多种抗体预测湿疹患儿牛奶过敏的价值

The value of multiple antibodies in predicting milk allergy in children with eczema

目的探讨特异性IgE和IgG对泉州市湿疹患儿牛奶过敏的诊断和预测价值。方法选取就诊于我院皮肤科经过敏原检测和SPT最终确诊为牛奶过敏的湿疹患儿200例作为研究对象。用ELISA测定血清的β-乳球蛋白特异性IgE,α-酪蛋白特异性IgE,β-乳球蛋白特异性IgA、IgG,α-酪蛋白特异性IgA、IgG,β-乳球蛋白特异性IgG4,α-酪蛋白特异性IgG4水平。结果牛奶过敏患儿初诊时各种特异性抗体阳性率均较高,以β-乳球蛋白特异性IgE、α-酪蛋白特异性IgE升高最为明显。脱敏后各抗体水平均有明显下降,β-乳球蛋白特异性IgE、α-酪蛋白特异性IgE、α-酪蛋白特异性IgA、α-酪蛋白特异性IgG、β-乳球蛋白特异性IgG4等五种抗体在初诊与脱敏后阳性率有显著差异,提示这几种抗体与患者牛奶过敏关系更为密切。结论各种特异性抗体阳性率均较高,初诊时与脱敏后比较5种抗体阳性率有显著性差异,以β-乳球蛋白特异性IgE尤为明显。

Objective To explore the diagnostic and predictive value of specific IgA and IgG in milk allergy of children with eczema in Quanzhou. Methods 200 children with eczema diagnosed as milk allergy by allergen test and SPT in dermatology department of our hospital were selected as the study subjects. Serum levels of beta-lactoglobulin specific IgE, alpha-casein specific IgE, beta-lactoglobulin specific IgA, IgG, alpha-casein specific IgA, IgG, beta-lactoglobulin specific IgG4 and alpha-casein specific IgG4 were determined by ELISA. Results The positive rate of various specific antibodies in children with milk allergy was higher at the initial diagnosis, and the positive rate of beta-lactoglobulin-specific IgE and alpha-casein-specific IgE was the higest. After desensitization, the levels of antibodies decreased significantly. The positive rates of five antibodies, including beta-lactoglobulin-specific IgE, alpha-casein-specific IgE, alpha-casein-specific IgA, alpha-casein-specific IgG, and beta-lactoglobulin-specific IgG4, were significantly different between the initial diagnosis and desensitization, suggesting that these antibodies were more closely related to milk allergy in patients. Conclusion The positive rates of various specific antibodies were high. There was a significant difference in the positive rate of the five antibodies at the time of initial diagnosis and desensitization, especially with beta-lactoglobulin-specific IgE.