迁延性慢性腹泻患儿食物特异性IgG、牛奶特异性IgEsIL-2R检测分析

发布时间：2018-03-10 19:20

  本文选题：食物过敏原IgG抗体　切入点：迁延性腹泻　出处：《山西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：研究背景：迁延性慢性腹泻是-组多病因、多因素共同作用所致的肠道疾病综合症,其病因复杂,多为急性腹泻未治愈、营养不良、过敏、乳糖不耐受、免疫功能低下及反复感染等引起。食物过敏是引起婴幼儿慢性腹泻的非感染因素之一。其中1岁以内婴儿牛奶蛋白过敏(CMPA)发生率为2.0%-7.5%。有学者认为食物过敏原IgG的升高和机体免疫系统的关系非常密切。可溶性白介素-2受体(soluble interleukin-2receptor, sIL-2R)是由活化T淋巴细胞膜上的白介素-2受体(mIL-2R)脱落形成,人类免疫应答和免疫调节作用的发挥与人血清可溶性白介素-2受体的表达调控有密切关系。血清sIL-2R的浓度变化可反映免疫细胞的活化程度,与过敏性疾病密切相关。 目的：①分析迁延性慢性腹泻患儿血清食物特异性IgG (sIgG)检测结果,比较并分析不同年龄患儿常见食物种类。 ②分析迁延性慢性腹泻患儿血清sIL-2R水平,对不同年龄患儿血清sIL-2R的水平进行比较。 ③分析牛奶蛋白过敏患儿血清牛奶特异IgE (sIgE)检测结果。 ④分别探讨食物过敏患儿血清食物sIgG、牛奶sIgE与sIL-2R水平变化及其关系。 方法：①选取2011年11月至2012年6月山西省儿童医院消化科(包括在门诊就诊或者住院患儿)人工喂养的迁延性慢性腹泻患儿100例中由食物回避-激发试验阳性确诊76例食物过敏患儿。 ②采用ELISA法检测人血清中14种食物过敏原sIgG抗体浓度,与血清sIL-2R水平,操作步骤严格按照试剂盒说明书进行。 ③选取20例牛奶蛋白过敏患儿血清(经家长同意后随机抽取22例牛奶蛋白过敏患儿血清,其中2例因血标本不合格去)采用酶联免疫荧光法检测牛奶特异性IgE浓度,操作步骤严格按照试剂盒说明书进行。 结果：①迁延性慢性腹泻患儿食物sIgG检出阳性率为89.5%,其中牛奶特异性IgG检出阳性率为85.5%,鸡蛋特异性IgG检出阳性率为44.7%。在牛奶蛋白过敏患儿中牛奶sIgE检出阳性率为20.0%。②迁延性慢性腹泻患儿食物过敏原IgG阳性组(68例)sIL-2R浓度为(837.9±171.0)pg/mL,较阴性患儿[8例,(782.4±130.9)pg/mL]显著升高(P0.05)；牛奶sIgG阳性患儿(65例)sIL-2R浓度为(846.7±168.9)pg/mL,较阴性患儿[11例,(745.3±133.7)pg/mL]显著升高(P0.05)；牛奶sIgE阴性患儿sIL-2R浓度为[16例,(859.2±161.7)pg/mL]较阳性患儿[4例,(826.3±183.6)pg/mL]显著升高(P0.05)。；鸡蛋sIgG阳性患儿(34例)sIL-2R浓度为(866.6±171.0)pg/mL,较阴性患儿[42例,(804.1±158.7)pg/mL]显著升高(P0.05)。 ③迁延性慢性腹泻患儿血清sIL-2R浓度与牛奶1gIgG浓度成正相关(r=0.522,P0.05),与鸡蛋1gIgG浓度不相关；腹泻患儿血清sIL-2R浓度与牛奶lgIgE浓度不相关。 结论：迁延性慢性腹泻患儿血清sIL-2R的升高与部分食物sIgG抗体有相关性,对婴幼儿主要是牛奶特异性IgG有关,与牛奶sIgE抗体浓度无相关性,表明血清sIL-2R水平是检测非IgE介导食物过敏的重要指标之一。
[Abstract]:Background: persistent chronic diarrhea is a syndrome of intestinal diseases caused by multiple etiological factors and multiple factors. Its etiology is complex, most of which are uncured acute diarrhea, malnutrition, allergy, lactose intolerance. Low immune function and repeated infection. Food allergy is one of the non-infectious factors of chronic diarrhea in infants. The incidence of milk protein hypersensitivity in infants under 1 year old is 2.0-7.5. some scholars believe that food allergen IgG. The soluble interleukin-2 receptor (sIL-2R) is formed by the exfoliation of interleukin-2 receptor (mIL-2R) on activated T lymphocyte membrane. The expression of soluble interleukin-2 receptor in human serum is closely related to the expression and regulation of human immune response and immunomodulation. The change of serum sIL-2R concentration can reflect the degree of activation of immune cells and is closely related to allergic diseases. Objective to analyze the results of serum food specific IgG in children with persistent chronic diarrhea, and to compare and analyze the common food types of children of different ages. 2 the serum sIL-2R levels in children with persistent chronic diarrhea were analyzed, and the serum sIL-2R levels in children of different ages were compared. 3 the results of serum milk specific IgE IgE in children with milk protein allergy were analyzed. 