14~55岁特应性皮炎患者严重程度与维生素D、总IgE和嗜酸性粒细胞的相关性

目的探究青少年及成人特应性皮炎患者疾病严重程度与血清25-羟基维生素D、总IgE和嗜酸性粒细胞计数的相关性。方法参考SCORAD评分法评估112例青少年及成人特应性皮炎患者疾病严重程度,并检测患者及70例健康组血清25-羟基维生素D水平以及患者总IgE、嗜酸性粒细胞数计数。结果特应性皮炎组患者血清25-羟基维生素D水平(20.42±6.96)ng/mL明显低于健康组(28.68±7.85)ng/mL,差异有统计学意义(P=0.000<0.01)。重度患者血清25-羟基维生素D水平(18.93±7.06)ng/mL低于轻中度患者(21.62±6.70)ng/mL,差异有统计学意义(P=0.041<0.05);重度患者总IgE水平(5184.08±7533.82)IU/mL明显高于轻中度患者(1075.07±1777.37)IU/mL,差异有统计学意义(P=0.000<0.01);重度患者嗜酸性粒细胞计数升高(37/50)的比例明显高于轻中度患者(17/62),差异有统计学意义(P=0.000<0.01);血清25-羟基维生素D、总IgE、嗜酸性粒细胞计数均与SCORAD评分相关。结论青少年及成人特应性皮炎患者的血清25-羟基维生素D水平较健康人明显偏低,且与病情严重程度呈负相关;总IgE、嗜酸性粒细胞计数与病情严重程度呈正相关。     

金银花口服液治疗幼儿特应性皮炎的临床疗效观察

目的 观察金银花口服液治疗幼儿湿热型特应性皮炎（AD）的临床疗效及对患儿血清总免疫球蛋白E(IgE)和外周血嗜酸粒细胞的影响。方法 选择沈阳市第七人民医院2020年1月—12月收治的92例AD患儿按随机分为治疗组和对照组各46例。对照组口服盐酸西替利嗪滴剂,外用院内制剂湿毒洗剂和硼酸氧化锌软膏;治疗组在对照组的基础上加服金银花口服液,均连续治疗2周。比较2组AD严重程度评分指数（SCORAD）评分、血清总IgE、外周血嗜酸粒细胞水平及临床疗效变化,并记录不良反应发生情况。结果 治疗后治疗组SCORAD评分和总IgE、嗜酸粒细胞水平均明显低于对照组（P<0.05）;治疗组有效率为71.74%高于对照组的47.83%（χ2=5.47,P=0.02）,2组不良反应比较差异无统计学意义（χ2=0.19,P=0.66）。结论 金银花口服液治疗幼儿湿热型AD疗效明显,可以有效降低血清总IgE和外周血嗜酸粒细胞水平,且安全性高。     

血清维生素D水平与婴儿特应性皮炎严重度的相关性研究

目的 检测婴儿特应性皮炎(AD)患者血清维生素D水平,了解血清维生素D与婴儿AD严重程度之间的关系.方法 2016年2-4月在山西省儿童医院采用问卷调查方式采集中重度AD组基本信息,参考SCORAD评分法评估疾病严重程度.酶联免疫吸附试验检测AD组和对照组(95例健康体检者)血清25-羟基维生素D3水平以及AD组血清总IgE水平,血细胞分析仪检测AD组血嗜酸性粒细胞比例.结果 97例AD患儿完成研究,中度43例(44.3％),重度54例(55.7％).AD组血清25-羟基维生素D3水平[(66.71±21.07) nmol/L]低于健康对照组[(85.43±14.87) nmol/L,P＜0.01)],重度组[(47.54±29.36) nmol/L]低于中度组[(63.89±26.67)nmol/L,P=0.006].重度AD组嗜酸性粒细胞比例(0.124±0.094)高于中度组(0.061±0.060)(P＜ 0.001).中度AD组与重度AD组血清总IgE水平差异无统计学意义(P=0.375).AD患者血清25-羟基维生素D3水平与嗜酸性粒细胞比例呈负相关(r=-0.336,P＜0.05),但与血清总IgE水平之间无相关性(r=-0.174,P＞0.05).母乳喂养、补充维生素D与25-羟基维生素D3水平显著相关(P＜0.05),而年龄、性别、AD病程、急性期渗出与25-羟基维生素D3水平无显著相关性(均P＞0.05).结论 婴儿期AD患者血清25-羟基维生素D3水平明显下降,维生素D缺乏与婴儿期AD的严重程度密切相关.     

