尘螨变应原SPT与血清sIgE诊断螨过敏症的相关性

Association between skin prick test of dust mites and serum specific IgE in diagnosis of mite allergy

目的分析研究屋尘螨和粉尘螨变应原SPT与血清sIgE水平在诊断IgE介导的螨过敏症中的相关性。方法按患者就诊顺序选取北京同仁医院、沈阳军区总医院和广州呼吸疾病研究所变态反应科门诊的屋尘螨与粉尘螨血清sIgE为阳性的变应性疾病患者166例，以屋尘螨和粉尘螨变应原皮肤点刺液进行SPT。同时，按照1：1比例配对选取sIgE为阴性的健康人190名为对照组。比较评价屋尘螨、粉尘螨皮肤点刺液SPT诊断螨过敏症的敏感度和特异度，并用直线相关法分析SPT与sIgE结果间的相关性。结果变应性疾病患者组中，屋尘螨、粉尘螨SPT检测阳性率分别为98．80％（164／166）和95．18％（158／166），健康对照组中，屋尘螨、粉尘螨SPT检测阳性率分别为2．11％（4／190）和1．58％（3／190），变应性疾病组与健康对照组的屋尘螨、粉尘螨SPT之间的差异有统计学意义（X2=285．5、386．3，P均〈0．01）。屋尘螨SPT的敏感度为98．80％（164／166）、特异度为97．89％（186／190）；粉尘螨SPT的敏感度为95．18％（158／166）、特异度为98．42％（187／190）。屋尘螨与粉尘螨SPT皮肤风团直径与血清sIgE的水平呈显著正相关（r分别为0．737、0．708，P均〈0．01）。结论屋尘螨与粉尘螨变应原SPT具有高敏感度和特异度，并与血清sIgE水平呈显著正相关，是一种诊断相关性好、操作简便、结果获取迅速的临床检测方法。

Objective To investigate the association between the results of Dermatophagoides pteronyssinus （Der p） and Dermatophagoides farinae （Der f） allergen SPT and serum sIgE in diagnosis of IgE-mediated mite allergy. Methods A total of 166 allergic outpatients with positive expression of serum sIgE of Der p and Der f diagnosed in Beijing Tongren Hospital, the General Hospital of Shenyang Military Region and Guangzhou Institute of Respiratory Disease were enrolled in the study. The SPT was performed by injecting liquid containing the allergen of Der p and Der f. One hundred ninety healthy subjects with negative serum sIgE of Der p and Der f were assigned as controls according to paired design ratio, 1 to 1. The sensitivity and specificity of SPT used Der p and Der f allergen were evaluated in the diagnosis of mite allergy. The association between the results of SPT and serum sIgE was analyzed by linear regression method. Results In the allergic group, the positive rates of SFF for Der p and Der f were 98.80% （ 164/ 166） and 95.18% （158/166） respectively. In the control group, the positive rate of STP for Der p and Der f were 2. 11% （4/190） and 1.58% （3/190） respectively. The SPT results of Der p and Der f showed significant statistical difference between healthy subjects and allergic patients （X2 = 285.5, 386. 3; P 〈0. 01 ）. The sensitivity and specificity of the SPT were 98.80% （164/166） and 97.89% （186/190） for Der p and 95.18% （158/166） and 98.42% （187/190） for Der f, respectively. There was a significant association between SPT and sIgE with linear correlation analysis （ r = 0. 737,0. 708 ; P 〈 0. 01 ）. Conclusions Both SPT of Der p and Der f is highly sensitive and specific. At the same time, SPT has a significant positive correlation with sIgE. It can be used as an accurate, convenient and fast test in diagnosis of mite allergic diseases.