目的：分析变应性鼻炎患者抗交叉反应性糖类决定簇 IgE（anti-CCDIgE）水平与血清 IgE 水平和皮肤点刺试验（SPT）的关联性。方法选取2012年1月—2013年7月北京大学第一医院确诊且符合纳入标准的变应性鼻炎患者和非变应性鼻炎患者161例为研究对象。按照患者是否为变应性鼻炎分为变应性鼻炎组（121例）和对照组（40例）。收集患者一般资料（包括性别、年龄、蜜蜂叮咬情况等），采用斑点免疫印迹法（dot-IBT）检测血清特异性IgE（sIgE）及anti-CCDIgE表达情况，荧光酶联免疫法（FEIA）检测 phadiatop、总 IgE（tIgE）表达情况，并进行 SPT。分析anti-CCDIgE表达情况与性别、年龄、蜜蜂叮咬情况、sIgE 特应性变应原表达情况、phadiatop 表达情况、tIgE 表达情况、SPT 吸入性变应原表达情况的关联性，SPT 结果与年龄、性别、phadiatop 表达情况、tIgE 表达情况的关联性。结果变应性鼻炎组患者 sIgE、anti-CCDIgE、phadiatop、tIgE 阳性表达率、SPT 阳性率均高于对照组，差异有统计学意义（P ﹤0.05）。anti-CCDIgE表达情况与性别，年龄，sIgE 特应性变应原中的混合树木、葎草、艾蒿、户尘、混合尘螨、混合霉菌、蟑螂、狗毛、猫毛表达情况，phadiatop 表达情况，SPT 吸入性变应原中的树1、杂草、云杉属、葎草、树2、禾本科/谷、艾蒿、刺槐、松、粉尘螨、户尘螨、烟曲霉菌、白假丝酵母菌、蟑螂、禾本科、霉菌1、霉菌2、动物毛表达情况无关联性（P ﹥0.05）；anti-CCDIgE表达情况与蜜蜂叮咬情况，sIgE 特应性变应原中的豚草表达情况，tIgE表达情况，SPT 吸入性变应原中的藜、大豚草表达情况存在关联性（ P ﹤0.05）。SPT 结果与性别、tIgE 表达情况无关联性（P ﹥0.05）；SPT 结果与年龄、phadiatop 表达情况存在关联性（ P ﹤0.05）。SPT 阳性率随年龄的增加而增大（χ2趋势＝4.264，P ＝0.039）。结论变应性鼻炎患者anti-CCDIgE水平与血清 IgE（sIgE、tIgE）水平、SPT 结果有一定的关联性，anti-CCDIgE表达情况对确诊变应原的 SPT 和 sIgE 试验有一定干扰，在分析试验结果时应予以注意。%Objective To analyze the correlation of anti - cross reactive carbohydrate determinants IgE(anti-CCDIgE level)with serum IgE level and skin prick test(SPT)of patients with allergic rhinitis. Methods From January 2012 to July 2013,we enrolled 161 patients who were definitely diagnosed as allergic rhinitis or non - allergic rhinitis and accorded with inclusion criteria in Peking University First Hospital. According to whether the patients had non - allergic rhinitis,they were divided into allergic rhinitis group(n = 121)and control group(n = 40). General data of patients were collected,including gender,age and history of hymenoptera stings. Dot immunobloting( dot-IBT)was used to detect the expression of sIgE and anti-CCDIgE. Phadiatop and tIgE expression was detected by FEIA,and SPT was conducted. The correlation of anti-CCDIgE expression with gender,age,history of hymenoptera stings,and the expression of sIgE,phadiatop,tIgE and SPT sensitization was analyzed,and the correlation of SPT results with gender,age,and the experession of phadiatop and tIgE was also analyzed. Results Allergic rhinitis group was higher than control group in the positive expression rate of sIgE,anti-CCDIgE,phadiatop and tIgE and SPT positive rate(P ﹤ 0. 05). The expression of anti - CCDIgE had no correlation with gender,age,expression of mixed trees,humulus,mugwort,household dust,mixed dust mites,mixed fungus,cockroaches,dog dander and cat dander of sIgE atopic allergens,expresion of phadiatop,expresion of trees 1,weeds,spruce,humulus,trees 2,gramineae/ grain, mugwort,robinia pseudoacacia, pine, dust mites, household dust mites, aspergillus fumigatus, candida albicans, cockroaches,gramineae,mould 1,mould 2 and animal dander of SPT inhaled allergens(P ﹥ 0. 05);the expression of anti -CCDIgE had correlation with history of hymenoptera stings,ragweed of sIgE atopic allergens,tIgE expression,quinoa and goosefoots of SPT inhaled allergens(P ﹤ 0. 05). SPT results had no correlation with gender and tIgE expression(P ﹥ 0. 05), and had correlation with age and phadiatop expression(P ﹤ 0. 05). SPT positive rate increased as age increased(χ2trend = 4. 264, P = 0. 039). Conclusion The anti-CCDIgE expression of patients with allergic rhinitis has correlation with serum IgE( sIgE and tIgE)level and SPT result. The expression of anti-CCDIgE disturbs the SPT and sIgE for the diagnosis of allergens.
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