特应性皮炎常见食物过敏原特应性斑贴试验研究

Study on atopy patch test of common food allergens in atopic dermatitis patients

目的了解常见食物过敏原特应性斑贴试验(atopy patch test,APT)结果与特应性皮炎发病及临床表型的关系。方法对79例特应性皮炎患者进行常见食物过敏原斑贴试验,并与皮肤点刺试验和特异性IgE(sIgE)检测结果以及临床表型相关性进行分析。结果 5种食物过敏原中,牛奶APT阳性率最高(24.3%),小麦阳性率最低(16.0%),各种食物APT阳性率均高于相应的皮肤点刺试验(SPT)及sIgE阳性率。各种食物过敏原APT、SPT和sIgE 3种诊断试验结果一致性比较差(Kappa值均<0.75)。儿童(≤14岁)患者各种食物过敏原APT阳性率均高于青少年成人(>14岁),但是仅有牛奶(P<0.01)和大豆(P<0.05)APT阳性率的差异有统计学意义。鸡蛋白、牛奶和大豆APT阳性率与特应性皮炎病情严重度评分呈一致的升高趋势,但是只有鸡蛋白阳性率升高趋势有统计学意义(P<0.05),小麦和海虾APT阳性率与病情严重度评分无相关性。结论在特应性皮炎患者特别是儿童患者中,食物过敏原特应性斑贴试验可作为辅助诊断食物过敏的方法之一。

Objective To investigate the relationship between the results of atopy patch test（APT） of common food allergens and clinical phenotype of atopic dermatitis. Methods Food allergen patch tests were performed in 79 atopic dermatitis patients and the results were compared with the results of skin prick test（SPT） and specific IgE（sIgE） test. Results Among the five food allergens of APT, cow milk showed the highest positive rate（24.3%）, while wheat showed the lowest（16.0%）. The positive rate of five food allergens of APT was higher than that of SPT and sIgE test. The agreement of results of five food allergens showed by APT, SPT and sIgE test was poor（Kappa values〈0.75）. The APT positive rate of five food allergens in children was higher than that of adolescents and adults, but the difference was statistically significant only in cow milk（P〈0.01） and soybean（P〈0.05）. The positive APT result to hen egg was significantly associated with SCORAD scores in AD patients. Conclusion In patients with atopic dermatitis, especially in children, food allergen atopy patch test is helpful in the diagnosis of common food allergy.