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首页> 外文期刊>Allergy >Influence of total IgE levels on the severity of sting reactions in Hymenoptera venom allergy.
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Influence of total IgE levels on the severity of sting reactions in Hymenoptera venom allergy.

机译：总IgE水平对膜翅目毒液过敏中ing反应严重程度的影响。

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BACKGROUND: Detection of specific IgE for Hymenoptera venoms and skin tests are well established diagnostic tools for the diagnosis of insect venom hypersensitivity. The aim of our study was to analyze the effect of total IgE levels on the outcome of generalized anaphylactic reactions after a Hymenoptera sting. METHODS: Two hundred and twenty patients allergic to bee, wasp, or European hornet venom were included in the study. Their specific and total IgE levels, serum tryptase levels, skin tests, and sting history were analyzed. RESULTS: In patients with mild reactions (grade I, generalized skin symptoms) we observed higher total IgE levels (248.0 kU/l) compared to patients with moderate reactions (grade II, moderate pulmonary, cardiovascular, or gastrointestinal symptoms; 75.2 kU/l) and severe reactions (grade III, bronchoconstriction, emesis, anaphylactic shock, or loss of consciousness; 56.5 kU/l; P < 0.001). Accordingly, 25% of the patients with low levels of total IgE (<50 kU/l), but no individualwith total IgE levels >250 kU/l, developed loss of consciousness (P = 0.001). Additionally, specific IgE levels were related to total IgE levels: Specific IgE levels increased from 1.6 to 7.1 kU/l in patients with low (<50 kU/l) and high (>250 kU/l) total IgE levels, respectively (P < 0.001). Specific IgE levels correlated inversely to the clinical reaction grades, however, this trend was not statistically significant (P = 0.083). CONCLUSION: Patients with Hymenoptera venom allergy and high levels (>250 kU/l) of total IgE, predominantly develop grade I and grade II reactions and appear to be protected from grade III reactions. However, this hypothesis should be confirmed by extended studies with sting challenges.
机译：背景：针对膜翅目毒液的特异性IgE的检测和皮肤测试是诊断昆虫毒液超敏反应的成熟诊断工具。我们研究的目的是分析膜翅目after虫后总IgE水平对广义过敏反应结果的影响。方法：本研究包括对蜜蜂，黄蜂或欧洲大黄蜂毒液过敏的220例患者。分析了它们的特异性和总IgE水平，血清类胰蛋白酶水平，皮肤测试和st病史。结果：在轻度反应（I级，全身性皮肤症状）患者中，与中度反应（II级，中度肺，心血管或胃肠道症状; 75.2 kU / l）相比，我们观察到较高的总IgE水平（248.0 kU / l） ）和严重反应（III级，支气管狭窄，呕吐，过敏性休克或意识丧失; 56.5 kU / l; P <0.001）。因此，有25％的患者的总IgE水平较低（<50 kU / l），但是没有个人的总IgE水平> 250 kU / l导致意识丧失（P = 0.001）。此外，特异性IgE水平与总IgE水平相关：总IgE水平低（<50 kU / l）和高（> 250 kU / l）的患者中特定IgE水平从1.6增加到7.1 kU / l（P <0.001）。特定的IgE水平与临床反应等级成反比，但是，这种趋势在统计学上不显着（P = 0.083）。结论：患有膜翅目毒液过敏和高水平（> 250 kU / l）总IgE的患者主要发展为I级和II级反应，并且似乎受到了III级反应的保护。但是，该假设应通过具有严峻挑战的扩展研究得到证实。

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