中华皮肤科杂志 ›› 2023, Vol. 56 ›› Issue (2): 136-141.doi: 10.35541/cjd.20220474

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过敏专科门诊3 051例湿疹皮炎患者血清特异性IgE检测结果分析

杨凡萍1    马莉1    陈圣安1    陈姿桦1    王兰庭1    张臻1    赵颖1    朱沁媛1    徐昱1    唐霖1    胡尧2    骆肖群1   

  1. 1复旦大学附属华山医院变态反应科/皮肤科，上海  200040；2复旦大学附属华山医院检验科，上海  200040
  • 收稿日期:2022-06-30 修回日期:2022-11-08 发布日期:2023-02-01
  • 通讯作者: 骆肖群 E-mail:luoxiaoqun913@126.com
  • 基金资助:
    复旦大学附属华山医院2021年国家临床重点专科建设项目

Analysis of serum allergen-specific immunoglobulin E in 3 051 patients with eczema or dermatitis in an allergy clinic

Yang Fanping1, Ma Li1, Chen Sheng′an1, Chen Zihua1, Wang Lanting1, Zhang Zhen1, Zhao Ying1, Zhu Qinyuan1, Xu Yu1, Tang Lin1, Hu Yao2, Luo Xiaoqun1   

  1. 1Department of Allergy and Immunology/Department of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China; 2Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
  • Received:2022-06-30 Revised:2022-11-08 Published:2023-02-01
  • Contact: Luo Xiaoqun E-mail:luoxiaoqun913@126.com
  • Supported by:
    National Key Clinical Specialty Construction Project of Huashan Hospital, Fudan University in 2021

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摘要： 【摘要】 目的 分析湿疹皮炎患者血清特异性IgE检测结果。方法 回顾2021年4月1日至2022年3月31日于华山医院过敏专科门诊就诊的3 051例湿疹皮炎患者，利用Phadia过敏原检测系统检测患者的血清特异性IgE水平，计算各项过敏原的检测阳性率，分析湿疹皮炎患者的常见吸入性过敏原和食物过敏原。计数资料组间比较采用χ2检验。结果 3 051例湿疹皮炎患者中，特应性皮炎1 412例，其他湿疹/皮炎1 639例。1 629例（53%）过敏原阳性，阳性过敏原数为（3.0 ± 1.6）个。最常见的3种吸入性过敏原分别是粉尘螨（904/1 522例，59%）、户尘螨（891/1 513例，59%）和链格孢霉（206/1 068例，19%）；最常见的3种食物过敏原分别是虾（251/1 432例，18%）、鸡蛋白（165/992例，17%）和牛奶（149/994例，15%）。3 051例中，25例（1%）年龄 < 2岁，571例（19%）2 ~ 12岁，285例（9%）12 ~ 18岁，2 170例（71%） > 18岁。在 < 2岁、2 ~ 12岁患者组中，最常见的食物过敏原为鸡蛋白（77%、37%），12 ~ 18岁、 > 18岁患者组中，最常见的食物过敏原为虾（31%、17%）；户尘螨、粉尘螨是所有年龄组最常见的吸入性过敏原（阳性率36% ~ 84%），此外2 ~ 12岁患者组中，霉菌过敏率也较高，其中霉菌混合（37%）、链格孢霉（27%）。2021年4月至2022年3月间，每个月就诊患者的室外过敏原检测阳性率在10% ~ 15%间；树花粉、草花粉阳性率从2021年4月开始增加，高峰期出现在10月。特应性皮炎组过敏原阳性率（73%）高于非特应性皮炎组（37%，χ2 = 389.36，P < 0.001），常见阳性过敏原排序与湿疹皮炎患者基本一致。结论 湿疹皮炎患者的常见过敏原为粉尘螨、户尘螨和链格孢霉，婴幼儿患者以食物过敏为主，而儿童、青少年和成人患者则均以吸入性过敏为主。特应性皮炎患者的过敏原阳性率明显高于非特应性皮炎患者。

