Kiviloog J, Irnell L, Wide L
Scand J Respir Dis. 1975 May;56(1):28-37.
This study involves an investigation of 185 subjects, aged 35--54 years, a representative sample of persons with chronic obstructive lung disease in a local Swedish population. Bronchial asthma was diagnosed in 86 persons, chronic bronchitis in 69 and a combination of bronchial asthma and chronic bronchitis in 30. Reaginic bronchial allergy as a provoking factor was considered as definite when the case history, an intracutaneous test, a bronchial provocation test and a radioallergosorbent test were all positive with regard to one and the same allergen. This was found in 28% of the asthmatics. In 16% of the asthmatics, the diagnosis of reaginic bronchial allergy was not supported by all the four diagnostic criteria used but was considered as probable since the case history or the bronchial provocation test was positive in association with a positive RAST or intracutaneous test with the same allergen. Reaginic (IgE) antibodies in serum to mites (Dermatophagoides pteronyssinus) were found in 20 subjects, 18 of whom also had a positive intracutaneous test for house dust. Four of these 20 subjects had definite and 12 had probable reaginic bronchial allergy. One of the remaining four subjects had chronic bronchitis without asthma. The percentage of definite reaginic bronchial allergy may possibly be increased when reliable bronchial provocations with mite allergen can be performed. Increased IgE levels in serum were found in only eight of the 51 asthmatics with reaginic bronchial allergy and in two of the 65 other asthmatics.
本研究对185名年龄在35至54岁之间的受试者进行了调查,他们是瑞典当地慢性阻塞性肺病患者的代表性样本。其中86人被诊断为支气管哮喘,69人患有慢性支气管炎,30人同时患有支气管哮喘和慢性支气管炎。当病史、皮内试验、支气管激发试验和放射变应原吸附试验对同一过敏原均呈阳性时,反应性支气管过敏作为诱发因素被确定为明确。在28%的哮喘患者中发现了这种情况。在16%的哮喘患者中,反应性支气管过敏的诊断并不完全符合所使用的四项诊断标准,但由于病史或支气管激发试验呈阳性,同时放射变应原吸附试验或皮内试验对同一过敏原呈阳性,因此被认为有可能。在20名受试者中发现血清中存在针对螨虫(粉尘螨)的反应性(IgE)抗体,其中18人对屋尘的皮内试验也呈阳性。这20名受试者中有4人有明确的反应性支气管过敏,12人有可能的反应性支气管过敏。其余4名受试者中有1人患有慢性支气管炎但无哮喘。当能够进行可靠的螨虫过敏原支气管激发试验时,明确的反应性支气管过敏的百分比可能会增加。在51名有反应性支气管过敏的哮喘患者中,只有8人血清IgE水平升高,在其他65名哮喘患者中只有2人血清IgE水平升高。