| Chronic spontaneous urticaria(CSU)is an allergic disease characterized by pruritic wheal in the skin and mucosa.A large number of studies have confirmed that the pathogenesis of CSU is significantly associated with autoimmunity.The aim of this study was aimed to investigate the differences in peripheral blood total IgE,IL-4,and IL-9 levels between CSU patients and healthy controls,and their correlation with the severity of the disease,and then further explored the role and clinical significance of IL-9 in chronic spontaneous urticaria.At the same time,we compared the changes of serum total IgE,IL-4 and IL-9 levels before and after treatment of CSU with rupatadine fumarate tablets(RT)and desloratadine tablets(DT).and observed the therapeutic effects of the two groups of drugs.A total of 78 CSU patients,who come from the Department of Dermatology of the First Affiliated Hospital of Hebei North University from February 2018 to August 2018,were selected as the experimental group,and 36 cases of healthy physical examination in our hospital were selected as the control group.The levels of total IgE,IL-4 and IL-9 in peripheral blood of CSU patients and control patients were detected by double antibody sandwich ELISA.According to the urticaria activity score(UAS)and visual analogue scale(VAS),the state of illness and the degree of itching of patients was scored and divided into three groups: mild,moderate,and severe.Then serum concentrations of total IgE,IL-4,IL-9 were compared with the three groups in turn.After initial diagnosis,CSU patients were given 10 mg qd of rupatadine fumarate tablets and 5 mg qd of desloratadine tablets,and the levels of total IgE,IL-4 and IL-9 in peripheral blood were measured againafter 28 days of continuous oral administration.At the same time,the severity of the patient's condition was evaluated and the symptom score reduction index(SSRI)was calculated.Finally,SPSS 22.0 statistical software was used for data entry and statistical analysis.The research results showed that:(1)The serum concentrations of total IgE,IL-4 and IL-9 in the CSU group were significantly higher than those in the healthy control group,with statistically significant differences(P<0.05).There was a positive correlation between serum IL-4 and IL-9 expression levels in the CSU group(r=0.298,P<0.01),and no significant correlation was found between serum total IgE and IL-4,IL-9 levels(r=0.0635,0.0867).(2)The concentrations of serum IL-4 and IL-9 in CSU patients were all positively correlated with three different severity degrees of their illness(r=0.312,P<0.05),(r=0.49,P<0.01).The results showed that there was no significant correlation between the level of total IgE in peripheral blood and the severity of CSU patients(r=0.106).(3)There was a positive correlation between serum IL-9 level and grade of pruritus in CSU patients(r=0.34,P<0.05),and there was no significant correlation between serum total IgE,IL-4 and the degree of pruritus in patients with CSU(r=0.132,0.091).(4)The effective rate of rupatadine fumarate in the treatment of CSU patients was 86%.In the experimental group,the UAS score decreased by(7.96±3.25)and the VAS score decreased by(4.62±2.93)after 28 days of treatment with rupatadine tablets,and the UAS score decreased by(6.27±2.03)and the VAS score decreased by(3.85±2.16)after 28 days of oral desloratadine tablets.The differences between the two groups before and after treatment was statistically significant(P<0.05).After treatment with the two groups of drugs,the serum total IgE,IL-4 and IL-9 levels were lower in the CSU group than before treatment.However,Oral RT the levels of serum IL-4 and IL-9 were significantly lower than those before treatment,and the statistical difference was statistically significant(P<0.05),but there was no significant difference in serum total IgE levels before treatment(P>0.05);Oral DT the levels of serum IgE and IL-4 were significantly lower than those before treatment,and the statistical difference was statistically significant(P<0.05),but there was no significant difference in serum IL-9(P>0.05).The above results suggested that:(1)The serum total IgE,IL-4,IL-9 levels in CSU patients were significantly higher than those in the normal control group,it is suggested that there is a synergistic effect among IgE,IL-4 and IL-9 during the pathogenesis of CSU.(2)The change of serum IL-4 and IL-9 level are closely related with the severity of CSU patients.(3)The serum IgE,IL-4 and IL-9 levels were decreased in CSU patients after two groups of drugs,and the decrease in rupatadine tablets was more significant.(4)The Rupatadine tablets has a better effect in relieving patients' condition. |
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