长春地区婴儿湿疹患者食物sIgG和sIgE检测的临床意义评价
发布时间：2018-11-01 10:37
【摘要】：目的:通过检测长春地区婴儿湿疹患者和健康对照组婴儿血清中的食物sIgG和sIgE水平,分析湿疹与食物sIgG、sIgE之间的相关性,为本地区患儿在湿疹治疗中提供饮食调节方面的理论依据。方法:严格按照纳入和排除标准选取至吉大一院皮肤科门诊就诊的长春地区156例婴儿湿疹患者,并随机选取23例至本院儿童保健科体检的健康婴儿作为对照组,分别对每个婴儿检测血清食物sIgG和sIgE。食物sIgG检测采用ELISA法对14种食物进行检测,包括牛肉、牛奶、蛋清/蛋黄、鸡肉、猪肉、虾、蟹、鳕鱼、大米、玉米、小麦、番茄、大豆、蘑菇。食物sIgE采用免疫印迹法检测,包括10种食物过敏原,分别为鸡蛋、牛奶、贝、虾、螃蟹、牛肉、腰果、菠萝、芒果、苋。结果:1.湿疹组156例患儿中有131例婴儿食物sIgG阳性,阳性率为83.97%,23例对照组有3例食物sIgG阳性,阳性率为13.04%。湿疹组阳性率明显高于健康对照组,差异具有统计学意义(c2=53.59,P0.001)。2.湿疹组14种食物sIgG阳性率由高到低依次为牛奶(63.46%)、蛋清/蛋黄(29.49%)、西红柿(23.72%)、小麦(18.59%)、大豆(10.26%)、大米(10.90%)、蘑菇(5.77%)、玉米(5.77%)、牛肉(4.49%)、鳕鱼(4.49%)、猪肉(1.92%)、鸡肉(0.64%)和螃蟹(0.64%),虾sIgG为阴性。在131例出现阳性反应的患儿中,sIgG阳性的食物种类个数有1~7种不等,以1~2种多见,其中1种食物sIgG阳性的构成比为45.04%(59/131),2种食物sIgG阳性的构成比为26.72%(35/131)。按敏感程度分类,高度敏感的食物依次为牛奶(34.62%)蛋清/蛋黄((10.26%)小麦(5.77%),中度敏感食物依次为牛奶(19.23%)蛋清/蛋黄(10.26%)西红柿(8.97%),轻度敏感食物依次为西红柿((10.90%)牛奶(9.62%)蛋清/蛋黄(8.97%)。3.156例湿疹组婴儿中有53例患儿食物sIgE阳性,阳性率为33.97%,23例对照组婴儿有2例食物sIgE阳性,阳性率为8.70%。两组结果比较差异显著,有统计学意义(c2=27.17,P0.001)。4.湿疹组患儿食物sIgE阳性率检测结果:牛奶(23.72%)鸡蛋白(14.74%)腰果(5.77%)芒果(1.92%)=菠萝(1.92%)牛肉(1.28%)虾(0.64%)=蟹(0.64%),贝和苋未检出。sIgE阳性的食物种类个数有1~5种不等,在53例sIgE阳性患者中,67.92%(36/53)的患儿只有1种食物过敏原抗体阳性。按食物sIgE检测含量级别看,+1级别食物是牛奶和鸡蛋,各占2例;+2级别食物过敏原主要为牛奶(22.44%)、鸡蛋白(9.62%)、腰果(5.13%);+3级别有7例患儿,其中6例患儿过敏原都为鸡蛋白,剩下1例对腰果过敏。5.湿疹组食物sIgG和sIgE检测结果的比较:湿疹组食物sIgG和sIgE阳性率分别是83.97%、33.97%。经配对四格表资料的Mc Nemar检验,两组阳性率差异性显著,有统计学意义(c2=69.14,P0.05)。经配对四格表资料的关联性分析,两种检测方法结果无相关性(c2=2.74,P0.05)。两种检测方法均检测了牛奶、鸡蛋、牛肉、蟹、虾5种食物,其中牛奶和鸡蛋阳性率结果间差异明显,有统计学意义(P0.05),其余三种食物阳性检测率的差异性无统计学意义(P0.05)。结论:1.婴儿湿疹与食物sIgG和sIgE有相关性,sIgG和sIgE均参与了湿疹的发病过程。2.长春地区高达80%的婴儿湿疹患者食物sIgG阳性,即存在食物不耐受。主要不耐受食物依次是牛奶、蛋清/蛋黄、西红柿、小麦。3.长春地区湿疹患儿不耐受食物涉及种类多样,以1~2种食物种类为主。中、重度敏感食物均主要为牛奶和蛋清/蛋黄。4.牛奶和鸡蛋白是导致长春地区婴儿湿疹患者sIgE升高,即引起食物过敏的主要食物。过敏食物种类主要以1种为主。5.引起长春地区婴儿湿疹患者食物sIgG和sIgE升高的主要食物过敏原均为牛奶和鸡蛋,但两种检测方法的检出率差异性较大,检测结果也无相关性,在临床应用中,二者不可互相替代。
[Abstract]:Objective: To investigate the correlation between eczema and food sIgG and sIgE by detecting the levels of serum sIgG and sIgE in infant eczema patients and healthy control group in Changchun area. Methods: 156 cases of infantile eczema were selected according to the inclusion and exclusion criteria, and 23 healthy infants were randomly selected as control group. The food sIgG detects 14 kinds of food by ELISA, including beef, milk, egg white/ egg yolk, chicken, pork, shrimp, crab, cod, rice, corn, wheat, tomato, soybean, and mushroom. The food sIgE is detected by Western blotting, including 10 kinds of food allergens, eggs, milk, shellfish, shrimp, crab, beef, cashews, pineapples, mangoes, and the like. Result: 1. Among 156 cases of eczema group, there were 131 cases of infant food sIgG positive, the positive rate was 83. 97%, 23 cases of control group had 3 cases of food sIgG positive, the positive rate was 13.04%. The positive rate of eczema group was significantly higher than that in healthy controls (c2 = 53. 59, P 0.001). The positive rates of sIgG in 14 kinds of foods were milk (63. 46%), egg white/ yolk (29.49%), tomato (23.72%), wheat (18.59%), soybean (10.26%), rice (10.90%), mushroom (5.77%), corn (5.77%) and beef (4.49%). Cod (4.49%), pork (1. 92%), chicken (0. 64%) and crab (0. 64%), shrimp sIgG was negative. Among 131 children with positive reaction, there were 1 to 7 different types of sIgG positive. Among them, 1 to 2 kinds were found. Among them, the composition ratio of sIgG was 45. 