慢性荨麻疹患者血清PAF、抗-CCD IgE水平变化及临床意义分析

Analysis of Changes and Clinical Significance of Serum PAF and Anti-CCD IgE Levels in Patients With Chronic Urticaria

目的探讨慢性荨麻疹患者血清血小板活化因子(platelet activating factor,PAF)、抗交叉反应性糖类决定簇免疫球蛋白E(anti-cross reactive carbohydrate determinants immunoglobulin E,抗-CCD IgE)水平变化及临床意义,为临床诊断及病情程度、预后评估提供参考依据。方法选取2021年5月—2023年5月广州市皮肤病防治所收治的100例慢性荨麻疹患者,根据荨麻疹活动评分分为轻度组(n=41)、中度组(n=35)和重度组(n=24)。采集患者空腹静脉血,通过酶联免疫吸附法测定血清PAF水平,通过斑点免疫印迹法测定抗-CCD IgE、过敏原特异性免疫球蛋白E(specific immunoglobulin E,sIgE)。比较不同病情程度慢性荨麻疹患者血清PAF水平,分析慢性荨麻疹患者血清PAF水平与荨麻疹活动评分相关性,比较不同临床特征慢性荨麻疹患者抗-CCD IgE阳性率。结果中度组、重度组患者血清PAF水平高于轻度组,重度组患者血清PAF水平高于中度组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,慢性荨麻疹患者血清PAF水平与荨麻疹活动评分呈正相关性(r=0.491,P<0.001)。年龄≥45岁、重度病情、sIgE阳性患者抗-CCD IgE阳性率高于年龄<45岁、轻度病情、sIgE阴性患者,差异有统计学意义(P<0.05)。抗-CCD IgE阳性患者中过敏原阳性最高的为尘螨组合(66.67%),其次为蟑螂、螃蟹、普通豚草,分别为55.56%、44.44%和44.44%。结论慢性荨麻疹患者血清PAF水平与病情密切相关,且抗-CCD IgE水平与sIgE水平有一定关系,抗-CCD IgE阳性表达情况对sIgE试验存在一定干扰,分析试验结果时应考虑抗-CCD IgE的影响。

Objective To analyze the changes and clinical significance of serum platelet activating factor(PAF)and anti-cross reactive carbohydrate determinants immunoglobulin E(anti-CCD IgE)levels in patients with chronic urticaria,in order to provide reference for clinical diagnosis,disease severity,and prognosis evaluation.Methods A total of 100 patients with chronic urticaria treated in Guangzhou Institute of Dermatology from May 2021 to May 2023 were selected and divided into mild group(n=41),moderate group(n=35)and severe group(n=24)according to urticaria activity score.Fasting venous blood was collected from the patients,and serum PAF levels were measured using enzymelinked immunosorbent assay.Anti-CCD IgE and allergen specific immunoglobulin E(sIgE)were measured using dot immunoblotting.The serum PAF levels of chronic urticaria patients with different degrees of illness were compared,the correlation between serum PAF levels and urticaria activity score in patients with chronic urticaria were analyzed,and the anti-CCD IgE positive rate in patients with different clinical characteristics of chronic urticaria were compared.Results The serum PAF levels of patients in the moderate group and severe group were higher than those in the mild group,while the serum PAF levels of patients in the severe group were higher than those in the moderate group,the difference was statistically significant(P<0.05).The Pearson correlation analysis results showed a positive correlation between serum PAF levels and urticaria activity score in patients with chronic urticaria(r=0.491,P<0.001).The anti-CCD IgE positive rate in patients with age≥45 years old,severe illness,and sIgE positive conditions was higher than that in patients with age<45 years old,mild illness,and sIgE negative conditions,the difference was statistically significant(P<0.05).Among anti-CCD IgE positive patients,the combination of dust mites(66.67%)had the highest allergen positivity,followed by cockroaches,crabs,and common ragweed,accounting for 55.56%,44.44%and 44.44%,respectively.Conclusion The serum PAF level in patients with chronic urticaria is closely related to their condition,and there is a certain relationship between anti-CCD IgE level and sIgE level.The positive expression of anti-CCD IgE in sIgE test may interfere with the results,and the impact of anti-CCD IgE should be considered when analyzing the test results.