采用ImmunoCAP法和EUROLine法检测血清IgE的对比分析

Comparative analysis of serum IgE detected by ImmunoCAP and EUROLine assays

目的过敏性疾病的诊断主要通过过敏原体内皮肤试验或体外特异性IgE测试。文中以ImmunoCAP法为标准方法,旨在探讨EUROLine法的检验效能及在中国南部的应用价值。方法收集2015～2017年就诊于广州医科大学附属第一医院的多过敏原致敏患者血清样本283份,采用EUROLine法检测系统检测血清样本中蟑螂、犬毛、猫毛、艾蒿、矮豚草、尘螨组合、鸡蛋白、牛奶、花生、黄豆、蟹、虾过敏原s IgE。对EUROLine法的检验效能、可靠性和级别一致率进行评价。结果在检验效能上,EUROLine法检测鸡蛋白过敏原的灵敏度最高,为89.7%,其次是牛奶过敏原(86.3%);鸡蛋白和牛奶过敏原的特异度分别为79.6%和80.4%。吸入性过敏原猫毛的灵敏度最高,达81.3%,特异度为92.3%,其次是尘螨组合过敏原,灵敏度为80.2%,特异度81.4%。等级资料的Spearman相关性分析结果显示,对于屋尘螨、猫毛、艾蒿、鸡蛋白、牛奶、花生及蟹过敏原,ImmunoCAP法与EUROLine法检测结果等级相关性均>0.7,其中鸡蛋白相关性最佳,为0.825(95%CI:0.776-0.865),蟹的相关性最差,为0.366(95%CI:0.251-0.471)。本研究中12项过敏原中鸡蛋白的级别一致率最高(93.17%),其次为牛奶(89.86%),而虾的级别一致率最差(70.83%);总级别一致率为82.68%。结论 EUROLine法具有较高的诊断效能,可适用于广大南方地区患者过敏原检测。

Objective The diagnosis of allergic diseases mainly relies on the allergen skin test or in vitro specific IgE test.This study was to explore the diagnostic efficiency of EUROLine and its application in southern China by reference to the standard method of the immunoenzymatic capsulated hydrophilic carrier polymer(ImmunoCAP). Methods Using the EUROLine system,we examined 12 common specific IgEs(sIgE)from 283 patients with multiple sensitizations in the First Affiliated Hospital of Guangzhou Medical University,including cockroach(i6),dog dander(e2),cat dander(e1),Mugwort(w6),ragweed(w1),dust mites(ds1),chicken protein(f1),milk(f2),crab(f23),shrimp(f24),peanut(f13)and soybean(f14). Results EUROLine showed that house dust mite allergens were the main aeroallergens in southern China,with a positive rate of 66.3%,while egg white had the highest positive rate(53.2%)in food allergens.The overall rate of the allergens detected by EUROLine was consistent to that of ImmunoCAP by 60.8%-90.1%,the positive rate by 63.3%-93.6%,and the negative rate by 54.5%-95.2%.The Kappa value of EUROLine was 0.203-0.702 in detecting each allergen and>0.6 with cat hair,egg white,peanut,milk and mugwort.The rank correlation coefficient between ImmunoCAP and EUROLine was>0.7 for dust mite combination,cat hair,mugwort,egg white,milk,peanut and crab allergens,with the highest consistency rate for egg white(93.17%[191/205]),the lowest for shrimp(70.83%[170/240]),and an overall consistency rate of 82.68%(1542/1865). Conclusion The EUROLine system has a high diagnostic performance,and it is inexpensive,efficient and applicable in the detection of allergens in southern China.