变态反应性疾病变应原的体内外诊断及分析

Diagnosis and analysis of allergen with skin prick test and serum specific IgE detection in allergic disease

目的应用变应原皮肤点刺试验（SPT）分析西安地区不同变态反应性疾病的主要变应原，同时应用UniCAP100检测血清特异性免疫球蛋白E（IgE），并对结果进一步评价。方法我院变态反应门诊就诊的变态反应性疾病患者679例，选用19种常见的变应原进行SPT，比较不同疾病患者主要变应原阳性率的异同；其中116例患者同时抽取静脉血检测血清粉尘螨特异性IgE，并与SPT结果比较。结果①在所有变态反应性疾病患者中，粉尘螨、屋尘螨均是最主要的变应原，总的阳性率分别是49．78％和43．00％，其次依次为蒿属花粉、霉菌、悬铃木属花粉和树I花粉等，总阳性率均在10％以上，上述变应原是西安地区变态反应性疾病的主要变应原；②羽毛、鸡蛋、牛奶、蒿属、虾和花生6种变应原的阳性率在4种变态反应性疾病组间比较差异有统计学意义（P〈0．05），其余变应原的阳性率在各组间差异无统计学意义，哮喘及过敏性鼻炎组患者的主要变应原以吸人性变应原为主，而荨麻疹组及过敏性紫癜组患者的主要变应原除以上吸入变应原外，还包括鸡蛋、牛奶、虾和花生等食人性变应原；③以血清特异性IgE为标准，以“＋＋＋及以上”为SPT阳性标准时的诊断价值高于以“＋＋及以上”为SPT阳性标准，且IgE定量与SPT风团直径呈对数关系（r=0．629，P〈0．05）。结论粉尘螨、屋尘螨、蒿属花粉、霉菌、悬铃木属花粉和树I花粉等变应原是西安地区变态反应性疾病的主要变应原；不同疾病的主要变应原稍有不同；IgE定量与SPT风团直径呈对数关系，两者检测结果可以。互补。

Objective To analyse the major allergen with skin prick test（SPT） in Xi＇an area in different allergic diseases and evaluate of the results of SPT with specific IgE detection with UniCAP 100 in vitro. Methods 679 patients with allergic disease from our allergic out-patient department were accepted SPT with 19 kinds of common allergens. And the positive rates in different allergic diseases were compared. 116 cases of these allergic diseases patients were measured serum specific IgE against dematophagoids farinae and the results were compared with SPT results. Results （1）Dematophagoids farinae and dematophagoids pteronyssinus were the major allergen in all kinds of allergic diseases with the SPT positive rate being 49.78% and 43.00%. Artemisia pollen, molds, Platanus acerifolia pollen and Tree I pollen were also the major allergen in turns with the SPT positive rate more than 10%. These allergens were all the major allergens in Xi＇an area in allergic diseases. （2）The SPT positive rates of feather, egg, milk, Artemisia pollen, shrimp and peanut were different in different kinds of allergic diseases significantly while the others had no significant difference in different kinds of allergic diseases. Inhalant allergens were the major allergens in athmatic and allergic rhinitis patients. Whereas in urticaria and allergic purpura patients some edibility allergens such as egg, milk, shrimp and peanut were also the major allergens aparting from the inhalant allergens. （3）The SPT diagnostic value with ＂＋＋＋ or more＂ as diagnostic criteria was higher than that of with ＂＋ ＋ or more＂ as diagnostic criteria when the serum specific IgE was used as golden criteria. The specific IgE quantitation and the diameter of SPT wheals were logarithmic correlated with each other （ r =0. 629, P〈0.05）. Conclusions Dematophagoids farinae, dematophagoids pteronyssinus, Artemisia pollen, molds, Platanus acerifolia pollen and Tree I pollen were the major allergens of allergic diseases in Xi＇an area. The major allergen was slightly different in different allergic diseases. The specific IgE quantitation and the diameter of SPT wheals were logarithmic correlated with each other and the two kinds of tests could complement with each other.