过敏专科门诊3051例湿疹皮炎患者血清特异性IgE检测结果分析

Analysis of serum allergen-specific immunoglobulin E in 3051 patients with eczema or dermatitis in an allergy clinic

目的分析湿疹皮炎患者血清特异性IgE检测结果。方法回顾2021年4月1日至2022年3月31日于华山医院过敏专科门诊就诊的3051例湿疹皮炎患者,利用Phadia过敏原检测系统检测患者的血清特异性IgE水平,计算各项过敏原的检测阳性率,分析湿疹皮炎患者的常见吸入性过敏原和食物过敏原。计数资料组间比较采用χ2检验。结果3051例湿疹皮炎患者中,特应性皮炎1412例,其他湿疹/皮炎1639例。1629例(53%)过敏原阳性,阳性过敏原数为(3.0±1.6)个。最常见的3种吸入性过敏原分别是粉尘螨(904/1522例,59%)、户尘螨(891/1513例,59%)和链格孢霉(206/1068例,19%);最常见的3种食物过敏原分别是虾(251/1432例,18%)、鸡蛋白(165/992例,17%)和牛奶(149/994例,15%)。3051例中,25例(1%)年龄<2岁,571例(19%)2~12岁,285例(9%)12~18岁,2170例(71%)>18岁。在<2岁、2~12岁患者组中,最常见的食物过敏原为鸡蛋白(77%、37%),12~18岁、>18岁患者组中,最常见的食物过敏原为虾(31%、17%);户尘螨、粉尘螨是所有年龄组最常见的吸入性过敏原(阳性率36%~84%),此外2~12岁患者组中,霉菌过敏率也较高,其中霉菌混合(37%)、链格孢霉(27%)。2021年4月至2022年3月间,每个月就诊患者的室外过敏原检测阳性率在10%~15%间;树花粉、草花粉阳性率从2021年4月开始增加,高峰期出现在10月。特应性皮炎组过敏原阳性率(73%)高于非特应性皮炎组(37%,χ2=389.36,P<0.001),常见阳性过敏原排序与湿疹皮炎患者基本一致。结论湿疹皮炎患者的常见过敏原为粉尘螨、户尘螨和链格孢霉,婴幼儿患者以食物过敏为主,而儿童、青少年和成人患者则均以吸入性过敏为主。特应性皮炎患者的过敏原阳性率明显高于非特应性皮炎患者。

Objective To analyze measurement results of serum allergen-specific immunoglobulin E(IgE)in patients with eczema/dermatitis.Methods A retrospective analysis was conducted on serum allergen-specific immunoglobulin E(IgE)levels in 3051 patients with eczema/dermatitis,who visited the allergy clinic of Huashan Hospital from April 1,2021 to March 31,2022.The serum allergen-specific IgE level was detected by using the Phadia allergen detection system,and positive rates of allergens were calculated to determine common inhaled allergens and food allergens in patients with eczema/dermatitis.Comparisons of enumeration data between groups were performed by chi-square test.Results Among the 3051 patients with eczema/dermatitis,there were 1412 with atopic dermatitis and 1639 were other eczema/dermatitis.Detection of serum allergen-specific IgE showed that 1629(53%)patients were positive for allergens,and the number of positive allergen-specific IgEs in each patient was 3.0±1.6.The top 3 common inhaled allergens in patients with eczema/dermatitis were Dermatophagoides farinae(904/1522,59%),Dermatophagoides pteronyssinus(891/1513,59%)and Alternaria alternata(206/1068,19%),and the top 3 common food allergens were shrimps(251/1432,18%),egg white(165/992,17%)and cow milk(149/994,15%).Among the 3051 patients,25(1%)were aged<2 years,571(19%)aged 2-12 years,285(9%)aged 12-18 years,and 2170(71%)were aged>18 years.The most common food allergens were both egg white in the age groups of<2 years and 2-12 years(77%,37%,respectively),and were both shrimps in the age groups of 12-18 years and>18 years(31%,17%,respectively).Dermatophagoides pteronyssinus and Dermatophagoides farina were the top 2 common inhaled allergens in all age groups,with the positive rate ranging from 36%to 84%;in addition,the positive rate of molds was relatively high in the age group of 2-12 years(mold mixture:37%;Alternaria alternata:27%).From April 2021 to March 2022,the positive rate of outdoor allergens ranged from 10%to 15%among outpatients in every month;the positive rates of tree pollen and grass pollen increased from April 2021,and peaked in October 2021.The patients with atopic dermatitis showed a significantly increased positive rate of allergens(73%)compared with those with other eczema/dermatitis(37%,χ2=389.36,P<0.001),and the rank of common allergens in the patients with atopic dermatitis was basically the same as that in those with eczema/dermatitis.Conclusions The common allergens were Dermatophagoides farina,Dermatophagoides pteronyssinus and Alternaria alternata in the patients with eczema/dermatitis.Food allergy was more common in infant patients,and inhalation allergy was more common in child,adolescent and adult patients.The positive rate of allergen-specific IgEs was markedly higher in the patients with atopic dermatitis than in those with other eczema/dermatitis.