自体血清皮肤试验阳性与阴性慢性荨麻疹患者临床特点分析

目的 探讨自体血清皮肤试验阳性的慢性荨麻疹患者的临床特点。方法 从82例慢性荨麻疹患者中筛选出29例自体血清皮肤试验阳性患者,对其症状体征及病史等进行分析,并用放免法测定其血清中的抗甲状腺球蛋白抗体(TG-AB)和抗甲状腺微粒体抗体(TM-AB),与自体血清皮肤试验阴性的慢性荨麻疹患者进行对比。结果 自体血清皮肤试验阳性与阴性的慢性荨麻疹患者在年龄分布、病程上差异无统计学意义(P>0.05)。两组患者症状体征评分比较,自体血清皮肤试验阳性患者皮疹发作时风团较大(P<0.05),数量较多(P<0.01),每次发作持续时间较长(P<0.05),瘙痒更剧烈(P<0.05);但风团外观较红,隆起不明显(P<0.01);而两组患者的皮疹发作频次差异无统计学意义(P>0.05)。自体血清皮肤试验阳性的慢性荨麻疹患者伴发血管神经性水肿及系统症状的比例较高,伴随其他自身免疫相关疾病和甲状腺抗体阳性的比例也明显高于自体血清皮肤试验阴性患者(P<0.05)。结论 自体血清皮肤试验阳性的慢性荨麻疹多表现为较严重的慢性荨麻疹。

Clinical Features of Chronic Urticaria in Patients with Positive and Negative Autologous Serum Skin Test

Objective To determine whether there are differences of c linical features or severity of chronic idiopathic urticaria(CIU) between patien ts with positive(ASST )and negative (ASST-)autologous serum skin test.Methods The clinical features of the patients with ASST were evaluated and compared wi th those of the patients with ASST-.Anti-thyroid antibodies in serum were det ected by radioimmunoassay.Results There were no significant difference of age distribution and course of the disease between the ASST and ASST-urticaria pa tients(both P > 0.05).ASST patients had larger wheals(P < 0.05),more wheals(P < 0.01),longer periods of individual wheals(P < 0.05),higher itch scores(P < 0.01),more systemic symptoms(P < 0.01)and higher positive rate of anti-thyroi d antibodies than ASST-patients did.ASST patients also had the history of au toimmune conditions more often than ASST-patients did(P < 0.05).Conclusion T he positive autologous serum skin test indicates a subset of patients with much severe CIU.