过敏原检测结果为何与过敏症状不一致

2022-09-08 检验之声 健康报、百度百科、检验医学网

基本概念在临床上很多皮肤病的发生与发展都与接触了过敏原有关。而临床上多数过敏性疾病的患者通常只是做缓解症状的

基本概念

在临床上很多皮肤病的发生与发展都与接触了过敏原有关。而临床上多数过敏性疾病的患者通常只是做缓解症状的治疗,而没有找到引发过敏的真正原因,因而也就做不到针对性的预防和治疗,导致病情反复加重、迁延不愈。因而建议经常过敏的患者,一定要做一下过敏原筛查检测,查清楚到底是接触性的、食入性的还是吸入性的过敏原引起的过敏反应,以便从根本上解决问题。千万不要把过敏当成小毛病而忽略了检查和治疗,最终导致严重的后果。

采用酶免疫法快速、准确、无痛检测过敏原。该方法可对患者血清或血浆中的过敏源(总IgE、总IgG、特异性IgE等)进行定性和定量检测。IVT用于检测IgE介导的速发型过敏反应,速发型的过敏反应有明显的季节性,发病时间短、发病率高。该试验解决了常规皮肤试验在I型变态反应病人发作期不宜检测过敏原的难点。FIgG用于检测迟发型的过敏反应。该反应主要与食物有关,即食物不耐受。表现为接触过敏原几天或一周后才出现相关症状。这些过敏反应常因症状滞后而被误诊,临床表现为各系统的慢性症状。如长期病因不明,反复发作,久治不愈,建议应查食物IgG。

现在,患过敏性疾病的人在增多,到医院进行过敏原检测的患者也越来越多。但是,并不是所有的患者对检测结果都满意,王先生就曾经对检测结果产生过很大疑惑。原来,王先生吃海鲜后发生过荨麻疹,当时医生告诉他是海鲜过敏,从此他不敢再吃海鲜了。后来,他到医院做了过敏原检测,想看看自己到底对哪些食物过敏。检测的结果让他吃惊:他对海鲜并不过敏但对鸡蛋过敏,可是他吃鸡蛋并没有不舒服的感觉。这到底是怎么回事呢?难道是检测结果错了吗?

检测出对某种食物过敏,并非一定不能食用

其实,检测结果并没有错,主要问题是如何解释这一结果。首先,检测的是患者是否对某种过敏原存在致敏,并不能证明患者所患疾病是由该过敏原引起的。有的患者进行过敏原检测后发现对很多种食物都过敏,结果不敢吃所有检查出过敏的食物,这是不对的。

因为检测出的过敏原是否有意义,还需要医生根据每位患者的情况具体分析才能作出合理判断。比如王先生虽然检测出对鸡蛋过敏,但是没有任何症状,患荨麻疹前后吃鸡蛋也一直没有反应,可以肯定鸡蛋过敏不是王先生患荨麻疹的原因。那么怎么会检测出鸡蛋过敏呢?

医学研究早就发现,过敏是机体对过敏原产生的一种异常免疫反应。这种反应只在少数敏感的个体中发生,大多数人并不会发生。

而机体一旦致敏,这种状态将终身存在。比如某人曾经发生过染发过敏,以后虽然不再染发,做过敏原检测时仍然会发现他对染发剂过敏。王先生应该也是在长期吃鸡蛋的过程中对鸡蛋致敏了。

但是,致敏以后是否发生临床症状,还与机体的免疫机能状态、是否合并其他疾病、是否应用了抑制免疫机能的药物或抗过敏药物等因素有关。更重要的是,在长期少量吃鸡蛋的过程中,有些人可以产生对鸡蛋耐受的现象,从而平安食用,不会出现任何症状。

过敏原检测为阴性的食物,也可能导致过敏反应

那么,为什么王先生吃海鲜后发生荨麻疹,而过敏原检测他对海鲜并不过敏呢?这种情况最大的可能是假过敏反应。医学研究已经证明许多食物,如海鲜、肉、蛋、蘑菇、草莓、茄子、竹笋、菠菜、苹果、李子以及食品添加剂,如酵母、水杨酸、柠檬酸等均可以直接促进机体肥大细胞脱颗粒,结果产生与过敏反应非常类似甚至完全相同的症状。

但是这种反应并不是真正的过敏反应,所以做过敏原检测时查不到过敏原。这种假过敏反应的重复性不高,并不是每次吃都会发生反应。

而过敏反应则不同,机体一旦致敏,以后哪怕遇到非常微量的过敏原也可能发生反应。除了假过敏反应外,不新鲜的海鲜尤其是虾和螃蟹,本身就含有一些胺类物质,可以导致皮肤发红、瘙痒等过敏症状,经常被医生或患者认为是过敏。这种情况过敏原检测自然也是查不到的。

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    2022-09-10 ms9000000810977445

    #学习#不错不错

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    2022-09-08 ms9000000187500039

    解释牵强没有文献支持

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