血清过敏原在住院哮喘患儿中的分布特征及临床意义

Distribution characteristics and clinical significance of serum allergens in hospitalized children with asthma

目的 分析住院哮喘患儿的血清过敏原分布特征及临床意义。方法 选取2012年1月至2021年2月我院儿科收治的有喘息症状且完成过敏原检测的患儿355例作为研究对象,回顾性分析患儿过敏原特异性免疫球蛋白E(sIgE)检出情况及血清总免疫球蛋白E(T-IgE)水平。根据诊断将患儿分为哮喘组(109例)和非哮喘组(246例),比较两组的过敏原分布差异及血清T-IgE水平。结果 355例患儿中,40.6%(144例)的患儿过敏原检测呈阳性。其中吸入性过敏原检出阳性率排名前3位的依次为尘螨(82.6%,119/144)、屋尘(10.4%,15/144)、猫毛(10.4%,15/144),食物性过敏原检出阳性率排名前3位的依次是鸡蛋白(12.5%,18/144)、鳕鱼/龙虾/扇贝(10.4%,15/144)、牛奶(10.4%,15/144)。哮喘组患儿的年龄大于非哮喘组[(8.8±2.9)岁vs (2.4±1.4)岁],过敏原sIgE阳性率高于非哮喘组[71.6%(78/109)vs 26.8%(66/246)],吸入性过敏原阳性率高于非哮喘组[54.1%(59/109)vs 16.3%(40/246)],多重致敏率高于非哮喘组[26.6%(29/109)vs 10.2%(25/246)],血清T-IgE水平高于非哮喘组[344.0(108.0,920.0)IU/mL vs 79.6(26.2,280.5)IU/mL],差异均有统计学意义(P<0.05)。结论 儿童哮喘免疫病理以IgE增高为主。哮喘患儿与非哮喘患儿过敏原阳性率及分布模式存在差异,哮喘患儿过敏原阳性率更高,吸入性过敏原、多重致敏者更多,T-IgE水平更高。

Objective To analyze the distribution characteristics and clinical significance of serum allergens in hospitalized children with asthma.Methods A total of 355 children with wheezing symptoms who were admitted to our pediatrics department from Jan.2012 to Feb.2021 and completed allergen detection were enrolled,and the results of allergen specific immunoglobulin E(sIgE)detection and the levels of serum total immunoglobulin E(T-IgE)were retrospectively analyzed.According to the diagnosis,the children were divided into asthma group(109 cases)and non-asthma group(246 cases),and the differences in allergen distribution and serum T-IgE levels were compared between the 2 groups.Results Among the 355 children,40.6%(144 cases)were positive for allergens.The top 3 inhalation allergens with positive detection were dust mite(82.6%,119/144),house dust(10.4%,15/144)and cat dander(10.4%,15/144).The top 3 food allergens were egg white(12.5%,18/144),cod/lobster/scallop(10.4%,15/144)and milk(10.4%,15/144).Compared with the non-asthma group,the age of the asthma group was significantly older([8.8±2.9]years vs[2.4±1.4]years);the positive rate of allergen sIgE(71.6%[78/109]vs 26.8%[66/246]),the inhalational allergen positive rate(54.1%[59/109]vs 16.3%[40/246]),the multiple sensitization rate(26.6%[29/109]vs 10.2%[25/246])and the T-IgE level(344.0[108.0,920.0]IU/mL vs 79.6 IU/mL[26.2,280.5])of the asthma group were significantly higher(all P<0.05).Conclusion The immunopathology of asthma in children is mainly characterized by high-IgE.There are differences in the positive rate and distribution of allergens between asthmatic children and non-asthmatic children.The positive rate of allergens is higher,the numbers of inhaled allergens and multiple sensitization are greater,and the level of T-IgE is higher in asthmatic children.