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目的观察免疫正常人和过敏性猝死者血清类胰蛋白酶、IgE含量及类胰蛋白酶在咽喉、肺和小肠组织的表达,探讨过敏性猝死的诊断方法。方法采用荧光酶联免疫法(FEIA)测定115例正常人和6例过敏性猝死者血清类胰蛋白酶;采用酶联免疫吸附试验(ELISA)测定7例过敏性猝死者血清IgE含量;采用免疫组织化学方法观察15例过敏性猝死者咽喉、肺、小肠组织中类胰蛋白酶的表达,并采用BL-2000病理图像分析系统进行定量分析。结果①115例免疫正常人血清中类胰蛋白酶含量在0.80μg/L～8.86μg/L之间,性别之间无明显差异(P>0.05)。20岁以下、21～40岁和41～60岁组之间血清中类胰蛋白酶含量无明显差别(P>0.05),而60岁以上组含量高于其他年龄组(P<0.05);②6例过敏性猝死者血清类胰蛋白酶含量均高于免疫正常人;③7例过敏性猝死者中有6例血清IgE水平高于正常值(>333U/mL);④过敏性猝死者咽喉、肺和小肠组织中类胰蛋白酶表达升高,与对照组之间有显著性差异(P<0.01)。结论过敏性猝死者血清IgE、类胰蛋白酶含量及咽喉、肺和小肠组织类胰蛋白酶表达升高,可对敏性猝死的诊断有一定参考价值。
Objective To observe the serum tryptase, IgE levels and the expression of tryptase in the throat, lung and small intestine of patients with immune-normal and sudden-onset of allergic diseases and to explore the diagnostic method of sudden death from the disease. Methods Serum tryptase of 115 normal subjects and 6 patients with sudden death from allergic disease were detected by fluorescence enzyme-linked immunosorbent assay (FEIA). Serum IgE levels were measured by enzyme-linked immunosorbent assay (ELISA) in 7 patients with sudden death of allergic disease. The chemical method was used to observe the expression of tryptase in the throat, lung and small intestine of 15 patients with sudden death from anaphylaxis. The expression of tryptase was analyzed by BL-2000 pathological image analysis system. Results ① The content of tryptase in serum of 115 immunized normal persons was between 0.80μg / L and 8.86μg / L, there was no significant difference between the sexes (P> 0.05). The content of tryptase in serum of 20 years old, 21 ~ 40 years old and 41 ~ 60 years old group had no significant difference (P> 0.05), while the content of 60 years old group was higher than other age groups (P <0.05) Serum tryptase levels in patients with sudden onset of anaphylaxis were significantly higher than those in normal controls; (6) Serum IgE level was higher than normal (> 333U / mL) in 7 patients with sudden onset of allergic disease; (4) Throat, lung and small intestine Tissue tryptase expression increased, and the control group was significantly different (P <0.01). Conclusions Serum IgE, tryptase levels and the expression of tryptase in the throat, lung and small intestine of patients with sudden onset of allergy may have some reference value for the diagnosis of sudden