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題名 | The Association of Atopy, Total IgE, and Pulmonary Function in Bronchiectasis=過敏體質、免疫球蛋白E總量與肺功能在支氣管擴張症中的關聯性 |
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作者姓名(中文) | 林玠模; 林鴻銓; 陳冠元; 謝孟亨; 鍾福財; 枋岳甫; 余志騰; 郭漢彬; | 書刊名 | 胸腔醫學 |
卷期 | 26:5 2011.10[民100.10] |
頁次 | 頁240-251 |
分類號 | 415.427 |
關鍵詞 | 過敏體質; 異位性體質; 免疫球蛋白E總量; 肺功能; 支氣管擴張症; Atopy; Total IgE; Pulmonary function; Bronchiectasis; |
語文 | 英文(English) |
中文摘要 | 前言:支氣管擴張症的特徵是氣道不可逆性的擴張和破壞,過敏體質(atopy)和過敏原在支氣管擴張症中的相關臨床表現目前並不清楚。本研究的目的在於探討過敏體質、免疫球蛋白E總量(total IgE)與肺功能在支氣管擴張症病人中的影響與關聯性。方法:本文回溯性回顧長庚醫院於2001年至2009年間被診斷為支氣管擴張症的病患,分析這些病患的過敏原特異性免疫球蛋白E定量測定(allergen specific IgE test)、血清免疫球蛋白E總量、嗜伊紅性白血球陽離子蛋白(ECP)、肺功能與高敏感性C-反應蛋白(hs-CRP)等檢驗值。結果:在114個成人支氣管擴張症病患中,有33個(28.9%)病人對於至少一種過敏原的特異性IgE定量測定呈現陽性反應。在這些有過敏體質的支氣管擴張症病人,肺功能測定顯示出有較差的第一秒用力吐氣量(FEV1)與第一秒用力吐氣量/用力吐氣總肺活量(FEV1/FVC)的比值,血清中也有較高的IgE總量。進一步分析這些有過敏體質的病人,肺功能有意義的減少僅發生在對於大於兩種過敏原特異性IgE測定為陽性反應的病患中發現,而在只對於一種或兩種過敏原測定為陽性反應的病人,其肺功能並無顯著的改變。對於愈多的過敏原特異性IgE呈陽性反應的病人,血清的IgE總量也較高。支氣管擴張症的病人若有較高的血清IgE總量(≥100 kU/L)會比有正常血清IgE總量(<100 kU/L)的病人有較差的肺功能,且會對更多的過敏原呈現陽性的特異性IgE反應。結論:在支氣管擴張症的病患中,有過敏體質且對於較多的過敏原呈現陽性IgE抗體反應或是有較高的血清IgE總量者,會有較差的肺功能。原因可能為與免疫球蛋白E相關的局部或系統性發炎反應所造成。 |
英文摘要 | Background: Bronchiectasis is characterized by irreversible airway dilation and destruction, but its clinical features relative to atopy and sensitized allergens remain unclear. Therefore, this study aimed to investigate the relationship between atopy, serum IgE level, and lung function in bronchiectasis patients.Method: The study included 114 adult patients with a clinical diagnosis of bronchiectasis between January 2001 and December 2009. They were all evaluated for allergen specific-IgE levels, serum total IgE and eosinophilic cationic protein (ECP) levels, spirometry values of the pulmonary function test, and high-sensitivity C-reactive protein (hs-CRP) levels. Atopy was defined as the presence of a specific IgE to 1 or more allergens.Results: Of the 114 adult bronchiectasis patients, 33 (28.9%) showed positive specific immunoglobulin E (IgE) levels to 1 or more allergens and were assessed as atopic. Atopic patients with bronchiectasis had worse pulmonary function parameters, in terms of forced expiratory volume in 1 second (FEV1) and FEV1/FVC (forced vital capacity) ratio, and higher levels of total serum IgE. There was a significant decrease in the pulmonary function test of atopic subjects with a positive specific-IgE response to more than 2 allergens, but not in those with only 1 or 2 positive allergens. There were higher serum total IgE levels in patients with more positive allergen-specific IgE tests. Bronchiectatic patients with a high total IgE level (≥100 kU/L) had significantly worse lung function (FEV1% predicted and FEV1/FVC ratio) and more sensitized allergens than those with a normal IgE level (<100 kU/L).Conclusion: The existence of atopy with more sensitized allergens or higher total serum IgE levels may lead to a worse pulmonary function in patients with bronchiectasis. This may be due to IgE-mediated local and systemic inflammation. |
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