特应性皮炎患者特应性斑贴试验与点刺试验的比较

Comparison of atopy patch test and skin prick test in patients with atopic dermatitis

目的:探讨特应性皮炎(AD)患者食物特应性斑贴试验与临床指标的相关性及其反应特点。方法:以7种常见食物过敏原为抗原,分别使用新鲜食物和过敏原提取液对60例AD患者同时进行食物特应性斑贴试验(APT)和皮肤点刺试验(SPT),对比两种皮肤试验的反应结果,并根据患者是否并发过敏性鼻炎或哮喘、年龄、背部皮肤干燥度分组对比分析APT反应与以上因素的相关性。结果:1食物APT的阳性率均高于SPT;2分析APT阳性率高于20%的食物,即海虾、大豆、牛肉,<12岁年龄组APT阳性率均高于≥12岁年龄组,但仅海虾APT组间差异有统计学意义(P<0.05)。并发或不并发过敏性鼻炎组,背部皮肤干燥与非干燥组相比,3种食物APT阳性率组间差异无统计学意义(P>0.05);3去除斑试器后24 h与0.5 h判读结果相比,食物APT的阳性反应均无逐渐增强趋势。结论:AD患者食物APT阳性反应率高于SPT;食物APT可能受年龄的影响,与患者是否并发过敏性鼻炎及皮肤干燥程度等因素无关;不应以反应渐强趋势作为APT的阳性判读标准。

Objective： To evaluate the diagnostic value of atopy patch test（APT） of food allergens in atopic dermatitis（AD） patients, explore the correlation between the different clinical indicators and APT, and the characteristic response of APT. Methods： Sixty outpatients with AD were enrolled for the study of APT with seven common food allergens, and all the pa- tients were simultaneously tested with skin-prick test （SPT） with the same seven allergens extracts. The results of two skin tests were compared, and the correlation between APT and several factors（complications, age, and the back skin dryness） was analyzed. Results： 1. Positive rates of food APT were higher than those of SPT; 2. The positive rates of 3 food allergens （prawn, soy bean, and beef） higher than 20% were analyzed, the positive rates of the patients under 12 years old were higher than those over the age of 12, but only the result of the prawn APT the difference was significant （P〈0.05）; there were no statistically significant differences in the groups of the patients with or without allergic rhinitis and skin dryness（〉 0.05）. 3. After removing the allergens from the patients for 0.5 h to 24 h, there was no tendency of gradual increase of the positive reaction of ApT（＂crescendo＂ phenomenon）. Conclusion： The positive rate of food APT were higher than that of SPT; food APT results might be correlated with the age of patients, not correlated with patient＇s skin dryness and complications such as allergic rhinitis; and the ＂crescendo＂ phenomenon should not be used as a positive standard for APT.