儿童特应性皮炎患者血清维生素D、总IgE及嗜酸性粒细胞水平的相关性研究

 目的 检测儿童特应性皮炎（AD）患者血清中维生素D（VitD）、总免疫球蛋白E（tIgE）水平及嗜酸性粒细胞（EOS)比例,评价VitD与AD患者病情相关性及其在AD发病中的免疫调节作用。方法采集120例AD患儿和60例健康体检儿童外周静脉血,酶联免疫吸附试验检测血清25-羟基维生素D［25(OH)D］水平以及AD组血清总IgE水平,血细胞分析仪检测AD组EOS比例。结果AD 组患儿血清25(OH)D 水平为(62.99±17.38) nmol/L,明显低于对照组的(72.44±18.07) nmol/L,差异有统计学意义(t=2.92,P<0.01)。轻度、中度及重度AD组三组患儿体内25(OH)D水平差异无统计学意义（F=1.32,P=0.275）。AD患儿血清维生素D水平与总IgE水平呈负相关（r=-0.38,P=0.003）,但与EOS比例无相关性（r=-0.03,P=0.827）。结论儿童AD患者体内25(OH)D水平较低,VitD不足与高水平tIgE存在一定的相关性,与EOS比例无相关性。     

儿童特应性皮炎严重程度与血清25-羟维生素D和总IgE水平的相关性

目的：明确儿童特应性皮炎患者特应性皮炎严重程度与血清25-羟维生素D和IgE水平的相关性。方法：参考SCORAD评分法评估60例特应性皮炎患者疾病严重程度，并检测特应性皮炎患者及55例对照组血清25-羟基维生素D3水平以及特应性皮炎患者总IgE水平。结果：特应性皮炎组患者血清25-羟维生素D水平(16.13±6.68)ng/mL低于对照组(19.81±8.24)ng/mL，差异有统计学意义（P<0.05）。根据SCORAD评分，特应性皮炎患者中33例为轻度、20例为中度，7例为重度。轻度组血清25-羟基维生素D3水平为(18.69±7.01)ng/mL，高于中度(12.81±4.35)ng/mL，差异有统计学意义（P<0.05）。血清25-羟维生素D与SCORAD评分之间有显著负相关（P<0.05）。IgE水平与SCORAD评分之间无相关性（P>0.05）。结论：AD患者血清25-羟基维生素D与AD严重程度呈负相关。     

中药健脾止痒颗粒合铍宝消炎癣湿药膏治疗特应性皮炎疗效分析

目的观察中药健脾止痒颗粒合铍宝消炎癣湿药膏治疗特应性皮炎(AD)的临床疗效。方法将64患者随机分为治疗组(健脾止痒颗粒合铍宝消炎癣湿药膏)和对照组(氯雷他定合1%丁酸氢化可的松软膏)连续治疗4周进行疗效对比。采用AD评分标准进行临床评估,用酶联免疫测定法(ELISA)及伊红酚法对免疫球蛋白E(IgE)水平、嗜酸性粒细胞(EOS)计数进行检测对比。结果治疗组总有效率为84%,与对照组比较,差异有显著性(χ2=12,P<0.01)。治疗组SCORAD积分较对照组明显降低(t=4.82,P<0.01)、VAS积分也降低(t=2.64,P<0.05)。治疗组血清总IgE水平与对照组比较差异无显著性(P>0.05)、E0S计数降低(P<0.05)。结论健脾止痒颗粒合铍宝消炎癣湿药膏治疗特应性皮炎临床疗效满意,能明显降低患者SCORAD积分和VAS积分,降低E0S计数。血清IgE水平下降差异无显著性。     

