山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (4): 34-38.doi: 10.6040/j.issn.1673-3770.0.2016.259

• 变应性鼻炎 • 上一篇    下一篇

健康成人血清总IgE和变应原特异性IgE检测及意义

袁源1,吴中飞1,巢长江2,陆美萍1,田慧琴1,程雷1   

  1. 1.南京医科大学第一附属医院〓江苏省人民医院耳鼻咽喉科, 江苏 南京 210029;
    2.苏州大学附属第三医院〓常州市第一人民医院耳鼻咽喉科, 江苏 常州 213003
  • 收稿日期:2016-06-09 出版日期:2016-08-16 发布日期:2016-08-16
  • 通讯作者: 程雷. E-mail:jspent@126.com E-mail:571795688@qq.co
  • 作者简介:袁源. E-mail:571795688@qq.co
  • 基金资助:
    国家自然科学基金(81200747,81300834);江苏高校优势学科建设工程(JX10231801);江苏省科教兴卫工程医学重点人才(RC2011071)

Detection of serum total IgE and allergen-specific IgE in healthy adults and its significance.

YUAN Yuan1, WU Zhongfei1, CHAO Changjiang2, LU Meiping1, TIAN Huiqin1, CHENG Lei   

  1. 1. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China;2. Department of Otorhinolaryngology, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China
  • Received:2016-06-09 Online:2016-08-16 Published:2016-08-16

摘要: 目的 通过检测健康成人血清总IgE和变应原特异性IgE,分析测定值在不同年龄和不同性别人群中的分布情况,探讨其科学意义及应用价值。 方法 接受健康体检的志愿者536例,其中男347例,女189例,19~60岁(中位数38岁),均无变态反应性疾病和全身系统性疾病的症状及病史。血清总IgE检测采用酶联免疫捕获法,总IgE水平≤100 kU/L为阴性,>100 kU/L阳性。特异性IgE检测采用荧光免疫法,以吸入性变应原过筛试验(Phadiatop)为测定指标,Phadiatop 0级为阴性,≥1级为阳性。 结果 健康成人的血清总IgE 水平为1.14~1 703.70(中位数37.18)kU/L,男性显著高于女性,差异有统计学意义(P=0.001)。血清总IgE 阴性占72.52%,阳性占27.48%。健康成人的Phadiatop测定值为0.01~59.50(中位数0.05)kU/L,男性与女性相比较,差异无统计学意义(P=0.154)。Phadiatop阴性占82.09%,阳性占17.91%。各年龄组之间血清总IgE水平、特异性IgE水平进行比较,差异均无统计学意义(P=0.119, P=0.225)。血清总IgE水平与特异性IgE水平的Spearman秩相关系数为0.683(正相关),具有统计学意义(P<0.001)。血清总IgE阴性388例中,Phadiatop阴性368例(94.85%),阳性20例(5.15%);血清总IgE阳性147例中,Phadiatop阳性75例(51.02%),阴性72例(占48.98%)。 结论 在该健康成年人群中超过1/4者血清总IgE水平高于100 kU/L,而对吸入性变应原致敏者不到1/5。血清总IgE与特异性IgE二者之间有较强的相关性。血清总IgE水平低于100 kU/L对筛查排除变应原致敏有较大价值,但总IgE水平高于100 kU/L时无法明确机体是否为致敏状态,需结合病史及临床表现进行合理评价。

