Kuo Ho-Chang, Chu Chi-Hsiang, Su Yu-Jih, Lee Chih-Hung
Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung.
Clinical Trial Center.
Medicine (Baltimore). 2020 Jul 24;99(30):e21255. doi: 10.1097/MD.0000000000021255.
Atopic dermatitis (AD) is a common chronic relapsing inflammatory skin disease associated with a personal or family history of atopic diseases. Determining the objective severity scoring of AD index (SCORAD) and total immunoglobulin E (IgE) to help to stage the severity (lesions extent and intensity of the lesions and then the itch and sleep disturbance they may cause) of AD in children.In this study, we adopted the SCORAD index, which consists of severity, area, and sleep disturbance, to evaluate the AD status of children up to 18 years old. We examined the blood levels of total serum IgE, white blood cell count/differential count (WBC/DC), eosinophil counts (EC), eosinophil cationic protein (ECP) and specific IgE.A total of 208 children with AD were enrolled in this study. Serum IgE values and a number of specific IgE that are positive significantly different SCORAD index through simple linear regression; however, after multiple linear regression, only IgE values (95% CI: 0.001-0.004, P < .001), total WBC count (95% CI: 0.112-1.736, P = .026), EC (95% CI: 0.045-6.706, P = .047), and specific IgE to Cheddar cheese (95% CI: 1.814-16.731, P = .015) remain different. After applying the Phi coefficient, we found that specific IgE to tuna (r = 0.632), codfish (r = 0.613), and clam (r = 0.613) each had a moderate correlation with specific IgE to Cheddar cheese. The 6 most common allergens were found to be mite (D. Farinae: 65.9%), mite (D. Pterony: 64.9%), house dust (47.6%), cockroach mix (37.0%), shrimp (30.8%), and crab (22.6%). Covariates of SCORAD index, severity, area, and sleep disturbance differed.In this study, we found that total IgE values, specific IgE values, WBC, EC, and specific IgE to Cheddar cheese have significant correlations with SCORAD index in AD of Taiwanese children.
特应性皮炎(AD)是一种常见的慢性复发性炎症性皮肤病,与个人或家族特应性疾病史相关。确定AD指数(SCORAD)的客观严重程度评分和总免疫球蛋白E(IgE),以帮助对儿童AD的严重程度进行分期(皮损范围和皮损强度,以及它们可能引起的瘙痒和睡眠障碍)。在本研究中,我们采用由严重程度、面积和睡眠障碍组成的SCORAD指数,来评估18岁及以下儿童的AD状况。我们检测了血清总IgE、白细胞计数/分类计数(WBC/DC)、嗜酸性粒细胞计数(EC)、嗜酸性粒细胞阳离子蛋白(ECP)和特异性IgE的血液水平。本研究共纳入208例AD患儿。通过简单线性回归分析,血清IgE值和一些呈阳性的特异性IgE与SCORAD指数有显著差异;然而,经过多元线性回归分析后,只有IgE值(95%可信区间:0.001 - 0.004,P<0.001)、白细胞总数(95%可信区间:0.112 - 1.736,P = 0.026)、嗜酸性粒细胞计数(95%可信区间:0.045 - 6.706,P = 0.047)和对切达干酪的特异性IgE(95%可信区间:1.814 - 16.731,P = 0.015)仍存在差异。应用Phi系数后,我们发现对金枪鱼的特异性IgE(r = 0.632)、对鳕鱼的特异性IgE(r = 0.613)和对蛤蜊的特异性IgE(r = 0.613)与对切达干酪的特异性IgE均有中度相关性。发现6种最常见的变应原分别为螨(粉尘螨:65.9%)、螨(柏氏禽刺螨:64.9%)、屋尘(47.6%)、蟑螂混合物(37.0%)、虾(30.8%)和蟹(22.6%)。SCORAD指数、严重程度、面积和睡眠障碍的协变量有所不同。在本研究中,我们发现台湾儿童AD中总IgE值、特异性IgE值、白细胞、嗜酸性粒细胞计数和对切达干酪的特异性IgE与SCORAD指数有显著相关性。