血清IgG4和IgE在过敏性皮肤病患儿食物不耐受筛查中的应用
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摘要
目的通过检测12周岁以下的过敏性皮肤病患儿血清IgG4及IgE,探讨IgG4和IgE在过敏性皮肤病患儿食物不耐受筛查中的应用价值。方法对165例过敏性皮肤病患儿(患儿组)及88名体检健康儿童(对照组)进行血清总IgG4、总IgE的定量检测及食物不耐受特异性IgG4(sIgG4)、特异性IgE(sIgE)的定性检测,并在不同类型皮肤病、不同年龄阶段及不同发病时间患儿间进行比较。结果患儿组血清总IgG4和总IgE水平均显著高于对照组(P<0.05)。不同类型皮肤病患儿血清总IgG4和总IgE水平均显著高于对照组(P<0.05),但不同类型皮肤病患儿间差异无统计学意义(P>0.05)。有消化道症状组患儿血清sIgG4阳性率(66.2%)显著高于无消化道症状组(47.7%,P=0.017),2组间sIgE阳性率差异无统计学意义(35.1%、36.4%,P=0.862)。患儿血清sIgG4阳性率为58.2%,显著高于sIgE(35.8%,P<0.01)。血清sIgG4与sIgE的阳性率均随着患儿年龄的增长而增加,各年龄段患儿血清sIgG4阳性率均高于sIgE,其中1～3岁组及7～12岁组患儿差异有统计学意义(P=0.031,P=0.008)。sIgG4阳性率较高的食物性过敏原依次为鸡蛋、芒果/菠萝/桃子、虾/蟹/贝类和鱼类。发病时间<2 h的患儿血清sIgE阳性率远高于sIgG4(P<0.01),而发病时间≥2 h的患儿则以sIgG4阳性为主(P<0.01)。结论血清sIgG4和sIgE的阳性率随儿童年龄的增长而增加,sIgG4在慢性过敏性皮肤病患儿中的应用价值较高,而sIgE则在急性期发病患儿中更有意义。
Objective To investigate the role of serum IgG4 and IgE in screening food intolerance in children with allergic dermatosis under 12 years old. Methods Total IgG4,total IgE,food intolerance specific IgG4(sIgG4) and specific IgE(sIgE) in 165 children with allergic dermatosis(patient group) and 88 healthy children(control group) were determined. The difference was compared among different types of allergic dermatosis,different ages and different onset times. Results The levels of serum total IgG4 and total IgE in patient group were higher than those in control group(P<0.05). Serum total IgG4 and total IgE levels with different types of allergic dermatosis were higher than those in control group(P<0.05),but there was no statistical significance for different types of allergic dermatosis(P>0.05). The positive rate of serum sIgG4 in children with digestive symptoms(66.2%) was higher than that in children without digestive symptoms(47.7%,P=0.017),but there was no statistical significance for sIgE positive rate between the 2 groups(35.1% and 36.4%,P=0.862). The positive rate of serum sIgG4 in patient group(58.2%) was higher than that of serum sIgE(35.8%,P<0.01). The positive rate of serum sIgG4 and sIgE were increased with age. The positive rate of sIgG4 in children with different ages was higher than that of sIgE,and there was statistical significance between 1-3 years old and 7-12 years old children(P=0.031,P=0.008). The positive rates of sIgG4 for egg,mango/pineapple/peach,shrimp/crab/shell and fish were high. The positive rate of serum sIgE was higher than that of serum sIgG4 for onset <2 h(P<0.01),which was lower than that of serum sIgG4 for onset ≥2 h(P<0.01). Conclusions The positive rates of serum sIgG4 and sIgE increase with age. The determination of sIgG4 is prefer for children with chronic allergic dermatosis,and the determination of sIgE in children with acute onset is more valuable.
