荨麻疹

20062605荨麻疹患者血清特异性IgE过敏原检测及两种氯雷他定的疗效比较/杨雪源(中国医科院),李安生,高建明…∥临床皮肤科杂志.-2006,35(1).-53~55采用德国“敏筛”定量过敏原检测系统对322例荨麻疹患者进行特异性IgE及过敏原检测和分析,应用2种氯雷他定片治疗84例慢性特发性荨麻疹患者,并进行疗效对比和随访观察,以了解322例荨麻疹患者的致病因素及各种因素之间相互关系及比较2种氯雷他定对慢性特发性荨麻疹患者疗效。结果示322例患者中有159例至少对1项过敏原阳性,阳性率为49·4%。平均阳性过敏原(1·36±1·70)项;78例患者血清特异性总…     

慢性荨麻疹患者血清特异性IgE及过敏原检测分析

近年的研究结果表明，约有1／3的慢性特发性荨麻疹患者存在自身免疫功能的异常。为了进一步分析本地区慢性荨麻疹的致病因素及各因素间的关系，笔者采用德国MEDIWISS敏筛过敏原检测系统，对298例慢性荨麻疹患者血清特异性IgE（sIgE）和总IgE进行检测，现将结果报告如下。     

慢性荨麻疹患者血清特异性IgE及甲状腺自身抗体的检测

目的：探讨自身免疫在特发性慢性荨麻疹和已知特异性过敏原慢性荨麻疹发病机制中的作用。方法：采用敏筛过敏原检测系统和放射免疫法，对120例慢性荨麻疹患进行血清特异性I姬及甲状腺自身抗体的检测。结果：86例血清特异性IgE阳性的慢性荨麻疹患中，23例(26．7％)甲状腺过氧化物酶抗体(TPOAb)阳性；18例(20．9％)促甲状腺受体自身抗体(TRAb)阳性。34例血清特异性IgE阴性的慢性荨麻疹患中，10例(29．4％)TPOAb阳性；8例(23．5％)TRAb阳性。两组慢性荨麻疹的TPOAb及TRAb均显高于正常对照组(P均＜0．01)；但两组之间的TPOAb及TRAb阳性率比较，均无显性差异(P均＞0．05)。结论：部分特发性慢性荨麻疹和已知特异性过敏原慢性荨麻疹的发病均可能有自身免疫机制参与。     

荨麻疹

20071846慢性荨麻疹患者血清特异性IgE及过敏原检测分析/禹卉千(河南省医院皮肤科),李振鲁,朱钵∥临床皮肤科杂志.-2006,35(12).-777~778采用德国MEDIWISS敏筛过敏原检测系统对298例患者血清特异性IgE(sIgE)和总IgE进行检测,并与20例正常体检人员对照。结果患者组sIgE阳性189例     

荨麻疹

82例荨麻疹病人血清总IgE水平的检测分析;左西替利嗪联合复方甘草酸苷与法莫替丁治疗慢性荨麻疹;氯雷他定片治疗慢性荨麻疹的临床观察;中西药结合治疗慢性特发性荨麻疹100例临床观察;肤痒颗粒联合左西替利嗪治疗慢性荨麻疹疗效观察     

慢性荨麻疹患者食物过敏原特异性IgE及IgG检测

目的 探讨慢性荨麻疹患者食物过敏原检测的意义。方法 对502例慢性荨麻疹患者进行食物过敏原特异性IgE与IgG检测,并进行统计学分析;同时对花生、黄豆、牛奶等过敏原的特异性IgE与IgG不同结果组进行双盲安慰剂食物激发试验。结果 １８８例患者食物过敏原特异性IgE阳性,阳性检出率为37.4%,其中腰果、花生黄豆阳性率较高;３６２例患者至少对１种食物过敏,IgG阳性检出率为72.1％,牛奶、鸡蛋、虾蟹为主要过敏原。双盲安慰剂食物激发试验证实,两种抗体检测都有假阳性与假阴性。结论 临床医生应在慢性荨麻疹的治疗中注意筛查食物过敏原,特别是IgG介导的过敏反应。     

