哮喘儿童2008及2019年免疫球蛋白E变化及相关危险因素

doi:10.6040/j.issn.1671-7554.0.2024.0574

摘要/Abstract

摘要： 目的通过横断面分析调查2008及2019年哮喘患儿免疫球蛋白 E(immunoglobulin E, IgE)的变化,并分析诱导哮喘患儿IgE升高的危险因素。方法回顾性分析2008年292例哮喘患儿和2019年503例哮喘患儿的病历,比较2个年份就诊患儿的临床特征和IgE水平。通过多元线性回归分析确定血清总IgE升高的独立危险因素。结果与2008年就诊哮喘患儿相比,2019年就诊哮喘患儿对霉菌的致敏比例升高(29.79% vs. 43.74%, χ2=17.45, P<0.001),对树花粉(33.22% vs. 17.89%, χ2=23.60, P<0.001)、屋尘螨(house dust mites, HDMs)(53.08% vs. 39.36%, χ2=13.02, P<0.001)、粉尘螨(dermatophagoides farina, DF)(54.11% vs. 42.35%, χ2=10.17, P=0.001)的致敏比例降低。同时,2019年血清就诊患儿总IgE水平明显低于2008年(184 IU/mL vs. 108 IU/mL, Z=-9.32, P<0.001)。2008年哮喘患儿IgE升高的独立危险因素包括过敏性疾病史和对霉菌、树花粉和DF致敏;2019年哮喘患儿IgE升高的独立危险因素包括年龄和对霉菌、树花粉和HDM致敏。同时,在独立危险因素中,无论是2008年还是2019年,对尘螨类过敏原致敏的标准化回归系数最高。结论哮喘患儿2019年的IgE水平较2008年明显下降,与尘螨致敏比例下降有关。

关键词: 儿童哮喘, 免疫球蛋白E, 过敏原, 危险因素, 横断面研究

Abstract: Objective To investigate immunoglobulin E(IgE)changes by a cross-sectional analysis between 2008 and 2019 and analyze risk factors for IgE elevation in asthmatic patients. Methods The medical records of 292 children in 2008 and 503 children in 2019 diagnosed with asthma were retrospectively analyzed, and clinical characteristics and IgE levels were compared between the two years. Independent risk factors for total serum IgE elevation were identified by performing multiple linear regression analyses. Results Compared with asthmatic children in 2008, asthmatic children had a significantly higher proportion of allergic sensitization to fungal spores(29.79% vs. 43.74%, χ2=17.45, P<0.001), and a significantly lower proportion of allergic sensitization to tree pollens(33.22% vs. 17.89%, χ2=23.60, P<0.001), house dust mites(HDMs)(53.08% vs. 39.36%, χ2=13.02, P<0.001), and dermatophagoides farina(DF)(54.11% vs. 42.35%, χ2=10.17, P=0.001)in 2019. Meanwhile, the level of total serum IgE was significantly lower in 2019 than that in 2008(184 IU/mL vs. 108 IU/mL, Z=-9.32, P<0.001). The independent risk factors for IgE elevation in 2008 included a history of allergic diseases and allergic sensitization to fungal spores, tree pollens, and DF, and in 2019 included age and allergic sensitization to fungal spores, tree pollens, and HDM. Meanwhile, the standardized regression coefficient of allergic sensitization to dust mites was highest whether in 2008 or 2019 among those of independent risk factors. Conclusion The level of IgE significantly decreased in asthmatic patients over 11 years, which was associated with a decline in the proportion of patients sensitized to dust mites.

Key words: Childhood asthma, Immunoglobulin E, Allergen, Risk factors, Cross-sectional study

中图分类号:

R562.2

张政,王建伟,杨玉娟,张宇,宋西成. 哮喘儿童2008及2019年免疫球蛋白E变化及相关危险因素[J]. 山东大学学报 (医学版), 2025, 63(7): 32-36.

ZHANG Zheng, WANG Jianwei, YANG Yujuan, ZHANG Yu, SONG Xicheng. Immunoglobulin E changes and risk factors in asthma children between 2008 and 2019[J]. Journal of Shandong University (Health Sciences), 2025, 63(7): 32-36.

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