变应性鼻炎两种血清学特异性IgE检测与皮肤点刺试验的相关性研究

Correlation analysis of two serum specific IgE test systems and skin prick test in allergic rhinitis patients

目的 探讨两种血清学特异性IgE（specific IgE,sIgE）检测系统（ImmunoCAP100系统和AllergyScreen系统）与皮肤点刺试验（skin prick test,SPT）在变应性鼻炎（allergic rhimtis,AR）诊断中的相关性及临床意义.方法 以AR阳性病史及SPT阳性结果与病史相符为AR诊断参考标准,选取2009年6-10月就诊于吉林大学中日联谊医院耳鼻咽喉头颈外科的216例AR病史阳性患者为研究对象,进行SPT及血清sIgE检查,选取本地常见的3种变应原（屋尘螨、艾蒿、豚草）,探讨两种检测系统sIgE检测结果与SPT的相关性及其临床意义.采用SPSS13.0统计软件对实验结果进行分析.结果 以SPT结果为诊断参考标准,216例患者中SPT阳性且与病史相符158例,确诊为AR,ImmunoCAP100和AllergyScreen与SPT结果的符合率分别为81.0%和81.9%,两系统检测结果差异无统计学意义（x2=0.112,P＞0.05）.ImmunoCAP100和AllergyScreen系统的灵敏度分别为87.2%和78.0%,差异有统计学意义（x2=7.361,P＜0.05）,特异度分别为74.1%和86.2%,差异有统计学意义（x2=10.222,P＜0.05）.ImmunoCAP100和AllergyScreen系统检测结果的分级状况与SPT分级分别呈正相关（rs值分别为0.663和0.617,P值均＜0.01）.ImmunoCAP100和AllergyScreen系统sIgE检测结果间的分级状况亦呈正相关（rs=0.715,P＜0.01）.结论 两种检测系统sIgE检测结果与SPT结果均有明显的一致性,以SPT为诊断参考标准,ImmunoCAP100系统具有较高的灵敏度,AllergyScreen系统具有较高的特异度.在临床应用中两种检测系统具有互补作用.

Objective To evaluate the correlation between two serum specific IgE and skin prick test （SPT） for the diagnosis of allergic rhinitis.Methods Two hundred and sixteen patients were referred to the allergist for a suspected allergic rhinitis between June and October in 2009. Patients were classified as positive for inhalant allergy if they had a positive clinical history and a related positive SPT for the suspected inhalant allergen. Statistical analysis was performed using SPSS13.0 software. Results One hundred and fifty-eight patients had a positive SPT, comparing with the SPT, the diagnostic indexes （accuracy,sensitivity, specificity） of the ImmunoCAP system and the AllergyScreen system were 0.810 and 0.819,0.872 and 0.780, 0.741 and 0.862 respectively. The accuracy was similar between the two systems （x2=0.112, P＞0.05）. The ImmunoCAP system had a higher sensitivity （x2=7.361, P＜0.05）. The AllergyScreen system had a higher specificity （x2=10.222,P＜0.05）. Conclusions This data supported the use of ImmunoCAP system and AllergyScreen system to identify potentially significant individual allergens in the diagnosis of allergic rhinitis. The ImmunoCAP system had a higher sensitivity. The AllergyScreen system had a higher specificity. The AllergyScreen system can be used as a complementary with the ImmunoCAP system.