免疫正常人和过敏性猝死者类胰蛋白酶含量测定

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。

Detection of typtase leveal in serum of the health adults and the individuals of sudden death from hypersensitivity

Objective To determine tryptase and IgE concentration in serum samples of the health adults and individuals who were certified as sudden deaths from hypersensitivity,and to detect tryptase in the throat,lungs and small intestine for approaching to diagnostic method for sudden death from hypersensitivity.Methods Serum level of tryptase was measured in 115 healthy adults and 15 cases died from hypersensitivity by fluorescent enzyme-linked immunosorbent assay.The content of IgE was determined in serum of 7 cases dead from hypersensitivity by enzyme-linked immunosorbent assay.Mast cell tryptase was detected by immunohistochemical method in the throat,lungs and small intestine in 15 cases dead from hypersensitivity with semi-quantitative analysis by a BI-2000 image analysis system.Results ①The concentration of tryptase ranged from 0.80μg/L to 8.86μg/L in serum of 115 healthy adults.There was no statistically significant difference between man and woman(P>0.05).No statistical difference was noted among healthy individuals <21 years old,those aged from 21 to 40 years old,and aged from 41 to 60 years old(P>0.05).The level of tryptase was significantly elevated in the healthy individuals over 60 years old age as compared with those in the other age groups(P<0.05).②Level of tryptase in serum of 6 cases was higher than that of healthy individuals.③ Level of IgE in the serum from 7 cases died from hypersensitivity,there are 6 cases which higher than normal level(>333U/mL),1 case is within normal(260.82 U/mL).④The content of tryptase in throat,lung,small intestine of the dead bodies died from hypersensitivity is higher than healthy individual,there is significant difference compare with control group(P<0.01).Conclusion The content of IgE and tryptase in the serum of the individuals dead from hypersensitivity and the content of tryptase in throat,lung,small intestine of the dead bodies died from hypersensitivity is higher than normal level.Accordingly,to detect the content of IgE and tryptase in the serum of the dead body can diagnosis sudden death from hypersensitivity,immunohistochemistry dyeing of tryptase in the throat,lung,small intestine can reflect tryptase'activity and content.