湖南地区某医院过敏性皮肤病患儿过敏原特异性免疫球蛋白E检测结果分析

Analysis of allergen specific immunoglobulin E test results in children with allergic skin diseases in a hospital in Hunan region

目的探讨湖南地区某医院过敏性皮肤病患儿的过敏原分布特征,为过敏性皮肤病的临床诊疗提供依据。方法收集2020年10月—2022年10月因过敏性皮肤病于湖南省儿童医院就诊的4161例患儿的基本情况和临床资料,采用免疫印迹法(WB)检测19项血清过敏原特异性免疫球蛋白E(IgE)。结果4161例过敏性皮肤病患儿中,至少对一种过敏原过敏的患儿共2267例(占54.48%);其中1014例(44.73%)为单一过敏,1253例(55.27%)为多重过敏。食入性过敏原的阳性率为36.39%,其中阳性率最高的前3位过敏原为鸡蛋白(24.08%)、牛奶(15.25%)和牛肉(9.48%);吸入性过敏原的阳性率为36.30%,阳性率最高的前3位是户尘螨/粉尘螨(31.68%)、屋尘(5.47%)和榆柳杨树花粉(2.63%)。除户尘螨/粉尘螨组合致敏级别较高外,其余18项过敏原的致敏级别程度以轻中度(1~3级)为主,重度(4~6级)较少。吸入性过敏原的过敏率随患儿年龄增长而逐渐增高,食入性过敏原的过敏率随年龄增加呈下降趋势。特应性皮炎患儿的过敏率为61.92%,明显高于荨麻疹(46.31%)和湿疹患儿(43.09%),且各项过敏原的过敏率均在特应性皮炎患儿中最高。结论湖南地区过敏性皮肤病患儿最主要的过敏原是户尘螨/粉尘螨、鸡蛋白和牛奶,且过敏原在不同年龄阶段趋势变化存在一定差异。

Objective To explore the distribution characteristics of allergens in children with allergic skin diseases in Hunan province,and to provide a basis for clinical diagnosis and treatment of allergic skin diseases.Methods The basic information and clinical data of 4161 children with allergic skin diseases who were treated at Hunan Children's Hospital from October 2020 to October 2022 were collected.Western blotting(WB)method was used to detect 19 items of serum allergen specific immunoglobulin E(IgE).Results Among 4161 children with allergic skin diseases,a total of 2267 cases(54.48%)were allergic to at least one allergen,among which 1014 cases(accounting for 44.73%)had a single allergy reaction and 1253 cases(accounting for 55.27%)had multiple allergy reactions.The positive rate of ingestive allergens was 36.39%,with the top three allergens with the highest positive rates being egg white(24.08%),milk(15.25%)and beef(9.48%).The positive rate of inhaled allergens was 36.30%,with the top three highest positive rates being household dust mites/dust mites(31.68%),house dust(5.47%)and elm willow poplar pollen(2.63%).Except for the combination of household dust mites and dust mites with higher sensitization levels,the sensitization levels of the other 18 items of allergens were mainly mild to moderate degree(which was of 1-3 grades),and less severe degree(which was of 4-6 grades).The allergy rate of inhaled allergens was gradually increased with age,while the allergy rate of ingested allergens was decreased with age.The allergic rate of children with atopic dermatitis was 61.92%,which was significantly higher than that of children with hives(46.31%)and eczema(43.09%),respectively.Conclusion The main allergens in children with allergic skin diseases in Hunan area are household dust mites and combinations of dust mites,egg white and milk,and there are certain differences in the trend changes of allergens at different age stages.