统计学意义(χ~2=5.598~137.2,均P<0.05),在种属相近的变应原之间呈现出高度一致的阳性现象。结论Ⅰ型变态反应疾病中单一致敏和多重致敏的sIgE变应原分布有显著差异,多重致敏中可能存在广泛的交叉致敏。

Objective To study the specific IgE（sIgE）allergens distributional characteristic of monosensitization and polysensitization inⅠtype hypersensitivity disease.Methods Subjects included 767 patients withⅠtype hypersensitivity disease clinically diagnosed in Xuzhou Institute of Medical Sciences from Oct 2014 to Sept 2017.Immunoblotting was used to detect19 kinds of allergen-specific IgE.Analysed the proportion of monosensitization and polysensitization,positive rates and distributional characteristic of sIgE allergens in monosensitization patients and polysensitization patients.Results In patients with sIgE positive response,monosensitization and polysensitization were 414（53.98）% and 353（46.02%）,respectively.The distributions of house dust mite and mixed mold in monosensitization/polysensitization were small differences：49.0%vs 51.0% and 43.4% vs 56.6%.Their positive rates were relatively stable in polysensitization with different numbers of allergens,but the others 75%~100% distributed in the polysensitizations,and there positive rates were increased trend with the increased allergen species.The main allergens of monosensitizations were house dust mite（64.8%）and mixed mold（19.0%）,followed by milk（3.9%）and cockroach（2.2%）.The positive rate of each sIgE allergen in polysensitizations was higher than that in monosensitizations,and the differences were all statistically significants（χ2=5.598-137.2,all P〈0.05）,whats more,high multiple positive phenomena was observed among similar species allergens in polysensitization patients.Conclusion The distributions of allergens were significant differences between monosensitization and polysensitization in Ⅰtype hypersensitivity disease,and there may be extensive cross-sensitizations in polysensitization.