慢性特發(fā)性蕁麻疹的流行病學(xué)調(diào)查與自體血清皮膚試驗(yàn)的應(yīng)用分析
發(fā)布時(shí)間：2019-02-19 18:08
【摘要】： 目的： 探討濟(jì)南地區(qū)慢性特發(fā)性蕁麻疹的流行病學(xué)特點(diǎn)、評(píng)估常規(guī)實(shí)驗(yàn)室檢查指標(biāo)及自體血清皮膚試驗(yàn)的臨床意義。從而進(jìn)一步認(rèn)識(shí)慢性自身免疫性蕁麻疹的發(fā)病規(guī)律,為有效指導(dǎo)臨床治療,改善患者預(yù)后提供參考。 方法： 按照一定的納入標(biāo)準(zhǔn),選取2009年6月到2010年3月在我科門診確診為慢性特發(fā)性蕁麻疹病例60人,詳細(xì)詢問(wèn)患者一般情況及病史,填寫調(diào)查問(wèn)卷,并行外周血嗜酸性粒細(xì)胞計(jì)數(shù)、血清總IgE測(cè)定、抗甲狀腺球蛋白抗體測(cè)定與自體血清皮膚試驗(yàn)。比較ASST陽(yáng)性組患者與陰性組患者的流行病學(xué)特點(diǎn),實(shí)驗(yàn)室檢查結(jié)果以及療效。所得數(shù)據(jù)應(yīng)用SPSS13.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果： 本課題共納入慢性特發(fā)性蕁麻疹患者60例,男性15例,女性45例,男女比例1：3；年齡為12歲～68歲,平均年齡為39.82±14.63歲,以30歲～50歲患者為多(占病例總?cè)藬?shù)的53.3％)。其中室內(nèi)工作者41例,室外工作者19例；城鎮(zhèn)居民39例,農(nóng)村居民21例。60例患者均行ASST檢測(cè),陰性29例,陽(yáng)性31例,陽(yáng)性率為51.7％。ASST陽(yáng)性組較陰性組風(fēng)團(tuán)數(shù)量多(P0.05)、瘙癢重(P0.05),發(fā)作持續(xù)時(shí)間長(zhǎng)(P0.05),風(fēng)團(tuán)大小無(wú)明顯差異(P0.05)。45例患者檢測(cè)外周血嗜酸性粒細(xì)胞計(jì)數(shù),共2例嗜酸性粒細(xì)胞計(jì)數(shù)升高,23例ASST陽(yáng)性病例中1例升高(4.3％),22例陰性病例中1例升高(4.5％)。44例患者行血清總IgE檢測(cè),共10例血清總IgE升高,其中22例ASST陽(yáng)性病例有6例升高(27.3％),22例陰性病例中4例升高(18.2％)。43例患者行抗甲狀腺球蛋白抗體檢測(cè),8例抗甲狀腺球蛋白升高,其中22例ASST陽(yáng)性病例共有7例升高(31.8％)；21例陰性病例中1例升高(4.8％),兩者之間差異存在統(tǒng)計(jì)學(xué)意義。分別于實(shí)驗(yàn)結(jié)束后2周及4周觀察療效顯示,ASST陽(yáng)性患者中24例應(yīng)用第二代抗組胺藥物療效顯著,其余7例聯(lián)合免疫抑制劑雷公藤多甙后癥狀緩解；29例ASST陰性患者應(yīng)用第二代抗組胺藥物后28例療效顯著,1例聯(lián)合雷公藤多甙后癥狀仍未緩解。試驗(yàn)過(guò)程中發(fā)現(xiàn)血液標(biāo)本靜置時(shí)間、皮試部位、患者皮膚劃痕反應(yīng)以及操作者熟練程度可能影響ASST結(jié)果。 結(jié)論： 1.濟(jì)南地區(qū)慢性特發(fā)性蕁麻疹患者以中青年為主,女性發(fā)病高于男性,室內(nèi)工作者高于室外工作者,城鎮(zhèn)居民高于農(nóng)村居民。 2.在濟(jì)南地區(qū)慢性特發(fā)性蕁麻疹患者中ASST陽(yáng)性率為51.7％,與國(guó)內(nèi)外以往報(bào)道相符。 3.ASST陽(yáng)性組患者與陰性組相比風(fēng)團(tuán)數(shù)量較多,持續(xù)時(shí)間較長(zhǎng),瘙癢較劇烈。 4.ASST陽(yáng)性組患者同時(shí)罹患自身免疫性甲狀腺疾病可能性更大。 5.ASST陽(yáng)性患者抗組胺藥與免疫抑制劑聯(lián)合應(yīng)用療效更好。 6.血液標(biāo)本靜置時(shí)間、皮試部位、患者皮膚劃痕反應(yīng)以及操作者熟練程度可能影響ASST結(jié)果。
[Abstract]:Objective: to investigate the epidemiological characteristics of chronic idiopathic urticaria in Jinan area and to evaluate the clinical significance of routine laboratory tests and autologous serum skin test. In order to further understand the pathogenesis of chronic autoimmune urticaria, to effectively guide the clinical treatment and improve the prognosis of patients with reference. Methods: according to certain inclusion criteria, 60 patients with chronic idiopathic urticaria were selected from June 2009 to March 2010. Peripheral blood eosinophil count, serum total IgE, anti-thyroglobulin antibody and autologous serum skin test were performed. The epidemiological characteristics, laboratory results and efficacy of ASST positive and negative patients were compared. The data were analyzed by SPSS13.0 software. Results: a total of 60 patients with chronic idiopathic urticaria were included in this study, including 15 males and 45 females, the ratio of male to female was 1: 3; The average age was 39.82 鹵14.63 years old. The majority of the patients were 30 ~ 50 years old (53.3% of the total cases). There were 41 indoor workers and 19 outdoor workers. There were 39 urban residents and 21 rural residents. All the 60 patients were tested by ASST, 29 cases were negative and 31 cases were positive. The positive rate was that