04% (59/ 131), and the composition ratio of two kinds of food sIgG was 26. 72% (35/ 131). The sensitive food was milk (34. 62%) egg white/ yolk (10.26%) wheat (5.77%) in turn, moderately sensitive food was milk (19. 23%) egg white/ yolk (10.26%) tomato (8.97%) in turn. The mild sensitive food was tomato (10.90%) milk (9.62%) milk (9.62%) egg white/ yolk (8.97%). Among the 156 cases of eczema group, 53 children had food sIgE positive, the positive rate was 33. 97%, 23 control group infants had 2 food sIgE positive, the positive rate was 8. 70%. There was significant difference between the two groups (c2 = 27.17, P0.001). The results of the positive rate of food sIgE in children with eczema were: milk (23.72%) egg white (14.74%) cashews (5.77%) mango (1.92%) = pineapple (1. 92%) beef (1. 28%) shrimp (0. 64%) = crab (0. 64%). Among 53 patients with sIgE positive, 67. 92% (36/ 53) had only 1 food allergen antibody positive. According to the level of food sIgE, + 1 level of food was milk and eggs, 2 in each; + 2 levels of food allergens were mainly milk (22. 44%), egg white (9.62%), cashews (5. 13%); + 3 levels had 7 children, 6 of them were egg white, One of the remaining cases had an allergic reaction to cashews. The results showed that the positive rates of sIgG and sIgE in eczema group were 83. 97%, 33. 97%, respectively. The positive rates of the two groups were significant (c2 = 69. 14, P0.05). There was no correlation between the two test methods (c2 = 2.74, P0.05). The results showed that there was no significant difference between the positive rates of milk and egg (P0.05). Conclusion: 1. Infant eczema is associated with food sIgG and sIgE, and sIgG and sIgE are involved in the pathogenesis of eczema. In Changchun, 80% of infant eczema patient food sIgG positive, that is, there is food intolerance. The main intolerance of food is milk, egg white/ yolk, tomato, wheat. The patients with eczema in Changchun area were not tolerant to food, and the variety of food involved was 1 ~ 2 types of food. The most sensitive foods are milk and egg white/ egg yolk. Milk and egg white are the main foods that lead to increased sIgE in infant eczema in Changchun area, that is, food allergy. The type of allergy food is mainly 1. 5. The main food allergens raised by food sIgG and sIgE in infant eczema patients in Changchun area were milk and eggs. However, the detection rates of the two methods were different, and there was no correlation between the two test methods. In clinical application, they could not be replaced with each other.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.23
本文编号：2303659
[Abstract]:Objective: To investigate the correlation between eczema and food sIgG and sIgE by detecting the levels of serum sIgG and sIgE in infant eczema patients and healthy control group in Changchun area. Methods: 156 cases of infantile eczema were selected according to the inclusion and exclusion criteria, and 23 healthy infants were randomly selected as control group. The food sIgG detects 14 kinds of food by ELISA, including beef, milk, egg white/ egg yolk, chicken, pork, shrimp, crab, cod, rice, corn, wheat, tomato, soybean, and mushroom. The food sIgE is detected by Western blotting, including 10 kinds of food allergens, eggs, milk, shellfish, shrimp, crab, beef, cashews, pineapples, mangoes, and the like. Result: 1. Among 156 cases of eczema group, there were 131 cases of infant food sIgG positive, the positive rate was 83. 