婴幼儿和儿童哮喘过敏原IgE检测及临床意义

Detecting allergens Ig E in infants and children with asthma and analyzing clinical significance

目的:研究婴幼儿和儿童血清特异性Ig E过敏原检测在哮喘中的临床意义。方法:选取2011年11月至2016年12月就诊的505例单纯哮喘婴幼儿和儿童(n=385)及非过敏患儿(n=120),采用德国FOOKE全自动酶免疫分析系统对过敏原特异性Ig E抗体进行检测,分别建立不同性别、年龄的单纯性哮喘组与非过敏对照组,对过敏原与哮喘进行多因素Logistic回归分析。结果:505例婴幼儿和儿童血清Ig E过敏原检测阳性者240例(47. 5%)。婴幼儿和儿童哮喘过敏原分布单因素分析结果显示,户尘螨、霉菌类、屋尘、牛奶、猫/狗毛皮屑、混合草等与哮喘发生有相关性(P<0. 05)。而多因素分析结果显示,户尘螨、霉菌类、屋尘螨是发病的危险因素(P<0. 05);不同年龄组婴幼儿和儿童单因素分析结果显示,在<3岁婴幼儿仅屋尘螨与哮喘发生有相关性(P<0. 05),在3～14岁患儿中户尘螨、屋尘螨与哮喘发生有相关性(P<0. 05),在7～14岁患儿中霉菌与哮喘发生有相关性(P<0. 05);户尘螨、屋尘螨是男、女性婴幼儿和儿童哮喘发生的危险因素(P<0. 05),而霉菌、腰果/花生是男性婴幼儿和儿童哮喘发生的危险因素(P<0. 05)。结论:婴幼儿和儿童哮喘以户尘螨、屋尘螨、霉菌类过敏原为主,血清过敏原检测对早期评估婴幼儿和儿童哮喘的发生、发展有重要意义。

Objective:To study the association between serum-specific immunoglobulin E(sIgE)allergens and asthma in infants and children.Methods:From November 2011 to December 2016,505 cases of asthmatic infants and children(n=385)and non allergic children(n=120)were examined by the FOOKE automatic enzyme immunoassay system to detect allergen specific IgE antibodies.The case-control models of asthma alone and non-allergic diseases were established.The association between allergens and asthma was investigated using multivariate Logistic regression analysis.Results:240 cases(47.5%)of 505 infants and children were serum IgE-positive.Single factor analysis of allergen distribution in infants and children showed that Dermatophagoides pteronyssinus,mold,house dust,milk,cat/dog fur and mixed grass were associated with asthma(P<0.05).The results of multiple factors showed that Dermatophagoides pteronyssinus,fungi and house dust were the risk factors for the disease(P<0.05).The single factor analysis of infants and children in different age groups showed that there was a correlation between house dust and asthma in 3 years old infants(P<0.05).In the 3-14 years old group,house-dust mite as allergens were identified as the risk factors for the development of asthma.In the 7-14 years old group,moulds as allergens were identified as the risk factors for the development of asthma(P<0.05).Dermatophagoides pteronyssinus and house dust are the risk factors of asthma in male and female children(P<0.05),while moulds and cashew nuts/peanuts as allergens increased the risk of asthma in boys.Conclusion:Asthma in infants and children was dominated by Dermatophagoides pteronyssinus,house dust and mycotic allergens.Serum allergen detection is very important for early assessment of the occurrence and development of asthma in infants.