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

doi:10.3969/j.issn.1673-8640.2018.06.009

摘要/Abstract

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。

关键词: IgG4, IgE, 食物不耐受, 过敏性皮肤病, 儿童

Abstract:

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.

Key words: IgG4, IgE, Food intolerance, Allergic dermatosis, Child

中图分类号:

R446.62

罗星星, 皮肖冰, 朱嫦琳, 李炜煊. 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[J]. 检验医学, 2018, 33(6): 503-507.

LUO Xingxing, PI Xiaobing, ZHU Changlin, LI Weixuan. Serum IgG4 and IgE in screening food intolerance in children with allergic dermatosis[J]. Laboratory Medicine, 2018, 33(6): 503-507.

图/表 5

参考文献 18

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组别	例数	总IgG4（g/L）	总IgE（IU/mL）
患儿组	165	1.067±0.203^*	416.0±71.5^*
荨麻疹组	67	1.110±0.208^*	421.3±73.4^*
湿疹组	71	1.023±0.201^*	411.0±70.5^*
皮炎组	27	1.077±0.193^*	415.9±70.9^*
对照组	88	0.182±0.007	208.3±44.7

组别	例数	总IgG4（g/L）	总IgE（IU/mL）
患儿组	165	1.067±0.203^*	416.0±71.5^*
荨麻疹组	67	1.110±0.208^*	421.3±73.4^*
湿疹组	71	1.023±0.201^*	411.0±70.5^*
皮炎组	27	1.077±0.193^*	415.9±70.9^*
对照组	88	0.182±0.007	208.3±44.7

组别	例数	sIgG4	sIgE
有消化道症状组	77	51（66.2）	27（35.1）
无消化道症状组	88	42（47.7）	32（36.4）
χ²值		5.719	0.030
P值		0.017	0.862

组别	例数	sIgG4	sIgE
有消化道症状组	77	51（66.2）	27（35.1）
无消化道症状组	88	42（47.7）	32（36.4）
χ²值		5.719	0.030
P值		0.017	0.862

年龄（岁）	例数	sIgG4	sIgE	χ²值	P值
<1	32	15（46.9）	8（25.0）	3.326	0.068
1~3	53	28（52.8）	17（32.1）	4.672	0.031
4~6	51	31（60.8）	22（43.1）	3.181	0.074
7~12	29	22（75.9）	12（41.4）	7.108	0.008
合计	165	96（58.2）	59（35.8）	16.655	<0.01