97%, 23 cases of control group had 3 cases of food sIgG positive, the positive rate was 13.04%. The positive rate of eczema group was significantly higher than that in healthy controls (c2 = 53. 59, P 0.001). The positive rates of sIgG in 14 kinds of foods were milk (63. 46%), egg white/ yolk (29.49%), tomato (23.72%), wheat (18.59%), soybean (10.26%), rice (10.90%), mushroom (5.77%), corn (5.77%) and beef (4.49%). Cod (4.49%), pork (1. 92%), chicken (0. 64%) and crab (0. 64%), shrimp sIgG was negative. Among 131 children with positive reaction, there were 1 to 7 different types of sIgG positive. Among them, 1 to 2 kinds were found. Among them, the composition ratio of sIgG was 45. 04% (59/ 131), and the composition ratio of two kinds of food sIgG was 26. 72% (35/ 131). The sensitive food was milk (34. 62%) egg white/ yolk (10.26%) wheat (5.77%) in turn, moderately sensitive food was milk (19. 23%) egg white/ yolk (10.26%) tomato (8.97%) in turn. The mild sensitive food was tomato (10.90%) milk (9.62%) milk (9.62%) egg white/ yolk (8.97%). Among the 156 cases of eczema group, 53 children had food sIgE positive, the positive rate was 33. 97%, 23 control group infants had 2 food sIgE positive, the positive rate was 8. 70%. There was significant difference between the two groups (c2 = 27.17, P0.001). The results of the positive rate of food sIgE in children with eczema were: milk (23.72%) egg white (14.74%) cashews (5.77%) mango (1.92%) = pineapple (1. 92%) beef (1. 28%) shrimp (0. 64%) = crab (0. 64%). Among 53 patients with sIgE positive, 67. 92% (36/ 53) had only 1 food allergen antibody positive. According to the level of food sIgE, + 1 level of food was milk and eggs, 2 in each; + 2 levels of food allergens were mainly milk (22. 44%), egg white (9.62%), cashews (5. 13%); + 3 levels had 7 children, 6 of them were egg white, One of the remaining cases had an allergic reaction to cashews. The results showed that the positive rates of sIgG and sIgE in eczema group were 83. 97%, 33. 97%, respectively. The positive rates of the two groups were significant (c2 = 69. 14, P0.05). There was no correlation between the two test methods (c2 = 2.74, P0.05). The results showed that there was no significant difference between the positive rates of milk and egg (P0.05). Conclusion: 1. Infant eczema is associated with food sIgG and sIgE, and sIgG and sIgE are involved in the pathogenesis of eczema. In Changchun, 80% of infant eczema patient food sIgG positive, that is, there is food intolerance. The main intolerance of food is milk, egg white/ yolk, tomato, wheat. The patients with eczema in Changchun area were not tolerant to food, and the variety of food involved was 1 ~ 2 types of food. The most sensitive foods are milk and egg white/ egg yolk. Milk and egg white are the main foods that lead to increased sIgE in infant eczema in Changchun area, that is, food allergy. The type of allergy food is mainly 1. 5. The main food allergens raised by food sIgG and sIgE in infant eczema patients in Changchun area were milk and eggs. However, the detection rates of the two methods were different, and there was no correlation between the two test methods. In clinical application, they could not be replaced with each other.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.23
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