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目的探讨血清总免疫球蛋白E(TIg E)、嗜酸性粒细胞阳离子蛋白(ECP)水平在过敏性哮喘诊断中的意义,为哮喘患者防治方案的个体化、具体化提供客观依据。方法:采用自动化快速检测系统(CAP)对90例哮喘患者进行6种吸入性、12种食入性混合过敏原特异性Ig E(SIg E)及TIg E、ECP检测。结果 (1)90例哮喘患者中过敏原总阳性率为68.89%,其中吸入性过敏原阳性率为58.89%,食入性过敏原阳性率为38.89%;(2)吸入混合过敏原中以Wx3(蒿属、车前草、藜属、一枝黄花、荨麻)及Hx2(屋尘、尘螨、粉瞒、蟑螂)占多数,食物以Fx3(小麦、燕麦、玉米、芝麻、荞麦)、Fx5(蛋白、牛奶、鳕鱼、花生、黄豆)占多数;(3)TIg E阳性率为64.44%,大多数哮喘患者以1~3种混合过敏原为主,过敏原种数、ECP水平与TIg E显著相关。过敏原种数与ECP无显著相关性。SIg E阳性组的血清TIg E明显高于SIg E阴性组,P<0.01。SIg E阳性组的血清ECP与SIg E阴性组相比无明显差异,P>0.05。结论蒿属、藜属类植物为就诊于我院哮喘患者导致支气管哮喘发作最主要的变应原,混合型过敏原为初步筛选患者主要的过敏种类,若筛查阳性可进一步进行单项过敏原测定。TIg E可以用来提示过敏的概率,并帮助医师决定是否对一组常见吸入性过敏原试验阴性的患者作进一步检查。ECP检测不能判断患者的过敏状态。过敏原检测在哮喘疾病的预防和治疗中起着重要作用,检测变应原对特异性免疫治疗具有重要的指导意义。
Objective To investigate the significance of serum total immunoglobulin E (Eos) and eosinophil cationic protein (ECP) in the diagnosis of allergic asthma and to provide an objective basis for the individualization and concretization of prevention and treatment programs for asthma patients. Methods: Sixty inhaled and 12 mixed ingestion allergens specific Ig E (SIg E) and TIg E and ECP were detected in 90 patients with asthma by automated rapid test system (CAP). Results (1) The total positive rate of allergens in 90 asthmatic patients was 68.89%, of which the positive rate of inhaled allergens was 58.89%, and the positive rate of in-feed allergens was 38.89%. (2) In inhaled mixed allergens, Wx3 (Artemisia, Plantain, Chenopodium, Solidago, Nettles) and Hx2 (House dust, Dust mite, Powder concealment, Cockroach), and foods Fx3 (wheat, oat, corn, sesame and buckwheat), Fx5 (Protein, milk, cod, peanut, soybeans); (3) The positive rate of TIg E was 64.44%. Most of the asthmatic patients had 1 ~ 3 mixed allergens. The number of allergens, ECP level and TIg E Significant correlation. There was no significant correlation between the number of allergens and ECP. Serum TIg E of SIg E positive group was significantly higher than that of SIg E negative group, P <0.01. Serum ECP of SIg E positive group had no significant difference compared with SIg E negative group, P> 0.05. Conclusion Artemisia and Chenopodiacens are the most important allergens in asthma patients with bronchial asthma attack in our hospital. The mixed allergens are the primary allergic species in patients with primary asthma. If the screening is positive, the allergen can be further tested . TIg E can be used to indicate the probability of allergy and help physicians decide whether to further examine a group of patients with a common negative allergen test. ECP testing can not determine the patient’s allergy status. Allergen detection plays an important role in the prevention and treatment of asthma diseases. Detection of allergen has important guiding significance for specific immunotherapy.