the number of wind masses in 51.7%.ASST positive group was more than that in negative group (P0.05), and the pruritus weight was heavy (P0.05). The attack lasted for a long time (P0.05), but there was no significant difference in wind mass size (P0.05). The eosinophil count in peripheral blood was detected in 45 patients, and the eosinophil count was increased in 2 patients. In 23 cases of ASST positive, 1 case (4.3%) was elevated, and 1 case (4.5%) of 22 cases was negative. Total serum IgE was detected in 44 cases (10 cases). In 22 cases of ASST positive, 6 cases (27.3%) were elevated, 4 cases (18.2%) of 22 negative cases were increased, 43 cases were tested for anti-thyroglobulin antibody, 8 cases were increased in anti-thyroglobulin. In 22 cases of ASST positive, 7 cases (31.8%) were elevated. One of the 21 negative cases was elevated (4.8%), and the difference was statistically significant. The curative effects were observed at 2 weeks and 4 weeks after the end of the experiment. The results showed that 24 cases of ASST positive patients were treated with the second generation antihistamine and the other 7 cases were relieved after the use of tripterygium wilfordii polyglycosides. Twenty-eight patients with ASST negative were treated with second generation antihistamine, and 1 patient with tripterygium wilfordii was not relieved. During the experiment, it was found that the rest time of the blood sample, the site of the skin test, the skin scratch reaction of the patient and the operator's proficiency may affect the results of ASST. Conclusion: 1. The incidence of chronic idiopathic urticaria in Jinan was mainly young and middle-aged, the incidence of female was higher than that of male, that of indoor worker was higher than that of outdoor worker, and that of urban residents was higher than that of rural residents. 2. The positive rate of ASST in patients with chronic idiopathic urticaria in Jinan area was 51.7%, which was consistent with previous reports at home and abroad. Compared with the negative group, the 3.ASST positive group had more wind masses, longer duration and more severe pruritus. 4.ASST positive patients were more likely to develop autoimmune thyroid disease at the same time. The combination of antihistamines and immunosuppressants was better in 5.ASST positive patients. 6. The rest time of the blood sample, the site of the skin test, the skin scratch reaction of the patient and the operator's proficiency may affect the results of ASST.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R758.24
本文編號(hào)：2426733
[Abstract]:Objective: to investigate the epidemiological characteristics of chronic idiopathic urticaria in Jinan area and to evaluate the clinical significance of routine laboratory tests and autologous serum skin test. In order to further understand the pathogenesis of chronic autoimmune urticaria, to effectively guide the clinical treatment and improve the prognosis of patients with reference. Methods: according to certain inclusion criteria, 60 patients with chronic idiopathic urticaria were selected from June 2009 to March 2010. Peripheral blood eosinophil count, serum total IgE, anti-thyroglobulin antibody and autologous serum skin test were performed. The epidemiological