儿童特应性皮炎严重度与25羟维生素D、总IgE及IL-4水平的相关性研究

 目的:探讨儿童特应性皮炎（AD）的严重度与血清25羟维生素D［25(OH)D］、总免疫球蛋白E（tIgE）及IL 4水平的相关性。方法：选取本院就诊的160例AD患儿，以AD严重度评分（SCORAD）评估分级，采用高效液相色谱法检测血清25(OH)D，采用化学发光法检测血清tIgE，采用酶联免疫吸附法检测血清IL-4，分析血清25 (OH) D水平、tIgE、IL-4水平与 AD患者SCORAD评分的相关性。结果：根据SCORAD评分，AD患儿轻度55例（34.38%）、中度84例（52.50%）、重度21例（13.13%）。AD患儿血清25(OH)D与SCORAD评分、血清tIgE和IL-4水平均呈明显负相关(r值分别为-0.61、-0.48和-0.33,P值均＜0.001)，SCORAD评分与血清tIgE和IL-4均呈明显正相关(r值分别为0.80、0.71, P值均＜0.001)。结论：AD患儿严重度与血清25(OH)D水平呈负相关，维生素D是AD的保护性因子。血清tIgE和IL-4水平均与AD的严重度呈负相关，维生素D可能通过影响血清tIgE和调控炎症因子IL-4参与皮肤的免疫调节，从而影响AD的严重程度。     

窄谱中波紫外线治疗特应性皮炎疗效观察及血清总IgE和EOS变化

目的观察窄谱中波紫外线(NBUVB)治疗特应性皮炎(AD)的疗效及治疗前后血清总IgE和末梢血嗜酸性粒细胞(EOS)计数的变化,以探讨治疗机制。方法给予64例AD患者NBUVB照射,每周3次,共12周;采用SCORAD计分系统对AD临床严重度进行评估;采用视觉模拟尺度评分法(VAS)对瘙痒程度进行评估;采用ELISA法检测血清总IgE。结果64例患者NBUVB治疗后12例痊愈,临床有效率86.2%;64例患者治疗前SCORAD和VAS积分以及血清总IgE和EOS计数较正常对照组水平升高,照射后显著下降。结论NBUVB是治疗AD的一种有效治疗方法;NBUVB可能是通过降低T细胞,抑制机体免疫来降低IgE和EOS。     

特应性皮炎婴儿抗马拉色菌特异性 IgE水平的检测

目的：探讨特应性皮炎（ AD）婴儿体内抗马拉色菌特异性IgE水平及与疾病的关系。方法：收集57例3～24月龄的AD患儿,记录患儿一般资料月龄和病程;采用SCORAD评分标准判定疾病严重程度;使用Immuno CAPTM系统检测血清中总IgE和抗马拉色菌特异性IgE,并与健康对照组进行比较;统计分析抗马拉色菌特异性IgE水平与月龄、病程、SCORAD评分和总IgE的关系。结果：57例中13例抗马拉色菌特异性IgE抗体阳性,阳性率22.8％,明显高于健康对照组（5.0％）,差异有统计学意义（礸2＝3.16,P ＜0.05）。抗马拉色菌特异性 IgE 水平[（28.52±23.52） IU／mL]与月龄（ r ＝0.10, P ＝0.113）和病程（r＝0.08, P ＝0.121）均无明显相关性,与SCORAD评分（r＝0.23, P＜0.05）和总IgE （ r＝0.46,P＜0.01）有相关性。结论：婴儿期AD患儿体内存在抗马拉色菌特异性IgE,马拉色菌在AD的发病中可能有着重要作用。     