关键词: 湿疹, 皮炎, 皮炎, 特应性, 变应原, 血清特异性IgE

Abstract: 【Abstract】 Objective To analyze measurement results of serum allergen-specific immunoglobulin E （IgE） in patients with eczema/dermatitis. Methods A retrospective analysis was conducted on serum allergen-specific immunoglobulin E （IgE） levels in 3 051 patients with eczema/dermatitis, who visited the allergy clinic of Huashan Hospital from April 1, 2021 to March 31, 2022. The serum allergen-specific IgE level was detected by using the Phadia allergen detection system, and positive rates of allergens were calculated to determine common inhaled allergens and food allergens in patients with eczema/dermatitis. Comparisons of enumeration data between groups were performed by chi-square test. Results Among the 3 051 patients with eczema/dermatitis, there were 1 412 with atopic dermatitis and 1 639 were other eczema/dermatitis. Detection of serum allergen-specific IgE showed that 1 629 （53%） patients were positive for allergens, and the number of positive allergen-specific IgEs in each patient was 3.0 ± 1.6. The top 3 common inhaled allergens in patients with eczema/dermatitis were Dermatophagoides farinae （904/1 522, 59%）, Dermatophagoides pteronyssinus （891/1 513, 59%） and Alternaria alternata （206/1 068, 19%）, and the top 3 common food allergens were shrimps （251/1 432, 18%）, egg white （165/992, 17%） and cow milk （149/994, 15%）. Among the 3 051 patients, 25 （1%） were aged < 2 years, 571 （19%） aged 2 - 12 years, 285 （9%） aged 12 - 18 years, and 2 170 （71%） were aged > 18 years. The most common food allergens were both egg white in the age groups of < 2 years and 2 -12 years （77%, 37%, respectively）, and were both shrimps in the age groups of 12 - 18 years and > 18 years （31%, 17%, respectively）. Dermatophagoides pteronyssinus and Dermatophagoides farina were the top 2 common inhaled allergens in all age groups, with the positive rate ranging from 36% to 84%; in addition, the positive rate of molds was relatively high in the age group of 2 - 12 years （mold mixture: 37%; Alternaria alternata: 27%）. From April 2021 to March 2022, the positive rate of outdoor allergens ranged from 10% to 15% among outpatients in every month; the positive rates of tree pollen and grass pollen increased from April 2021, and peaked in October 2021. The patients with atopic dermatitis showed a significantly increased positive rate of allergens （73%） compared with those with other eczema/dermatitis （37%, χ2 = 389.36, P＜0.001）, and the rank of common allergens in the patients with atopic dermatitis was basically the same as that in those with eczema/dermatitis. Conclusions The common allergens were Dermatophagoides farina, Dermatophagoides pteronyssinus and Alternaria alternata in the patients with eczema/dermatitis. Food allergy was more common in infant patients, and inhalation allergy was more common in child, adolescent and adult patients. The positive rate of allergen-specific IgEs was markedly higher in the patients with atopic dermatitis than in those with other eczema/dermatitis.

Key words: Eczema, Dermatitis, Dermatitis, atopic, Allergens, Serum specific immunoglobulin E

引用本文

杨凡萍 马莉 陈圣安 陈姿桦 王兰庭 张臻 赵颖 朱沁媛 徐昱 唐霖 胡尧 骆肖群. 过敏专科门诊3 051例湿疹皮炎患者血清特异性IgE检测结果分析[J]. 中华皮肤科杂志, 2023,56(2):136-141. doi:10.35541/cjd.20220474

Yang Fanping, Ma Li, Chen Sheng′an, Chen Zihua, Wang Lanting, Zhang Zhen, Zhao Ying, Zhu Qinyuan, Xu Yu, Tang Lin, Hu Yao, Luo Xiaoqun. Analysis of serum allergen-specific immunoglobulin E in 3 051 patients with eczema or dermatitis in an allergy clinic[J]. Chinese Journal of Dermatology, 2023, 56(2): 136-141.doi:10.35541/cjd.20220474