655例慢性荨麻疹患者血清食物特异性IgG、IgG4检测分析

doi:10.3969/j.issn.1673-8640.2017.09.007

摘要/Abstract

摘要：

目的检测慢性荨麻疹患者血清中20种食物特异性IgG（sIgG）、特异性IgG4（sIgG4）的水平,分析sIgG、sIgG4水平与荨麻疹严重程度及患者生活质量的关系,并观察患者在阳性食物回避6个月后荨麻疹相关参数的变化。方法采用酶联免疫吸附试验（ELISA）定量检测655例慢性荨麻疹患者（患者组）和51名正常者（对照组）血清中20种食物sIgG和sIgG4水平,通过问卷调查其中65例患者（随机抽取）的荨麻疹活动评分（UAS7）、皮肤科生活质量评分（DLQI）、抗组胺药用量,并对26例进行了阳性食物回避6个月的患者再次评估。结果患者组食物sIgG、sIgG4的阳性率分别为74.4%和69.3%,对照组食物sIgG、sIgG4的阳性率分别为13.7%和5.9%,对照组食物sIgG、sIgG4的阳性率明显低于患者组（P<0.01）。患者组阳性率较高的食物为鸡蛋、花生、牛奶、大豆、蟹。65例慢性荨麻疹患者UAS7、DLQI、抗组胺药用量与sIgG、sIgG4水平无相关性。患者食物回避前后UAS7、DLQI、抗组胺药用量差异均有统计学意义（P<0.01）。结论食物sIgG和sIgG4水平对慢性荨麻疹的病因诊断和治疗可能有参考价值。

关键词: 特异性IgG, 特异性IgG4, 慢性荨麻疹, 食物不良反应

Abstract:

Objective To determine serum food-specific IgG（sIgG）and specific IgG4（sIgG4）in patients with chronic urticaria,to analyze the correlations of the levels of sIgG and sIgG4 with the disease severity of urticaria and life quality,and to evaluate the clinical outcome of dietary avoidance after 6 months.Methods Enzyme-linked immunosorbent assay（ELISA） was used to determine the levels of sIgG and sIgG4 against 20 kinds of food in 655 patients with chronic urticaria and 51 healthy subjects（healthy control group）. The Weekly Urticaria Activity Score（UAS7）,the Dermatology Life Quality Index（DLQI）and oral antihistamine dosage were evaluated by questionnaires for 65 patients selected randomly. The clinical outcome of dietary avoidance was evaluated after 6 months in 26 patients. Results The positive rates of sIgG and sIgG4 were higher in chronic urticaria patients（74.4% and 69.3%） than in healthy control group（13.7% and 5.9%）（P<0.01）. Egg,peanut,milk,soya bean and crab were the most common food with high positive rates. There was no correlation of the levels of sIgG and sIgG4 with UAS7,DLQI and oral antihistamine dosage. There was statistical significance for UAST,DLQI and oral antihistamine dosage before and after dietary avoidance（P<0.01）.Conclusionss The determinations of sIgG and sIgG4 may be helpful for the etiologic diagnosis and treatment of chronic urticaria.

Key words: Specific IgG, Specific IgG4, Chronic urticaria, Food adverse reaction

中图分类号:

R446.62

王新新, 吴善东, 程浩, 朱可建. 655例慢性荨麻疹患者血清食物特异性IgG、IgG4检测分析[J]. 检验医学, 2017, 32(9): 773-778.

WANG Xinxin, WU Shandong, CHENG Hao, ZHU Kejian. Serum food-specific IgG and specific IgG4 in 655 patients with chronic urticaria[J]. Laboratory Medicine, 2017, 32(9): 773-778.

图/表 8

参考文献 19

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评分	风团	瘙痒
0	无	无
1	轻度（<20个风团/24 h）	轻度（有瘙痒,但不引起患者的烦恼）
2	中度（20~50个风团/24 h）	中度（引起患者的烦恼,但尚未影响患者的日常活动和睡眠）
3	重度（>50个风团/24 h或大片融合）	重度（影响患者的日常活动和睡眠）

评分	风团	瘙痒
0	无	无
1	轻度（<20个风团/24 h）	轻度（有瘙痒,但不引起患者的烦恼）
2	中度（20~50个风团/24 h）	中度（引起患者的烦恼,但尚未影响患者的日常活动和睡眠）
3	重度（>50个风团/24 h或大片融合）	重度（影响患者的日常活动和睡眠）

组别	引起sIgG升高的食物项目					引起sIgG4升高的食物项目
组别	0项	1项	2项	3项	≥4项	0项	1项	2项	3项	≥4项
患者组	25.7	34.1	15.4	10.7	14.2	30.7	32.5	13.6	10.2	13.0
对照组	86.3	13.7	0.0	0.0	0.0	94.1	5.9	0.0	0.0	0.0

组别	引起sIgG升高的食物项目					引起sIgG4升高的食物项目
组别	0项	1项	2项	3项	≥4项	0项	1项	2项	3项	≥4项
患者组	25.7	34.1	15.4	10.7	14.2	30.7	32.5	13.6	10.2	13.0
对照组	86.3	13.7	0.0	0.0	0.0	94.1	5.9	0.0	0.0	0.0

组别	过敏原
组别	菠萝	鸡蛋	鸡肉	牛奶	虾	小麦
A组	12.91 （0.39,339.00）	66.20 （0.63,499.05）	14.28 （1.08,152.41）	15.17 （1.76,145.47）	15.17 （1.76,145.47）	15.77 （3.15,285.99）
B组	13.39 （0.00,169.26）	37.33 （1.62,594.42）	13.11 （0.18,400.00）	8.19 （0.28,400.00）	19.74 （2.77,189.04）	13.98 （0.00,354.05）
C组	16.57 （1.48,400.00）	21.72 （0.49,400.00）	15.56 （3.07,89.51）	6.88 （0.53,160.23）	21.83 （3.22,158.06）	14.37 （2.33,79.96）
P值	0.031	0.000	0.035	0.000	0.000	0.029