特应性皮炎患者血清转谷氨酰胺酶2特异性IgE水平与病情相关性研究

目的 检测特应性皮炎(AD)患者血清中转谷氨酰胺酶2(TG2)特异性IgE(sIgE)的表达水平,并分析与患者病情的相关性.方法 共入组77例AD患者,其中,44例≥12岁,33例＜12岁,内源性AD(特异性sIgE阴性,且总IgE＜150 kU/L)20例,外源性AD(一种以上的外源性过敏源sIgE++以上,或总IgE≥150 kU/L)49例.采用免疫捕获及生物素标记的酶联免疫分析法检测77例AD患者、40例成人寻常性银屑病患者和30例成人健康对照血清中TG2 sIgE水平.记录AD患者年龄、病程、SCORAD评分、嗜酸性粒细胞计数和总IgE及TG2的sIgE水平.结果 ≥12岁AD组、＜12岁AD组、银屑病组和对照组外周血TG2 sIgE水平(A450)分别为1.02±0.2、1.04±0.044、0.93±0.25、0.71±0.13.≥12岁AD、寻常性银屑病和健康对照组外周血中TG2 sIgE表达水平差异有统计学意义(x2=37.407,P＜0.001);两两组间比较发现,≥12岁AD组、银屑病组TG2 sIgE水平均显著高于对照组(t值分别为7.38、4.83,均P＜0.001).内源性AD组TG2 sIgE水平(1.16±0.03)高于外源性AD组(1.02±0.20)(t=2.27,P=0.02).AD患者组TG2 sIgE水平与年龄、病程、SCORAD评分、嗜酸性粒细胞计数、血清总IgE水平均无显著相关性(r值分别为0.03、0.14、-0.04、-0.08和0.06,均P＞0.05).结论 AD患者血清中TG2 sIgE水平明显升高,TG2可能是AD患者的一种自身抗原,但TG2 sIgE与患者的病情严重程度无明显相关性.     

Serum eosinophil cationic protein in children with atopic dermatitis

BACKGROUND: Eosinophil cationic protein (ECP) is a cytotoxic agent secreted by activated eosinophils during allergic and inflammatory processes. The aim of the study was to determine the ECP level, absolute and relative eosinophil count and IgE antibodies in children with atopic dermatitis (AD) compared with those of nonatopic children, and to assess the correlation of these laboratory parameters with the clinical severity of AD. METHODS: This prospective study comprised 70 children. There were 49 children with AD aged 3-36 months, and the control group comprised 21 children with a negative personal and family history for atopic diseases. Detailed history, serum ECP levels (UniCAP FEIA), relative and absolute eosinophil counts and total serum IgE antibodies were determined in both groups. In the children with AD, skin involvement was measured by the SCORAD index. RESULTS: The calculated SCORAD index was between 16 and 83. IgE antibodies, relative and absolute eosinophil counts showed a significantly wider range of values and a statistically higher median (P < 0.001) in the patients with AD compared with the control group. These laboratory parameters did not correlate with the severity of AD. The serum ECP median level, in the children with AD, was 16.2 microg/L (range 3.01-65.30) compared with 5.92 microg/L (range 2.76-21.90) in the control group. Correlation of the total SCORAD index and the serum ECP levels was negative, weak (r = -0.065) and statistically not significant (P > 0.05). The same was found for the correlation of serum ECP and intensity of skin changes (r = -0.095) and serum ECP and subjective symptoms (r = -0.045). The correlation was positive, but weak and statistically not significant for the serum ECP and extent of the skin lesions (r = 0.079, P > 0.05). CONCLUSION: Elevated levels of ECP, relative and absolute eosinophil counts, as well as IgE antibodies were determined in the patients with AD. As these laboratory findings did not correlate with the severity of AD, they can be considered only as additional methods in the evaluation of patients with AD.     

Vitamin D Level in Children Is Correlated with Severity of Atopic Dermatitis but Only in Patients with Allergic Sensitizations

Vitamin D is believed to affect the progression and severity of atopic dermatitis (AD). Allergic sensitization may cause this effect to vary. Individuals who fulfilled the Hanifin and Rajka criteria for AD underwent epidermal prick tests and blood tests for specific immunoglobulin E(IgE), serum total IgE, 25‐hydroxy vitamin D, and peripheral blood eosinophil count and percentage. Disease severity was determined according to the Scoring Atopic Dermatitis (SCORAD) index. Patients were grouped according to allergic sensitization. Seventy‐three children with AD (median age 33.0 mos, interquartile range 19.0–61.5 mos) were enrolled in the study; 33 (45.2%) were found to have allergic sensitization. In this group there was a negative correlation between SCORAD score and serum vitamin D level (p = 0.047, correlation coefficient [r] = ?0.349), whereas there was no correlation in the group without sensitization (p = 0.30, r = ?0.168). Vitamin D was not correlated with total IgE and eosinophil percentage in either AD group (p = 0.77, r = 0.054 and p = 0.73, r = ?0.062, respectively). Vitamin D may affect the severity of AD, especially in children with allergic sensitization.     

