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[血液透析的过敏风险。138例患者的变态反应学调查结果]

[Allergic risks of hemodialysis. Results of an allergologic investigation in 138 patients].

作者信息

Kessler M, Moneret-Vautrin A D, Mariot A, Cao H T, Chanliau J, Guéant J L, Nicolas J P

机构信息

Service de Néphrologie, CHRU de Nancy.

出版信息

Nephrologie. 1990;11(4):249-54.

PMID:2074927
Abstract

One hundred and thirty eight unselected hemodialysis patients were screened for allergic symptoms, atopy, total IgE, eosinophil count, specific IgE against ethylene oxyde (ETO), formaldehyde (FA) and isocyanates (Iso) and delayed hypersensitivity to formaldehyde. Six patients demonstrated hypersensitivity to formaldehyde. Six patients demonstrated hypersensitivity reactions at the beginning of hemodialysis; one had recurrent urticaria and one aggravated a preexistent asthma. There were no predicting factors but 6 out of these 8 patients (62%) had positive RAST against ETO, FA or Iso. Eczematous lesions occurred in 40 patients (20%) mainly located around the fistula. Eczema is significantly more frequent in men, atopic patients, and patients using a type of machine where we measured high residual FA concentrations (greater than 50 mg/l). A positive FA patch test was observed in 22% of the patients with an eczema compared to 1.3% in the asymptomatic patients (p less than 0.01).

摘要

对138例未经挑选的血液透析患者进行了过敏症状、特应性、总IgE、嗜酸性粒细胞计数、针对环氧乙烷(ETO)、甲醛(FA)和异氰酸酯(Iso)的特异性IgE以及对甲醛的迟发型超敏反应筛查。6例患者表现出对甲醛过敏。6例患者在血液透析开始时出现过敏反应;1例有复发性荨麻疹,1例使原有哮喘加重。没有预测因素,但这8例患者中有6例(62%)针对ETO、FA或Iso的RAST呈阳性。40例患者(20%)出现湿疹样病变,主要位于瘘管周围。男性、特应性患者以及使用我们测量到高残留FA浓度(大于50mg/l)的某类机器的患者中,湿疹明显更常见。22%有湿疹的患者甲醛斑贴试验呈阳性,而无症状患者中这一比例为1.3%(p<0.01)。

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