总IgE、sIgE、25(OH)D在婴儿特应性皮炎病情评估中的价值

Roles of total IgE,sIgE and 25(OH)D in the evaluation of infant atopic dermatitis

目的探讨总免疫球蛋白E(IgE)、特异性免疫球蛋白E(sIgE)、25-羟基维生素D[25(OH)D]水平在婴儿特应性皮炎(AD)病情评估中的价值。方法选取婴儿AD患儿120例。根据患儿病情严重程度分为轻度组(39例)、中度组(64例)和重度组(17例);根据有无并发症分为无并发症组(51例)、有并发症组(69例)。以120名体检健康婴儿作为正常对照组。检测所有对象的血清总IgE、sIgE和25(OH)D水平。采用Logistic回归分析评估重度AD的危险因素。结果AD组血清25(OH)D水平低于正常对照组(P=0.000),总IgE、sIgE水平高于正常对照组(P=0.000)。轻度组、中度组、重度组血清25(OH)D水平依次降低(P=0.000),血清总IgE、sIgE水平依次升高(P=0.000)。有并发症组血清25(OH)D水平低于无并发症组(P=0.000),血清总IgE和sIgE水平高于无并发症组(P=0.000)。Logistic回归分析结果显示,总IgE、sIgE和25(OH)D均为婴儿AD病情严重的危险因素[比值比(OR)值分别为35.023、15.502、4.993,95%可信区间(CI)分别为17.431~70.370、6.900~34.830、2.456~10.150]。结论血清25(OH)D、总IgE、sIgE均与婴儿AD病情的严重程度有关,或可作为判断婴儿AD病情的指标。

Objective To investigate the roles of total immunoglobulin E(IgE),specific immunoglobulin E(sIgE)and 25-hydroxyvitamin D[25(OH)D]in the evaluation of infant atopic dermatitis(AD).Methods A total of 120 infants with AD were enrolled and classified into mild group(39 cases),moderate group(64 cases)and severe group(17 cases)according to the severity of the disease and into non-complication group(51 cases)and complication group(69 cases)according to the complications.Totally,120 healthy infants were enrolled as control group.Serum total IgE,sIgE and 25(OH)D levels were determined.Risk factors for severe AD were assessed by Logistic regression analysis.Results The level of serum 25(OH)D in AD group was lower than that in control group(P=0.000),and the levels of total IgE and sIgE were higher than those in control group(P=0.000).The levels of serum 25(OH)D in mild,moderate and severe groups decreased in turn(P=0.000),and the levels of serum total IgE and sIgE increased in turn(P=0.000).The level of serum 25(OH)D in complication group was lower than that in non-complication group(P=0.000),and the levels of serum total IgE and sIgE were higher than those in non-complication group(P=0.000).Logistic regression analysis showed that total IgE,sIgE and 25(OH)D were risk factors for severe AD in infants[odds ratios(OR)were 35.023,15.502,4.993,95%confidence intervals(CI)were 17.431-70.370,6.900-34.830,2.456-10.150,respectively].Conclusions Serum 25(OH)D,total IgE and sIgE are correlated with the severity of AD in infants,or they can be used as indicators to judge the severity of AD in infants.