中华皮肤科杂志 ›› 2023, Vol. 56 ›› Issue (6): 496-503.doi: 10.35541/cjd.20220791

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[开放获取]   慢性诱导性荨麻疹患者168例过敏原反应性和特应性病史的临床分析

陈奇权    孔敏敏    杨显杰    王欢    李健    张名望    宋志强    

  1. 陆军军医大学西南医院皮肤科，重庆  400036
  • 收稿日期:2022-11-09 修回日期:2023-02-01 发布日期:2023-06-05
  • 通讯作者: 宋志强 E-mail:drsongzq@hotmail.com
  • 基金资助:
    国家自然科学基金（82003359）

Clinical analysis of allergen reactivity and atopic disease history in 168 patients with chronic inducible urticaria

Chen Qiquan, Kong Minmin, Yang Xianjie, Wang Huan, Li Jian, Zhang Mingwang, Song Zhiqiang   

  1. Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing 400036, China
  • Received:2022-11-09 Revised:2023-02-01 Published:2023-06-05
  • Contact: Song Zhiqiang E-mail:drsongzq@hotmail.com
  • Supported by:
    National Natural Science Foundation of China（82003359）

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摘要： 【摘要】 目的 分析慢性诱导性荨麻疹（CIndU）患者过敏原反应性和特应性病史与临床特征的联系。方法 回顾性分析2014年6月至2015年6月于陆军军医大学西南医院皮肤科门诊就诊的168例CIndU患者的临床资料及随访结果，分析各CIndU亚型患者过敏原反应性及特应性病史与临床特征［患者对疾病严重程度的评分（PGA）、瘙痒程度、皮肤病生活质量指数（DLQI）、合并血管性水肿的比例、自然病程等］的联系。统计分析主要采用χ2检验、Mann-Whitney U检验及Kaplan-Meier生存分析。结果 168例CIndU患者中人工荨麻疹（SD）117例，冷接触性荨麻疹（CCU）32例，热接触性荨麻疹5例，胆碱能性荨麻疹（CholU）14例，各亚型分别有46例（39.3%）、14例（43.8%）、3例、9例皮肤点刺试验（SPT）阳性，SPT阳性率差异无统计学意义（χ2 = 3.86，P = 0.283）。SPT阳性的CIndU患者组PGA、瘙痒程度评分、DLQI以及合并血管性水肿的比例均显著高于SPT阴性患者组（均P＜0.05）；有个人或家族特应性病史的CIndU患者组PGA和DLQI也都显著高于无个人或家族特应性病史的患者组（均P＜0.05）。各CIndU亚型中，SPT阳性SD患者组瘙痒程度评分、PGA、DLQI、合并血管性水肿的比例均显著高于SPT阴性SD患者组（均P＜0.05）；SPT阳性CholU患者组DLQI显著高于SPT阴性CholU患者组（Z = -2.28，P = 0.019）；有个人或家族特应性病史的CCU患者组瘙痒程度评分高于无个人或家族特应性病史的CCU患者组（Z = -2.41，P = 0.022）。结论 CIndU患者的过敏原反应性和特应性病史与疾病严重程度、瘙痒程度、生活质量和合并血管性水肿的比例均有关，但与自然病程的关系有待进一步研究确认。

关键词: 荨麻疹, 慢性诱导性荨麻疹, 特应性, 皮肤点刺试验

Abstract: 【Abstract】 Objective To analyze the relationship between allergen reactivity, atopic disease history and clinical features in patients with chronic inducible urticaria （CIndU）. Methods A retrospective analysis was conducted on clinical data and follow-up results from 168 patients with CIndU in the Department of Dermatology, Southwest Hospital of Army Medical University from June 2014 to June 2015. Associations were analyzed between allergen reactivity, atopic disease history and clinical characteristics （including patient global assessment ［PGA］ scores, pruritus intensity, dermatology life quality index ［DLQI］, proportions of cases with complicated angioedema, natural course, etc.） in patients with different CIndU subtypes. Chi-square test, Mann-Whitney U test and Kaplan-Meier survival analysis were used for statistical analysis. Results Among the 168 patients with CIndU, 117 were diagnosed with symptomatic dermographism （SD）, 32 with cold contact urticaria （CCU）, 5 with heat contact urticaria （HCU）, and 14 with cholinergic urticaria （CholU）; there were 46 （39.3%）, 14 （43.8%）, 3, and 9 patients with positive skin prick test （SPT） among the patients with SD, CCU, HCU and CholU respectively, and no significant difference was observed in the positive rate of SPT among patients with different CIndU subtypes （χ2 = 3.86, P = 0.283）. The SPT-positive CIndU patients showed significantly increased PGA scores, pruritus scores, DLQI scores and proportions of cases with complicated angioedema compared with the SPT-negative patients （all P＜0.05）; the CIndU patients with a personal or family history of atopic diseases also showed significantly increased PGA and DLQI scores compared with those without （both P < 0.05）. For different CIndU subtypes, the pruritus scores, PGA scores, DLQI scores, and proportions of cases with complicated angioedema were significantly higher in the SPT-positive SD patients than in the SPT-negative SD patients （all P < 0.05）; the DLQI scores were significantly higher in the SPT-positive CholU patients than in the SPT-negative CholU patients （Z = -2.28, P = 0.019）; the pruritus scores were significantly higher in the CCU patients with a personal or family history of atopic diseases than in those without （Z = -2.41, P = 0.022）. Conclusion The allergen reactivity and atopic disease history of CIndU patients were associated with disease severity, pruritus intensity, quality of life, and the proportion of cases with complicated angioedema, but their relationship with the natural course of CIndU needs to be confirmed by further studies.

Key words: Urticaria, Chronic inducible urticaria, Atopy, Skin prick test

引用本文

陈奇权 孔敏敏 杨显杰 王欢 李健 张名望 宋志强. [开放获取]   慢性诱导性荨麻疹患者168例过敏原反应性和特应性病史的临床分析[J]. 中华皮肤科杂志, 2023,56(6):496-503. doi:10.35541/cjd.20220791

Chen Qiquan, Kong Minmin, Yang Xianjie, Wang Huan, Li Jian, Zhang Mingwang, Song Zhiqiang. Clinical analysis of allergen reactivity and atopic disease history in 168 patients with chronic inducible urticaria[J]. Chinese Journal of Dermatology, 2023, 56(6): 496-503.doi:10.35541/cjd.20220791