摘要
目的 分析大疱性类天疱疮(bullous pemphigoid, BP)患者中有特应性特征(包括临床表现、实验室检查和病史)患者的比例,以探讨BP与特应性之间的关系。方法 回顾性研究89例BP患者的临床表现、实验室检查及合并特应性个人史和/或家族史的特征。根据血清免疫球蛋白E(immunoglobulin E, IgE)升高及外周血嗜酸性粒细胞(blood eosinophils, EO)升高特征进行临床分层分析。组间比较视特征采用t检验、Mann-Whitney U检验、卡方检验及Fisher精确检验。结果 89例BP患者中,80例(89.89%)有特应性特征。合并特应性疾病者43例(48.31%),其中特应性皮炎18例(20.22%),过敏性鼻炎29例(32.58%),慢性荨麻疹9例(10.11%),哮喘8例(8.99%),过敏性结膜炎13例(14.61%),27例(30.34%)一级亲属中有特应性疾病史,43/53例(81.13%)血清总IgE升高,41/76例(53.95%)外周血嗜酸粒细胞升高,17/26例(65.38%)过敏原特异性IgE阳性。分层分析表明,血清IgE升高的患者病情更重(Fisher精确性检验,P=0.033);外周血EO升高的患者病情更重(χ^(2)=5.287,P=0.021);合并过敏性鼻炎的患者死亡风险较低(χ^(2)=9.428,P=0.002)。结论 本研究表明,约90%的BP患者具有特应性疾病和/或实验室检查异常和/或家族史,BP可能是一种特应性疾病,提出特应性大疱性类天疱疮的概念。
Objective To analyze the relationship between BP and atopic feature in order to re-understand the essence of BP.Methods The clinical manifestations, laboratory findings and the comorbidity of atopic diseases in 89 BP patients were studied retrospectively. Striated analysis was performed based on the increase in total serum Immunoglobulin E(IgE) level and peripheral blood eosinophil(EO) counting. T-test, Mann Whitney U test, Chi square test and Fisher exact test was used for statistics analysis.Results Of all 89 BP patients, 80(89.89%) had atopy. Forty-three patients(48.31%) were found to have atopic diseases, including atopic dermatitis in 18 patients(20.22%), allergic rhinitis in 29 patients(32.58%), asthma in 8 patients(8.99%), urticaria in 9 patients(10.11%) and allergic conjunctivitis in 13 patients(14.61%). Twenty-seven patients(30.34%) had atopic diseases in their first-degree relatives. Forty-three out of 53 patients(81.13%) had elevated total serum IgE levels and 41/76 patients(53.95%) had elevated peripheral blood eosinophils. Seventeen out of 26 patients(65.38%) had at least one positive allergen-specific IgE. The disease was more severe in patients with elevated total serum IgE(Fisher exact test, P= 0.033) and in patients with elevated peripheral blood eosinophils(χ^(2)=5.287, P=0.021);Patients with allergic rhinitis had a lower risk of death(χ^(2)=9.428, P=0.002).Conclusion About 90% BP patients had clinical manifestations and/or laboratory findings and/or family history of atopic diseases. These suggest that BP might be an atopic disease. We propose the concept of atopic bullous pemphigoid.
作者
窦沅青
于聪
高子蕊
赵培
张春雷
张建中
DOU Yuanqing;YU Cong;GAO Zirui;ZHAO Pei;ZHANG Chunlei;ZHANG Jianzhong(Department of Dermatology,People′s Hospital of Peking University,Beijing 100044,China;Department of Dermatology,Peking University Third Hospital,Beijing 100191,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2022年第11期1271-1275,共5页
The Chinese Journal of Dermatovenereology
基金
国家自然科学基金青年基金(82003336)
作者简介
窦沅青,于聪对本文的贡献相同;于聪,窦沅青,对本文的贡献相同;通信作者:张建中,E-mail:rmzjz@126.com
