两种方法配制破伤风抗毒素皮试液的皮试结果对比

Comparative study of different ways to make tetanus antitoxin test liquid lead to different results judgments of skin test

目的采用两种破伤风抗毒素皮试液的配置方法进行皮试,并探讨4组两对患者皮试液浓度与结果的关系。方法从947例门诊需要破伤风抗毒素(TAT)皮试的患者排除皮肤对75%酒精过敏患者、12 h内有饮酒的患者和48 h内曾使用H1受体阻断药患者共164例。把剩下783例作为研究对象,把其TAT皮肤过敏试验的结果分为4组:把主诉在外院皮试阳性后被转介我院进行脱敏的116例患者的外院皮试结果设为第1组;第2组采用实验方法配制TAT皮试液对第1组116例进行再次皮试,并将第1组与第2组的皮试结果进行来自同一个体对比。余下667例患者按月份奇偶数日分为第3组和第4组:把奇数日的患者设为第3组,按教科书方法配制皮试液进行皮试;把偶数日的患者设为第4组,采用实验方法配制皮试液进行皮试。实验方法是去除注射器和针头的死腔容量和破伤风抗毒素原液<1 mL/支两个干扰因素对配制皮试液的影响后较精确地配制试液进行皮试。结果第2组使用实验法配制破伤风抗毒素皮试液皮试阳性率为61.21%,明显低于同一个体在外院的皮试阳性率100%:第4组使用实验法配制破伤风抗毒素皮试液皮试阳性率为17.30%,明显低于教科书方法配制破伤风抗毒素皮试液皮试阳性率为27.22%,差异有统计学意义(P<0.05)。结论实验显示较精确的破伤风抗毒素皮试液浓度可能明显降低皮试结果的假阳性率。

Objective To evaluate the impact of different concentrations of tetanus antitoxin（TAT） skin test liquid made by different ways on skin test outcomes.Methods A total of 947 outpatients who needed TAT tests were enrolled.One hundred and sixty-four patients were excluded based on the following criteria： who were allergic to alcohol;who had alcohol intake histories during the past 12 hours and who had any H1 receptor antagonists administration histories during the past 24 hours.The remaining 783 subjects were included and classified into four studying groups.Group 1 included 116 patients who were transferred from other hospitals to our hospital for desensitization therapy due to positive TAT test results in the previous hospitals.Group2： The same patients in group 1,but TAT skin test results were obtained from tests in our hospital using the TAT skin test liquid made by the experimental method.The remaining 667 patients were divided into group 3 and group 4 randomly.Textbook instructions for performing TAT skin tests were followed for patients in group 3 while experimental method was used for patients in group 2 and group 4.Results The frequency of the positive results in four groups were 100%,61.21%,27.22% and 17.30% respectively.Significant differences（P 0.05） were found between group 1 and group 2 as well as between group 3 and group 4.No allergy symptoms in negative cases in group 2,group 3 and group 4 were reported.Conclusion False-positive results can be reduced by using the precise concentration of TAT skin test liquid made by the experimental method.