| Objective:To explore the clinical application value of detections of aeroallergen specific IgE,food allergen specific IgE or Ig G,total IgE,Fe NO in bronchial asthma and allergic rhinitis.Method: This study enrolled 333 patients with the results of of aeroallergen specific IgE and total IgE.Among these patients,98 patients were suffered from allergic rhinitis,152 patients from bronchial asthma,83 patients from bronchial asthma combined with allergic rhinitis.87 patients without allergic airway disease were selected as a control group.170 patients of observation groups and 57 patients of control group also have the results of Fe NO.The results of aeroallergen specific IgE,Fe NO among these groups were analyzed.The relationship between total IgE and aeroallergen specific IgE,food allergen specific IgE or IgG in 72 patients whose asthmatic symptoms were uncontrolled or partly controlled has also been investigated.RESULTS:1.Dust mites were the most common aeroallergens in patients with asthma and allergic rhinitis.2.The area under the receiver-operator characteristic(ROC)curve of total IgE for diagnosing allergic asthma and allergic rhinitis was 0.807[95%CI: 0.761~0.854].The sensitivity and specificity at the optimal cutoff of 96.4U/L were76.83%,80.79%,respectively.The ROC curve defined total IgE giving a moderate diagnostic value for allergic asthma and allergic rhinitis.In the ROC curve analysis of total IgE value to predict aeroallergen sensitization in subjects with asthma and allergic rhinitis,the AUC was 0.708[95%CI:0.632~0.783],P<0.05.The sensitivity and specificity at the cutoff of 114.67U/L were 73.68%,70.59%,respectively.Total IgE could acts as a screening method for aeroallergen s IgE in the patients with asthma and allergic rhinitis.3.The ROC curve defined Fe NO giving a moderate diagnostic value for asthma and allergic rhinitis,the area under the curve was 0.782[95%CI:0.721~0.843],P<0.05.The sensitivity and specificity at the cutoff of of 26 ppb were 70.59%,80.7%,respectively.But for aeroallergen sensitization,the AUC was 0.384,P>0.05,Fe NO has no diagnostic value.4.In those uncontrolled or partly controlled asthmatics,the positive rates of aeroallergen s IgE and food allergens s IgG were higher than food allergen s IgE.The difference is statistically significant(P < 0.05).Dust mites were still the most prevalence aeroallergen.In IgE medicated food allergy,shrimp had the highest positive ratio.In IgG medicated food allergy,the positive rate of eggs,milk and mushrooms were lined in the top 3.5.Egg,milk and wheat were the most prevalence in 8 kinds of food allergen with the results of both s IgE and s Ig G.Shrimp and beef only showed s IgE positive.But eggs,milk,wheat were given priority to s Ig G.6.Compared with the patients whose total IgE was positive,the patients with negative total IgE have lower positive rates of aeroallergen or food allergen s IgE,and a higher positive rate of food allergen s Ig G.But the difference only in aeroallergen s IgE is statistically significant.Conclusion: Aeroallergens,especially dust mites,were the most common aeroallergens in patients with asthma and allergic rhinitis.Total IgE has moderate diagnostic performance for detecting allergic asthma and allergic rhinitis,aeroallergen sensitization.Total IgE could acts as a screening method for aeroallergen s IgE in the patients with asthma and allergic rhinitis.Although Fe NO has a moderate diagnostic performance for detecting allergic asthma and allergic rhinitis,but there was no difference in asthma and allergic rhinitis.In addiation,many factors could affect the result of Fe NO.Therefore,Fe NO could not be used in the diagnosis or differential diagnosis of asthma and allergic rhinitis.Both IgE mediated and IgG mediated food allergy should be paid attention in the patients with uncontrolled or partly controlled asthma.In these patients with negative total IgE,testing food allergen s IgG might has greater clinical significance. |