4 to investigate the changes of serum Siga g, milk sIgE and sIL-2R levels in children with food allergy. Methods from November 2011 to June 2012, we selected 100 children with persistent chronic diarrhea who were artificially fed by the Department of Digestive Medicine, Shanxi Children's Hospital (including outpatients or hospitalized children). The positive results were confirmed by food avoidance test. 76 cases of food allergy were diagnosed. (2) ELISA method was used to detect the sIgG antibody concentration of 14 food allergens in human serum and the level of sIL-2R in serum. The procedure was carried out strictly according to the instructions of the kit. 3Twenty serum samples from children with milk protein allergy (22 children with milk protein allergy were randomly selected with parental consent, 2 of them were disqualified for blood samples) were detected for milk specific IgE concentration by enzyme linked immunosorbent assay (Elisa). The operation steps are strictly in accordance with the kit instructions. Results the positive rate of food sIgG in children with persistent chronic diarrhea was 89.5.The positive rate of milk specific IgG was 85.5, and the positive rate of egg specific IgG was 44.7. The positive rate of milk sIgE in children with milk protein allergy was 85.5, and that of egg specific IgG was 44.7. 20.0.2 the concentration of sIL-2R in 68 patients with food allergen IgG positive group was 837.9 卤171.0 g / mL, which was significantly higher than that in negative children [782.4 卤130.9 PG / mL], and the serum sIL-2R level in 65 sIgG positive children was 846.7 卤168.9 PG / mL, which was significantly higher than that in negative children [11 cases with sIgE > 74.3 卤133.7 PG / mL]. The concentration of sIL-2R was 85.9.2 卤161.7 渭 g / mL in sex children, significantly higher than that in positive children [826.3 卤183.6 PG / mL], while the concentration of sIL-2R was 866.6 卤171.0 PG / mL in 34 cases of sIgG positive in eggs, which was significantly higher than that in negative children [804.1 卤158.7 PG / mL]. 3There was a positive correlation between serum sIL-2R concentration and milk 1g IgG concentration in children with persistent chronic diarrhea, but no correlation between serum sIL-2R concentration and milk lgIgE concentration in children with diarrhea. Conclusion: the increase of serum sIL-2R in children with persistent chronic diarrhea is related to partial food sIgG antibody, but not to milk specific IgG in infants and young children, but not to the concentration of sIgE antibody in milk. The results suggest that serum sIL-2R level is one of the important markers for non-IgE mediated food allergy.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R725.7

【参考文献】

相关期刊论文 前10条

1 欧阳文献;游洁玉;段柏萍;陈昌斌;;食物特异性IgG抗体检测在儿童慢性腹泻中的应用价值[J];中国当代儿科杂志;2008年01期

2 赵京,陈育智,文昭明;婴幼儿和儿童食物过敏的诊断及治疗管理[J];国外医学(儿科学分册);2001年02期

3 朱秀琴;刘f逃，

本文编号：1594716