儿童荨麻疹患者过敏原特异性IgG和IgE检测结果分析

目的：分析儿童荨麻疹患者过敏原血清特异性IgG和IgE检测结果。方法：对63例儿童荨麻疹患者采用酶联免疫法检测食物过敏原特异性IgG,采用免疫印迹法检测食物及吸入性过敏原特异性IgE。结果： 食物过敏原IgG的总阳性率为76.19%,其中主要过敏原是鸡蛋、牛奶;食物过敏原IgE的总阳性率为41.27%,其中主要过敏原是鸡蛋、淡水鱼;食物过敏原IgG和IgE的检测结果不一致(P=0.000)。吸入性过敏原IgE的总阳性率为57.14%,其中主要过敏原是尘螨和蟑螂。不同年龄组患儿过敏原阳性检出率无明显差异。结论：针对儿童荨麻疹患者进行血清特异性IgG和IgE抗体进行联合检测,有助于明确过敏性皮肤病的过敏原,对临床过敏性疾病的预防和治疗具有重要意义。     

86例慢性荨麻疹患者过敏原检测分析

近年的研究结果表明，约有1／3的慢性荨麻疹患者存在自身免疫功能的异常。为了进一步分析本地区慢性荨麻疹的致病因素及各因素间的关系，我们采用德国MEDIWISS敏筛过敏原检测系统，对86例慢性荨麻疹患者血清中部分过敏原特异性IgE（sIgE）和总IgE进行检测，现将结果报告如下：     

慢性荨麻疹患者血清特异性IgE的检测

目的　探讨IVT过敏原体外检测系统在检测慢性荨麻疹患者血清特异性IgE水平的作用。 方法　对 77例慢性荨麻疹患者的血清进行特异性IgE检测。 结果　吸入性血清过敏原阳性率为 70 .2 7% ,最常见的吸入性过敏原为狗牙根、黑麦、梯牧草、六月禾、户尘螨、粉尘螨等 ;食入性血清过敏原阳性率为 64 .94% ,最常见者为牛奶、花生、大豆、蟹、虾等。大部分患者对 2种以上过敏原过敏。结论　IVT法适用于慢性荨麻疹病因的筛查 ,对临床诊断和治疗有重要的参考价值。     

3种抗组胺药治疗慢性特发性荨麻疹的临床研究

目的:评价第2代抗组胺药咪唑斯汀、西替利嗪、氯雷他定治疗慢性特发性荨麻疹的疗效和安全性。方法:采用随机开放平行对照的方法,对96例慢性特发性荨麻疹患者进行随机分组,分别予以咪唑斯汀10mg、西替利嗪10mg、氯雷他定10mg,均每日1次口服,观察治疗第14天、第28天的临床疗效及停药1周后的复发率。结果:三者治疗慢性特发性荨麻疹第14天和第28天的有效率分别为:咪唑斯汀组90.0%和96.7%,西替利嗪组85.3%和94.2%,氯雷他定组90.6%和93.8%,三者之间差异无显著性(P>0.05)。停药1周后的复发率,咪唑斯汀组为40.0%,西替利嗪组为35.3%,氯雷他定组为28.1%。整个试验过程中均无明显严重不良反应出现。结论:咪唑斯汀、西替利嗪和氯雷他定治疗慢性特发性荨麻疹临床疗效好,安全性高,在改善临床症状及控制复发方面各有所长。     

The characteristics of urticaria in 390 patients

Data were collected on 390 patients who attended a dermatology out-patient department in whom a clinical diagnosis of urticaria was made. Two hundred and thirty-seven (61%) were women. The median age at onset of symptoms was 40 years. Sixty-one (16%) had acute urticaria with symptoms of less than 6 weeks duration at presentation. The disorder was deemed idiopathic in 217 (56%) patients, 59 (15%) had physical urticaria and 57 (15%) had both idiopathic and physical urticaria. Thirty-eight (10%) patients reported intolerance to salicylate or similar drugs, and 31 of these 38 patients also had idiopathic symptoms. One hundred and seventy-two (44%) patients reported a good response to treatment with H₁ receptor antagonists. Those who gained little or no benefit from these drugs were more likely to have a physical urticaria ( P  < 0.05) or to report intolerance reactions ( P  < 0.05). Only 113 (29%) patients were asymptomatic when discharged. One in five of a small sample contacted still had symptoms 10 years after presentation. Patients seen in an urticaria clinic were less likely to have routine investigations performed and more likely to be discharged at first attendance. When compared with previous published surveys, these figures show a lower proportion of intolerance reactions and a greater proportion of patients responding well to treatment with antihistamines.     