Pathophysiology of nocturnal scratching in childhood atopic dermatitis: the role of brain-derived neurotrophic factor and substance P

BACKGROUND: Childhood atopic dermatitis (AD) is a distressing disease associated with pruritus and sleep disturbance. The pathophysiology of pruritus is complex and various neuropeptides may be involved. OBJECTIVE: To evaluate whether or not brain-derived neurotrophic factor (BDNF) and substance P are associated with disease severity, quality of life and nocturnal scratching in AD. METHODS: Patients with AD aged under 18 years were recruited. Disease severity was assessed with the SCORing Atopic Dermatitis (SCORAD) index, and quality of life with the Children's Dermatology Life Quality Index (CDLQI). Concentrations of plasma BDNF, substance P, AD-associated chemokines [cutaneous T-cell attracting cytokine (CTACK), thymus and activation regulated chemokine (TARC)], serum total IgE and eosinophil counts were measured in these patients. All children were instructed to wear the DigiTrac monitor on their dominant wrist while sleeping. The monitor was programmed to record limb motion between 22.00 and 08.00 h the following morning. RESULTS: Twenty-eight children with AD [mean (SD) age 11.1 (3.3) years] were recruited. The mean (SD) SCORAD was 48.1 (21.5) and CDLQI was 8.7 (5.4) in the patients with AD. Their mean (SD) plasma concentrations of BDNF, substance P, CTACK and TARC were 1798 (935), 94 (42), 1424 (719) and 824 (1000) pg mL(-1), respectively. BDNF was significantly correlated with SCORAD (r = 0.478, P = 0.010) and CDLQI (r = 0.522, P = 0.004), whereas substance P showed significant correlation only with CDLQI (r = 0.441, P = 0.019). BDNF and substance P were also significantly correlated with the average (r = 0.905, P < 0.001 and r = 0.925, P < 0.001) and frequency-specific (r = 0.826, P < 0.001 and r = 0.870, P < 0.001) nocturnal wrist activities measured by DigiTrac. However, there was no correlation between BDNF or substance P and the subjective symptoms of pruritus or sleep-loss scores as reported by the parents in the SCORAD. In contrast, serum total IgE levels showed significant correlations with the subjective symptoms of pruritus (r = 0.576, P = 0.001) and sleep loss (r = 0.419, P = 0.027). CONCLUSIONS: Serum levels of BDNF and substance P correlate with the clinical score and quality of life score in patients with AD. The strong correlations with nocturnal wrist movements suggest that they may be the pathogenic factors of the annoying symptoms of scratching.     

40例成人发病型特应性皮炎患者外周血嗜酸性粒细胞和血清总IgE的检测

 目的: 探讨外周血嗜酸性粒细胞（EOS）和血清总IgE与成人发病型特应性皮炎（AD）的关系。方法：选取首次发病年龄>18岁的40例AD患者作为病例组,30例健康成年体检者作为对照组,检测两组外周血EOS和血清总IgE水平,比较性别、年龄、外周血EOS和血清总IgE水平在病例组和对照组以及不同疾病严重程度、伴／不伴呼吸道过敏、伴／不伴户尘螨阳性的病例组间分布情况。结果： 病例组EOS和血清总IgE水平均明显高于对照组(t分别为2.80、3.88,均P<0.05)。性别在重度与轻度、重度与中度间分布均有明显差异(  X² 分别为12.29、10.89, 均P<0.05);EOS在中度、重度组的分布均高于轻度组(t分别为2.23、2.53,均P<0.05)。血清过敏原检测户尘螨阳性的患者血清总IgE水平高于阴性患者(t＝2.32,P＝0.03)。结论：外周血EOS和血清总IgE水平与成人发病型特应性皮炎的发生和发展有一定的相关性。