咳嗽變異性哮喘患者吸入性和食物性變應(yīng)原檢測(cè)分析

摘要：目的 研究吸入性和食物性變應(yīng)原在咳嗽變異性哮喘患者中的檢出率，為臨床的診斷和治療提供依據(jù)。方法 對(duì)145例咳嗽變異性哮喘CVA患者，采用歐蒙印跡法檢測(cè)吸入性和食物性變應(yīng)原特異性IgE抗體，以非CVA組112例作為對(duì)照。結(jié)果 CVA組吸入性和食物性變應(yīng)原陽(yáng)性率分別為70.34%和21.38%，相比非CVA組的16.07%和5.54%，二者比較差異有明顯的統(tǒng)計(jì)學(xué)意義（P<0.01）。吸入性變應(yīng)原以塵螨和蟑螂為主，食物性變應(yīng)原以蝦和蟹為主。結(jié)論 CVA患者以吸入性變應(yīng)原感染為主，但存在吸入性和食物性變應(yīng)原同時(shí)被檢出現(xiàn)象，食物性變應(yīng)原檢測(cè)在預(yù)測(cè)過(guò)敏過(guò)程和預(yù)防CVA發(fā)生中具有潛在的應(yīng)用價(jià)值。

關(guān)鍵詞：咳嗽變異性哮喘；吸入性和食物性變應(yīng)原；檢測(cè)分析

Abstract：Objective To study the detection rate of inhaled food allergen in patients with cough variant asthma， thus to provide basic datas for clinical diagnosis and treatment. Methods 145 cases of the patients with CVA ， Euroimmun imprinting method was used to detect specific IgE antibody for inhaled food allergens， 112 patients with not- CVA group was set up as the contrast. Results Compared with not-CVA group's 16.07% and 5.54%， the positive rate of inhalant allergen of the patients with CVA was 70.34% and the positive rate of food allergen was 21.38%， and there was significant statistical difference between two groups（P<0.01）. Inhalant allergens in patients with CVA were given priority to dust mites and cockroaches， food allergens were given priority to shrimp and crab. Conclusion The patients with CVA were given priority to inhalant allergen infection. Food allergies in patients with CVA frequently coexist with inhaled allergies， and food allergens detection in predicting allergic process and the prevention of CVA occurs has potential applications.

Key words：Cough variant asthma；Inhalant food allergen；Detection and diagnosis

咳嗽變異性哮喘（CVA）是哮喘的一種類型，又稱過(guò)敏性咳嗽，以慢性咳嗽為唯一或主要表現(xiàn)，不伴明顯喘息的特殊類型哮喘。CVA存在與典型哮喘相似的呼吸道炎癥和呼吸道重構(gòu)，伴呼吸道反應(yīng)性增高，是導(dǎo)致慢性咳嗽的最常見(jiàn)病因之一。變應(yīng)原是CVA的主要致病因素，報(bào)道多以吸入性的變應(yīng)原為主，食物性變應(yīng)原引發(fā)CVA的分析報(bào)告尚少。本研究回顧性分析了145例CVA患者和112例非CVA型慢性咳嗽患者的吸入性和食物性變應(yīng)原結(jié)果，以探討CVA與變應(yīng)原致病的關(guān)系。

1 資料與方法

1.1一般資料 收集2015年10月～2016年6月同濟(jì)醫(yī)院呼吸內(nèi)科就診的145例CVA患者，其中男性82例，女性63例，年齡≥18歲，診斷符合我國(guó)《咳嗽的診斷與治療指南》中CVA診斷標(biāo)準(zhǔn)；112例非CVA型慢性咳嗽患者為同期就診的支氣管炎、肺炎和胃食道反流患者，其中男性55例，女性57例，年齡≥18歲。……