The evaluation of patients with urticaria

Not only is urticaria a condition of disparate cause, but it also may be produced through the action of one or more of a long list of chemical mediators. This article discusses some of the accepted procedures in the evaluation of patients with urticaria, which includes not only categorization but also a search for the sources of aggravation and laboratory testing to confirm the clinical diagnosis. An example of a printed history form is included, which comprises questions that hopefully will help to identify aggravating factors as well as potential causes.     

Tissue parasites in patients with chronic urticaria

Chronic urticaria is an important diagnostic and therapeutic problem. We aimed to investigate the sero-prevalence of tissue parasites causing toxocariasis and fasciolosis in patients with chronic urticaria. All cases were analyzed for antibodies against Toxocara canis and Fasciola hepatica by modified (homemade) ELISA. The excretory/secretory products of Toxocara and Fasciola were used as antigens (ES-ELISA) in the test. In this study, the highest toxocariasis seropositivity (29.0%) rate and the highest fasciolosis seropositivity (14.5%) rate were found in patients with chronic urticaria. Fasciolosis seropositivity and total seropositivity of toxocariasis and fasciolosis in patients with chronic urticaria was significantly higher than in healthy controls (p<0.05). Toxocariasis seropositivity in patients with chronic urticaria was not significantly higher than that in healthy controls (p>0.05). We suggest that parasitic infections should be considered as an important cause of chronic urticaria. Serological methods should be used to expose the diagnosis of tissue parasites in such cases.     

Monoclonal gammopathies and malignancies in patients with chronic urticaria

BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) has been described in association with chronic urticaria (CU) in patients with Schnitzler syndrome. Chronic urticaria may be a manifestation of hematologic malignancies. METHODS: This study was conducted to evaluate the frequency and characteristics of MGUS or malignancy in patients with CU. The Mayo Clinic electronic database was reviewed to identify patients with the diagnosis of CU. RESULTS: Of the 1639 patients presenting with CU between 1994 and 2001, 797 (49%) underwent laboratory evaluation for the presence of a coexisting monoclonal protein. Forty-seven CU patients had MGUS, 142 had a malignancy, and 24 had both. Fifteen percent of CU patients with MGUS had a hematologic malignancy compared with 0.9% of CU patients without MGUS (P < 0.001). Patients presenting with a new diagnosis of CU at an older age (> 56 years) were more likely to have associated underlying MGUS. The occurrence of MGUS in this group was higher than the reported incidence of MGUS in the general population. CONCLUSIONS: Patients with CU younger than 43 years were unlikely to have associated MGUS or malignancy. A higher percentage of patients with CU and MGUS had an associated diagnosis of hematologic malignancy.     

Evaluation of six antihistamines in vitro and in patients with urticaria

Six commonly prescribed antihistamines have been ranked according to their relative potencies in blocking H₁ and muscarinic receptors by an in vitro method on the myenteric plexus-longitudinal muscle preparation of the guinea pig ileum. Calculation of the ratios of K_e against acetyl choline to K_c against histamine suggested that mepyramine was the drug which discriminated most clearly between histamine H₁ and acetyl choline receptors. In contrast, using a self-assessment method in patients with chronic urticaria, cyproheptadine was the highest ranked antihistamine in terms of both effectiveness and relative freedom from side-effects. It is concluded that in vitro evaluation of antihistaminic and antimuscarinic potencies may produce misleading results in terms of clinical usefulness of a given antihistamine.     

Cold urticaria. Clinical findings in 220 patients

Patients with cold urticaria, a total of 220, were studied in Finland. Sixty-three percent of the patients were female. The diagnosis was based on a positive ice cube test in 90% of cases, and the other cold tests were needed to certify the diagnosis for the remainder of patients. The mean age at the onset of the disease was 25.1 years (range, 1-74), and the mean duration of symptoms was 6.3 years (range, 3 weeks to 37 years). Cold urticaria symptoms had disappeared in fifty-three patients (24%), but there was a recurrence of the disease in twelve. Idiopathic (primary acquired) cold urticaria was present in 96% of the patients. Only two patients had a secondary acquired cold urticaria. Two patients had cold-induced, "cholinergic" urticaria, and four patients had a delayed type of cold urticaria. Twenty-one percent of the patients had dermatographism, 8% had cholinergic urticaria, and two patients (1%) had heat urticaria concurrently with cold urticaria.