儿童特应性皮炎血清特异性IgE和斑贴试验结果的临床分析

Clinical analysis of serum specific IgE measurement and skin patch test in children with atopic dermatitis

目的:回顾性分析广州地区特应性皮炎(AD)患儿常见变应原,为AD预防和诊治提供依据。方法:ELISA检测138例AD患儿血清特异性IgE(sIgE),并分析其吸入组、食入组变应原;其中43例患儿同时接受了用于检测日常接触类变应原的皮肤斑贴试验,分析其结果分布特征。结果:吸入性特异性总IgE抗体检测结果阳性率为57.97%(80/138),明显高于健康对照组的10.00%(3/30)(P<0.01);粉尘螨、蟑螂和兽毛sIgE阳性率与健康对照组相比显著增高(P<0.01);食入性特异性总IgE抗体检测结果阳性率为47.10%(65/138),显著高于健康对照组的3.33%(1/30)(P<0.01);牛奶、鸡蛋和海鲜(蟹/虾)sIgE阳性率明显高于健康对照组(P<0.05)。43例AD患儿斑贴试验总阳性率81.40%(35/43),其中1种变应原阳性13例(37.14%)、2种阳性8例(22.86%)、3种阳性9例(25.71%)、4种以上变应原阳性5例(14.29%),前3位常见接触类变应原依次为氯化镍、氯化钴、硫酸镍与甲醛并列。结论:血清特异性IgE抗体检测和斑贴试验有助于帮助临床发现AD患儿的吸入性、食入性和接触性变应原,尘螨、蟑螂、动物毛、牛奶、鸡蛋、虾蟹类海鲜、镍和钴金属制品、甲醛可能是诱发本地区AD儿童发病的重要过敏原。

Objective:Retrospective analyze of the allergens among children with atopic dermatitis(AD)in Guangzhou area,and to provide evidence for prevention and treatment for AD.Methods:138 AD children serum specific IgE(sIgE)were measured by ELISA,and positive rates of inhaled,ingested allergens were analyzed.A skin patch test for contact allergens detection was done simultaneously in 43 AD children among the 138 cases,and distribution characteristics of results were analyzed as well.Results:Positive rate of all inhaled allergens was 57.97%(80/138),significantly higher than control group(10.00%,3/30,P<0.01).Positive rates of dust mites,cockroaches and animal hair were significantly higher than those of control group(P<0.01).Positive rate of all ingested allergens was 47.10%(65/138),significantly higher than that in control group(3.33%,1/30,P<0.01).Positive rates of milk,egg and seafood were significantly higher than those of control group(P<0.05).Positive rate of skin patch test in 43 AD children was 81.40%(35/43).One kind of allergies was found in 13 cases(37.14%),while two kinds of allergies were found in 8 cases(22.86%),three kinds of allergies in 9 cases(25.71%)and more than 4 kinds of allergies in 5 cases(14.29%).The most common contact allergies were nickel chloride,cobalt chloride,nickel sulfate and formaldehyde.Conclusion:Serum sIgE measurement and skin patch test could help clinicians to detect inhaled,ingested and contact allergens in AD children effectively.Dust mites,cockroaches,animal hair,milk,seafood,nickel/cobalt based materials and formaldehyde may be the most common allergens that induce relapse in AD children in Guangzhou area.