特应性皮炎患者吸入性特异性lgE与年龄、呼吸道过敏性疾病的相关性

Correlation of Inhalation-Specific lgE with Age Grades and Respiratory Irritability in Patients with Atopic Dermatitis

摘要: 背景：特应性皮炎(atopic dermatitis, AD)患者的一些吸入性过敏原特征会因年龄而异，并可合并呼吸道过敏性疾病等其他各种疾病，对诊断、治疗和预后产生重要影响。目的：探讨活动性AD患者中血清吸入性特异性lgE检测结果和年龄的相关性，及其与呼吸道过敏性疾病的关系，为与AD患者年龄阶段有关的临床管理及合并症的诊疗提供参考。方法：选取2015-09至2020-09在我院确诊为AD并处于活动期的患者409例，对其进行血清吸入性特异性IgE抗体检测，并根据是否合吸道过敏性疾病分为两组，计量资料采用独立样本t检验及方差分析，事后比较采用LSD法进行校正。计数资料采用卡方检验。等级资料采用秩和检验。结果：<6岁、6~12岁、≥12岁三个年龄段阳性率最高的前三种过敏原均依次为榆树、点青霉/烟曲霉/交链孢霉、梧桐，阳性率最低的两种过敏原均依次为豚草、艾蒿。18岁以下AD患者，点青霉/烟曲霉/交链孢霉和梧桐的阳性率随年龄呈上升趋势(P < 0.05)，其余吸入性过敏原则未发现此趋势，且不同年龄组梧桐致敏的阳性等级存在差异(P < 0.05)；三个年龄段中，6~12岁患者吸入性过敏原阳性种类数高于<6岁的患者(F = 4.270, P < 0.05)。此外，合并呼吸道过敏性疾病的患者吸入性过敏原阳性种类数高于未合并呼吸道过敏性疾病的患者(P < 0.01)。结论：患者各个年龄段吸入性过敏原结果有相同点，又有不同点：各年龄段致敏率最高的过敏原均为榆树、点青霉/烟曲霉/交链孢霉、梧桐；但18岁以下，点青霉/烟曲霉/交链孢霉和梧桐致敏率及致敏级别可能随年龄增大而变化；且不同年龄阶段的患者合并的过敏原种类数也有差异。此外可得出假设，AD患者合并的吸入物过敏原阳性种类数越高，越可能合并呼吸系统道过敏性疾病。

Abstract: Background: The characteristics of some inhaled allergens in patients with AD may vary with age, and may be associated with respiratory allergic diseases and other diseases, which have an important impact on the diagnosis, treatment and prognosis. Objective: To investigate the correlation between serum inhalation-specific lgE test results and age in patients with active AD and its relationship with respiratory allergic disease to provide reference for clinical management and diagnosis and treatment of complications related to AD patients with different grades of age. Methods: A total of 409 active patients diagnosed with AD in our hospital from September 2015 to September 2020 were selected for the detection of serum inhalation-specific IgE antibody. They were divided into two groups according to whether or not they had closed suction tract allergic diseases. Independent sample T-test and analysis of variance were used for measurement data, and LSD method was used for correction of subsequent comparison. Chi-square test was used for counting data. Rank sum test was used for grade data. Results: The first three allergens with the highest positive rates at the ages of 6, 6~12, and ≥12 years all were elm, Penicillium punctatus/Aspergillus fumigatus/Alternaria alternata, and Wutong, respectively; the two allergens with the lowest positive rates all were ragweed and Artemisia argyi, respectively. In AD patients under 18 years of age, positive rates of Penicillium/Aspergillus fumigatus/Alternaria alternata and Sycamore showed an increasing trend with age (P < 0.05); no such trend was found in other inhalation allergy principles, and there were differences in positive levels of sycamore sensitization in different age groups (P < 0.05). Among the three age groups, the number of positive types of inhalant allergens in AD patients aged 6~12 years was higher than that in AD patients aged less than 6 years (F = 4.270, P < 0.05). In addition, the number of inhalant allergen positive types in patients with respiratory allergic diseases was higher than that in patients without respiratory allergic diseases (P < 0.01). Conclusion: The results of inhaled allergens in patients of different ages are similar and different: the allergens with the highest sensitivities in all ages grades were elm, Penicillium oryzae, Aspergillus fumigatus, and Sycamore. However, under the age of 18, the sensitization rate and the sensitization level of Penicillium/Aspergillus fumigatus/Alternaria alternaria and Sycamore may vary with age; there were also differences in the number of associated allergens in patients of different ages. In addition, it can be hypothesized that the higher the number of positive types of inhaled allergens in AD patients, the more likely they are to be associated with respiratory tract allergic diseases.