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目的探讨儿童支气管哮喘严重程度与血清嗜酸粒细胞阳离子蛋白(eosinophil cationic protein,ECP)、总IgE(Total IgE,TIgE)、嗜酸粒细胞(eosinophils,EOS)水平的关系;了解儿童支气管哮喘常见过敏原,为儿童支气管哮喘的预防、病情判断及治疗提供依据。方法据儿童哮喘严重程度分级标准将95例哮喘患儿分为间歇发作组(n=23)、轻度组(n=29)、中度组(n=23)、重度组(n=20)四个组,选取20例健康体检儿作为对照组。采用ImmunoCAP100E体外过敏原检测系统定量测定血清ECP、TIgE、过敏原特异性IgE(Specific IgE,SIgE)的水平,Sysmex XT-2000i血球分析仪进行EOS计数。结果 95例患儿吸入性过敏原SIgE阳性率为71.58%,以户尘螨、粉尘螨、屋尘为主,分别占69.47%、68.42%、32.63%;食入性过敏原SIgE阳性率为22.11%,以虾、螃蟹为主,分别占21.05%、18.95%。血清ECP在哮喘各组与对照组;轻、中、重三组间均有显著性差异,P均<0.05,最高值出现在重度组。血清TIgE在轻度组、间歇发作组、对照组三组之间差异均无统计学意义,P均>0.05。EOS在哮喘各组与对照组间均有显著性差异,P均<0.05;在重度与中度,中度与轻度,轻度与间歇发作组间差异均无统计学意义,P均>0.05。血清ECP水平与TIgE、EOS水平呈正相关(r=0.615,P<0.01;r=0.533,P<0.01);TIgE水平与EOS水平呈正相关(r=0.239,P<0.05)。结论血清ECP水平更能准确地反映气道炎症的程度,较TIgE和EOS更为敏感,可作为临床检测气道炎症的客观指标。户尘螨、粉尘螨和屋尘是导致3岁以上儿童支气管哮喘病情发作的主要过敏原。
Objective To investigate the relationship between the severity of bronchial asthma and the levels of serum eosinophil cationic protein (ECP), total IgE (TIgE) and eosinophils (EOS) in children. Allergen for children with bronchial asthma prevention, disease judgment and treatment provide the basis. Methods Ninety - five asthmatic children were divided into intermittent attack group (n = 23), mild group (n = 29), moderate group (n = 23), severe group (n = 20) Four groups, select 20 cases of healthy children as a control group. The levels of serum ECP, TIgE and Specific IgE (SIgE) were measured by using ImmunoCAP100E in vitro allergen detection system. EOS counts were performed by Sysmex XT-2000i hemacytogenetic analyzer. Results The positive rate of SIgE in inhalational allergens was 71.58% in 95 cases, accounting for 69.47%, 68.42% and 32.63% respectively for house dust mites, dust mite and house dust. The positive rate of SIgE for ingestion allergens was 22.11 %, Mainly shrimp and crab, accounting for 21.05% and 18.95% respectively. Serum ECP in asthmatic groups and control group; light, moderate and heavy three groups were significantly different, P <0.05, the highest value in the severe group. Serum TIgE in mild group, intermittent attack group, control group, there was no significant difference between the three groups, P> 0.05. There was significant difference between EOS group and control group (P <0.05). There was no significant difference between severe and moderate, moderate and mild, moderate and intermittent seizures, P> 0.05 . Serum ECP levels were positively correlated with TIgE and EOS levels (r = 0.615, P <0.01; r = 0.533, P <0.01). The level of TIgE was positively correlated with EOS (r = 0.239, P <0.05). Conclusions Serum ECP level can accurately reflect the degree of airway inflammation, which is more sensitive than TIgE and EOS, and can be used as an objective index for clinical detection of airway inflammation. House dust mites, dust mites and house dust are the major allergens that cause bronchial asthma attacks in children over the age of 3 years.