characteristics, laboratory results and efficacy of ASST positive and negative patients were compared. The data were analyzed by SPSS13.0 software. Results: a total of 60 patients with chronic idiopathic urticaria were included in this study, including 15 males and 45 females, the ratio of male to female was 1: 3; The average age was 39.82 鹵14.63 years old. The majority of the patients were 30 ~ 50 years old (53.3% of the total cases). There were 41 indoor workers and 19 outdoor workers. There were 39 urban residents and 21 rural residents. All the 60 patients were tested by ASST, 29 cases were negative and 31 cases were positive. The positive rate was that the number of wind masses in 51.7%.ASST positive group was more than that in negative group (P0.05), and the pruritus weight was heavy (P0.05). The attack lasted for a long time (P0.05), but there was no significant difference in wind mass size (P0.05). The eosinophil count in peripheral blood was detected in 45 patients, and the eosinophil count was increased in 2 patients. In 23 cases of ASST positive, 1 case (4.3%) was elevated, and 1 case (4.5%) of 22 cases was negative. Total serum IgE was detected in 44 cases (10 cases). In 22 cases of ASST positive, 6 cases (27.3%) were elevated, 4 cases (18.2%) of 22 negative cases were increased, 43 cases were tested for anti-thyroglobulin antibody, 8 cases were increased in anti-thyroglobulin. In 22 cases of ASST positive, 7 cases (31.8%) were elevated. One of the 21 negative cases was elevated (4.8%), and the difference was statistically significant. The curative effects were observed at 2 weeks and 4 weeks after the end of the experiment. The results showed that 24 cases of ASST positive patients were treated with the second generation antihistamine and the other 7 cases were relieved after the use of tripterygium wilfordii polyglycosides. Twenty-eight patients with ASST negative were treated with second generation antihistamine, and 1 patient with tripterygium wilfordii was not relieved. During the experiment, it was found that the rest time of the blood sample, the site of the skin test, the skin scratch reaction of the patient and the operator's proficiency may affect the results of ASST. Conclusion: 1. The incidence of chronic idiopathic urticaria in Jinan was mainly young and middle-aged, the incidence of female was higher than that of male, that of indoor worker was higher than that of outdoor worker, and that of urban residents was higher than that of rural residents. 2. The positive rate of ASST in patients with chronic idiopathic urticaria in Jinan area was 51.7%, which was consistent with previous reports at home and abroad. Compared with the negative group, the 3.ASST positive group had more wind masses, longer duration and more severe pruritus. 4.ASST positive patients were more likely to develop autoimmune thyroid disease at the same time. The combination of antihistamines and immunosuppressants was better in 5.ASST positive patients. 6. The rest time of the blood sample, the site of the skin test, the skin scratch reaction of the patient and the operator's proficiency may affect the results of ASST.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R758.24
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