关键词: 变应原, 成人, 免疫球蛋白E, 健康志愿者, 致敏

Abstract: Objective To explore the scientific significance and practical application of serum levels of total IgE(tIgE)and allergen-specific IgE(sIgE)in excluding allergen sensitization. Methods A total of 536 volunteers including 347 males and 189 females, aged 19-60 years with median age of 38 years old received the healthy physical examination were recruited in the study. All the subjects had no history and symptoms of allergic diseases as well as systemic diseases. Serum tIgE was detected by the capture enzyme-linked immunosorbent assay. The tIgE level ≤100 kU/L represented negative while >100 kU/L positive. Serum sIgE was assessed by means of the Phadiatop test using the fluoroimmunoassay. The Phadiatop class 0 means negative and class ≥1 positive. Results Serum level of tIgE among healthy adults was 1.14-1 703.70(median 37.18)kU/L, and it was significantly higher in males than in females(P=0.001). The negative and positive rates of serum tIgE were 72.52% and 27.48%, respectively. Serum level of sIgE(Phadiatop)among healthy adults was 0.01-59.50(median 0.05)kU/L, which had no significant significance between the male and the female(P=0.154). The negative and positive rates of Phadiatop were 82.09% and 17.91%, respectively. There were no statistically significant differences in serum tIgE and sIgE levels among different age groups(P=0.119 and P=0.225, respectively). The Spearman rank correlation coefficient between serum tIgE and sIgE levels was 0.683 with statistical significance(positive correlation, P<0.001). There were 368 subjects(94.85%)with negative Phadiatop and 20 subjects(5.15%)with positive Phadiatop in the serum tIgE negative subjects(n=388), while 75 山东大学耳鼻喉眼学报30卷4期 -袁源,等.健康成人血清总IgE和变应原特异性IgE检测及意义 \=-subjects(51.02%)with positive Phadiatop and 72 subjects(48.98 %)with negative Phadiatop in the serum tIgE positive subjects(n=147). Conclusion More than one fourth subjects among healthy adults have a serum tIgE level higher than 100 kU/L, while less than one fifth subjects have a sensitization to inhaled allergens. There is an obvious correlation between the serum levels of tIgE and sIgE. The serum tIgE level below 100 kU/L may have a clinical value to exclude allergen sensitization; however, the sensitized status may not be confirmed when the tIgE level is higher than 100 kU/L, and case history and clinical manifestations also should be considered.

Key words: Healthy volunteers, Allergens, Adult, Hypersensitivity, Immunoglobulin E

中图分类号: 

  • R392.8
[1] Zhang L, Han D, Huang D, et al. Prevalence of self-reported allergic rhinitis in eleven major cities in china[J]. Int Arch Allergy Immunol, 2009, 149(1):47-57.
[2] Wang X, Zheng M, Lou H, et al. An increased prevalence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011[J]. Allergy, 2016, 71(8):1170-1180. doi: 10.1111/all.12874. Epub 2016 Apr 13.
[3] Hamilton R G. Proficiency survey-based evaluation of clinical total and allergen-specific IgE assay performance[J]. Arch Pathol Lab Med, 2010, 134(7):975-982.
[4] Bousquet J, Heinzerling L, Bachert C, et al. Practical guide to skin prick tests in allergy to aeroallergens[J]. Allergy, 2012, 67(1):18-24.
[5] Bousquet J, Khaltaev N, Cruz A A, et al. Allergic rhinitis and its impact on asthma(ARIA)2008 update(in collaboration with the World Health Organization, GA2LEN and AllerGen)[J]. Allergy, 2008, 63 Suppl 86: 8-160.
[6] 殷凯生,何韶衡,周林福. 临床过敏疾病学[M]. 北京:科学出版社,2012: 478-479.
[7] Wüthrich B, Schindler C, Medici T C, et al. IgE levels, atopy markers and hay fever in relation to age, sex and smoking status in a normal adult Swiss population. SAPALDIA(Swiss Study on Air Pollution and Lung Diseases in Adults)Team. Int Arch Allergy Immunol, 1996, 111(4): 396-402.
[8] Garcia-Marcos L, Sanchez-Solis M, Martinez-Torres A E, et al. Phadiatop compared to skin-prick test as a tool for diagnosing atopy in epidemiological studies in schoolchildren[J]. Pediatr Allergy Immunol, 2007, 18(3):240-244.
[9] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(1):6-24.
[10] Kraft S, Kinet J P. New developments in FcepsilonRI regulation, function and inhibition[J]. Nat Rev Immunol, 2007, 7(5):365-378.
[11] Burney P, Malmberg E, Chinn S, et al. The distribution of total and specific serum IgE in the European Community Respiratory Health Survey[J]. J Allergy Clin Immunol, 1997, 99(3):314-322.
[12] Kim E J, Kwon J W, Lim Y M, et al. Assessment of total/specific IgE levels against 7 inhalant allergens in children aged 3 to 6 years in Seoul, Korea[J]. Allergy Asthma Immunol Res, 2013, 5(3):162-169.
[13] Tu Y L, Chang S W, Tsai H J, et al. Total serum IgE in a population-based study of Asian children in Taiwan: reference value and significance in the diagnosis of allergy[J]. PLoS One, 2013, 8(11):e80996.
[14] Warren C P, Holford-Strevens V, Wong C, et al. The relationship between smoking and total immunoglobulin E levels[J]. J Allergy Clin Immunol, 1982, 69(4):370-375.
[15] Holford-Strevens V, Warren P, Wong C, et al. Serum total immunoglobulin E levels in Canadian adults[J]. J Allergy Clin Immunol, 1984, 73(4):516-522.
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