Objective To investigate the role of serum IgG4 and IgE in screening food intolerance in children with allergic dermatosis under 12 years old. Methods Total IgG4,total IgE,food intolerance specific IgG4(sIgG4) and specific IgE(sIgE) in 165 children with allergic dermatosis(patient group) and 88 healthy children(control group) were determined. The difference was compared among different types of allergic dermatosis,different ages and different onset times. Results The levels of serum total IgG4 and total IgE in patient group were higher than those in control group(P<0.05). Serum total IgG4 and total IgE levels with different types of allergic dermatosis were higher than those in control group(P<0.05),but there was no statistical significance for different types of allergic dermatosis(P>0.05). The positive rate of serum sIgG4 in children with digestive symptoms(66.2%) was higher than that in children without digestive symptoms(47.7%,P=0.017),but there was no statistical significance for sIgE positive rate between the 2 groups(35.1% and 36.4%,P=0.862). The positive rate of serum sIgG4 in patient group(58.2%) was higher than that of serum sIgE(35.8%,P<0.01). The positive rate of serum sIgG4 and sIgE were increased with age. The positive rate of sIgG4 in children with different ages was higher than that of sIgE,and there was statistical significance between 1-3 years old and 7-12 years old children(P=0.031,P=0.008). The positive rates of sIgG4 for egg,mango/pineapple/peach,shrimp/crab/shell and fish were high. The positive rate of serum sIgE was higher than that of serum sIgG4 for onset <2 h(P<0.01),which was lower than that of serum sIgG4 for onset ≥2 h(P<0.01). Conclusions The positive rates of serum sIgG4 and sIgE increase with age. The determination of sIgG4 is prefer for children with chronic allergic dermatosis,and the determination of sIgE in children with acute onset is more valuable.
引文
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[18]张玉娥,魏琳,单蓓兰,等.支气管哮喘患儿急性发作期血清免疫球蛋白E、免疫球蛋白G4和白三烯B4水平的临床研究[J].中华实用儿科临床杂志,2014,29(21):1625-1627.
[2]曾华松.大力加快我国儿童免疫学科的发展[J].中华实用儿科临床杂志,2014,29(9):641-644.
[3]RADLOVIC N,LEKOVIC Z,RADLOVIC V,et al.Food allergy in children[J].Srp Arh Celok Lek,2016,144(1-2):99-103.
[4]谢志贤,刘倩.食物不耐受与相关性疾病[J].中华内科杂志,2006,45(2):150-151.
[5]MAUHIN W,HABAROU F,GOBIN S,et al.Update on lysinuric protein intolerance,a multifaceted disease retrospective cohort analysis from birth to adulthood[J].Orphanet J Rare Dis,2017,12(1):3.
[6]陈婷婷,王润超,陈少秀,等.湖北十堰市360例过敏性皮肤病患者食物不耐受检测分析[J].中国麻风皮肤病杂志,2016,32(8):474-476.
[7]练明建,刘丹,李丹,等.比浊法检测血清IgG4对自身免疫性胰腺炎诊断的Meta分析[J].检验医学,2015,30(11):1131-1137.
[8]BARON S E,COHEN S N,ARCHER C B,et al.Guidance on the diagnosis and clinical management of atopic eczema[J].Clin Exp Dermatol,2012,37(Suppl 1):7-12.
[9]BOJOVIC K,STANKOVIC B,KOTUR N,et al.Genetic predictors of celiac disease,lactose intolerance,and vitamin D function and presence of peptide morphins in urine of children with neurodevelopmental disorders[J].Nutr Neurosci,2017,24:1-11.
[10]YAO T C,OU L S,YEH K W,et al.Associations of age,gender,and BMI with prevalence of allergic diseases in children:PATCH study[J].J Asthma,2011,48(5):503-510.
[11]全国儿科哮喘协作组,中国疾病预防控制中心环境与健康相关产品安全所.第三次中国城市儿童哮喘流行病学调查[J].中华儿科杂志,2013,51(10):729-735.
[12]MAAZI H,SHIRINBAK S,DEN BOEF LE,et al.Cytotoxic T lymphocyte antigen 4-immunoglobulin G is a potent adjuvant for experimental allergen immunotherapy[J].Clin Exp Immunol,2013,172(1):113-120.
[13]TSABOURI S,NICOLAOU N,DOUROS K,et al.Food protein induced proctocolitis:a benign condition with an obscure immunologic mechanism[J].Endocr Metab Immune Disord Drug Targets,2017,17(1):32-37.
[14]彭炜,冯小清.荨麻疹发病因素与食物特异性IgG抗体的关系[J].检验医学与临床,2014,11(1):83-84.
[15]BERNI CANANI R,PEZZELLA V,AMOROSOA,et al.Diagnosing and treating intolerance to carbohydrates in children[J].Nutrients,2016,8(3):157.
[16]顾猛,丁翠君,陆冬明,等.血清sIgE和sIgG4检测在儿童过敏性疾病中的临床应用[J].国际检验医学杂志,2014,35(22):3013-3014.
[17]王国庆,王翠环,张黎黎,等.食物不耐受检测在复发性阿弗他溃疡中的临床价值[J].检验医学,2017,32(4):290-294.
[18]张玉娥,魏琳,单蓓兰,等.支气管哮喘患儿急性发作期血清免疫球蛋白E、免疫球蛋白G4和白三烯B4水平的临床研究[J].中华实用儿科临床杂志,2014,29(21):1625-1627.