变应性鼻炎患者sIgE水平不同时血清多项细胞因子及血脂相关指标的表达差异

Differential Expressions of Serum Cytokines and Blood Lipid Related Indexesin Patients of Allergic Rhinitis with Different Concentrations of sIgE

目的探讨变应性鼻炎(allergic rhinitis,AR)患者过敏原特异性IgE(allergen-specific IgE,sIgE)水平不同时,血清白介素-17(IL-17)、白介素-4(IL-4)、白介素-5(IL-5)及血脂水平的表达差异,分析上述指标对AR的发生发展及多重致敏判断的临床意义。方法对入组160例AR患者分别采用多重微球流式免疫荧光法、欧蒙印迹法、酶比色法检测血清细胞因子、sIgE及血脂水平。结果160例AR患者中31.9%的患者对一种过敏原致敏,63.7%的患者对2种及2种以上过敏原致敏;AR患者过敏原筛查阳性率分布前3位的分别是室内尘螨组合[59.1%(91/154)]、艾蒿[27.9%(43/154)]和树木组合[24.7%(38/154)];女性AR患者猫毛sIgE阳性率高于男性AR患者(P<0.05);多重过敏原致敏AR患者IL-17、IL-4、TIgE水平更高,HDL-C水平更低(P<0.05);室内尘螨组合致敏3或4级时IL-4及IL-5水平较1或2级更高(P<0.05)。结论AR患者外周血血清IL-17、IL-4、IL-5及HDL-C与sIgE致敏原数量和水平级别之间相互联系、相互补充。在sIgE水平级别与临床症状不完全一致时,上述指标会对临床判断AR疾病严重程度提供重要的参考依据。

Objective To investigate expressions of serum interleukin-17(IL-17),interleukin-4(IL-4),interleukin-5(IL-5)and blood lipids in patients of allergic rhinitis(AR)with different allergen-speci91 max fic IgE(sIgE)concentrations,and to analyze the clinical significance of the above indexes in the occurrence and development of AR and the judgment of multiple sensitization.Methods Levels of serum cytokines,sIgE and blood lipids were measured by multiple microsphere flow immunofluorescence,olympiad blotting and enzyme colorimetry in 160 patients with AR.Results 31.9%of the AR patients were sensitized to one allergen,and 63.7%of the patients were sensitized to two or more allergens;The top three allergen screening positive rates in AR patients were indoor dust mite group[59.1%(91/154)],artemisia argyi[27.9%(43/154)]and tree combination[24.7%(38/154)];The positive rate of sIgE in cat hair of female AR patients was higher than that of male AR patients;Levels of IL-17,IL-4 and TIgE were higher,while HDL-C was lower in AR patients sensitized by multiple allergens,and levels of IL-4 and IL-5 in indoor dust mite group 3 or 4 were higher than those in grade 1 or 2(P<0.05).Conclusion IL-17,IL-4,IL-5,TIgE and HDL-C in peripheral blood of patients with AR are related to the number and concentration of sIgE allergens and complement to each other.When the concentration level of sIgE is not completely consistent with the clinical symptoms,the above indexes can provide an important reference basis for the clinical judgment of the severity of AR disease.