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摘要: 目的 研究北京地区桦树花粉过敏的主要致敏蛋白组分及其临床意义。方法 采用横断面研究的方法将58例桦树花粉过敏的患者纳入研究。根据临床表现分为变应性鼻炎(allergic rhinitis，AR)和过敏性哮喘(allergic asthma，AA)组。采用ImmunoCAP荧光酶联免疫法检测患者血清桦树花粉sIgE浓度，以及桦树花粉主要致敏蛋白组分Bet v 1，Bet v 2，Bet v 4，Bet v 6 sIgE浓度并分级。分析桦树花粉和各组分蛋白sIgE在AR和AA中的差异。结果 入组患者中，AR为44例(75.9%)，AA为14例(24.1%)。单独春季花粉过敏的18例患者全部为AR患者，无AA患者。春秋季花粉过敏的患者共计40例，其中AR为26例(65%)；AA为14例(35%)。58例纳入研究的患者均为桦树花粉sIgE 2级及以上阳性。4种桦树花粉的致敏蛋白组分中，对任意一种桦树花粉蛋白组分阳性占94.8%。单一组分致敏占77.6%；2种组分致敏占17.2%。Bet v 1和(或)Bet v 2阳性率为93.1%。4种蛋白组分的阳性率依次为：Bet v 1(82.8%)、Bet v 2(29.3%)、Bet v 6(1.7%)、Bet v 4(0)。桦树花粉sIgE和Bet v 1的sIgE级别呈显著正相关性(r=0.898，P < 0.001)。Bet v 2的sIgE浓度在AA组显著高于AR组[(4.34±14.35) kUA/L vs (1.56±3.26) kUA/L，P < 0.05]，其他组分无显著性差异。结论 北京地区桦树花粉的主要致敏蛋白组分为Bet v 1，桦树花粉组分蛋白以单一致敏为主，Bet v 1联合Bet v 2检测可诊断90%以上的桦树花粉过敏患者。Abstract: Objective To explore the allergen components of birch pollen in the Beijing area and interpret its clinical significance.Methods A total of 58 patients with birch pollen allergy were included in the cross-sectional study and divided into allergic rhinitis(AR) and allergic asthma(AA) groups according to clinical manifestations. Concentration of birch pollen allergen sIgE, as well as Bet v 1, Bet v 2, Bet v 4 and Bet v 6 sIgE were detected by ImmunoCAP immunolinked immunoassay. Differences of sIgE concentration of birch pollen allergen component in AR and AA were analyzed.Results There were 44(75.9%) cases of AR and 14(24.1%) cases of AA were enrolled. All the 18 patients with spring pollen allergy were AR patients without AA. There were 40 cases with both spring and autumn pollen allergy, of which 26 cases(65%) were AR and 14 cases(35%) were AA. The sIgE of birch pollen allergen was level 2 or above in all subjects. 94.8% were positive for any four allergen components. 77.6% were mono-sensitized to any allergen component while 17.2% were dual-sensitized. The positive rate of Bet v 1 and/or Bet v 2 was 93.1%. The positive rates of four protein components were: Bet v 1(82.8%), Bet v 2(29.3%), Bet v 6(1.7%), Bet v 4(0%). sIgE of birch pollen was positively correlated with sIgE level of Betv 1(r=0.898, P < 0.001). The sIgE concentration of Bet v2 in AA group was significantly higher than that in AR group([4.34±14.35] kUA/L vs [1.56±3.26] kUA/L, P < 0.05). There was no significant difference in other components.Conclusion Bet v 1 is the main allergen component of birch pollen in the Beijing area, and Bet v 1 plus Bet v 2 can diagnose more than 90% of birch pollen allergy.
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Key words:
- pollen allergy /
- birch pollen /
- allergen component /
- Bet v 1 /
- Bet v 2
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表 1 桦树花粉及各个蛋白组分的阳性率
% sIgE级别 桦树花粉 Bet v 1 Bet v 2 Bet v 4 Bet v 6 level 1 0 1.7 1.7 0 0 level 2 22.4 15.5 13.8 0 1.7 level 3 39.7 43.1 12.1 0 0 level 4 29.3 15.5 0 0 0 level 5 3.4 5.2 1.7 0 0 level 6 5.2 1.7 0 0 0 合计 100.0 82.7 29.3 0 1.7 
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