过敏性疾病患者变应原皮肤点刺试验与血清特异性IgE检测的临床应用

Clinical Value of Combined Use of Serum Specific IgE Detection and Skin Prick Test in Allergic Diseases

目的探讨过敏性疾病(过敏性鼻炎、过敏性结膜炎等)患者变应原皮肤点刺试验(SPT)结果与血清特异性IgE(血清sIgE)检测值之间的相关性及两种方法结合使用的临床应用价值。方法选取239例过敏性疾病(过敏性鼻炎、过敏性结膜炎等)患者的SPT与sIgE(Unicap系统检测)检测结果,分析其阳性率,两种检测结果的相关性及SPT的特异性和阳性预测值。结果屋尘螨SPT阳性率、血清sIgE检测阳性率分别为76.15%、65.69%,总阳性率80.75%,一致性80.33%,SPT阳性率高于血清sIgE(χ^2=69.50,P<0.05)。粉尘螨SPT、血清sIgE检测阳性率分别为80.75%、66.52%,总阳性率84.94%,一致性为76.99%,SPT阳性率高于血清sIgE(χ^2=50.50,P<0.05)。屋尘螨SPT反应强度与sIgE等级呈正相关(r=0.764,P<0.05);粉尘螨SPT反应强度与sIgE等级呈正相关(r=0.789,P<0.05);屋尘螨检测中以“2级及以上”为SPT诊断标准时,其特异性和阳性预测值(90.91%、94.12%)均高于以“1级及以上”为SPT诊断标准时的特异性和阳性预测值(56.10%、80.22%);粉螨检测中以“2级及以上”为SPT诊断标准时特异性(80.25%)高于以“1级及以上”为SPT诊断标准时的特异性(78.26%)。结论过敏性疾病(过敏性鼻炎、过敏性结膜炎等)患者变应原SPT检测敏感性高于血清sIgE,两者同时检测可以提高检出率;两种检测结果具有较高的相关性。

Objective To evaluate the correlation of serum specific IgE detection and clinical value of combined use in allergic diseases.Method The SPT and sIgE(using the Unicap system test)test results for 239 patients with allergic diseases(allergic rhinitis,allergic conjunctivitis,etc.)were selected and the correlation between the two test results and SPT specificity and positive predictive value were analyzed.Results The house dust mite SPT positive rate and serum sIgE test positive rate were 76.15%and 65.69%,respectively.The total positive rate was 80.75%and the consistency was 80.33%.The SPT positive rate was higher than that of serum sIgE(χ^2=69.50,P<0.05).The positive rates of acaroid mites SPT and serum sIgE detection were 80.75%and 66.52%,the total positive rate was 84.94%,and the consistency was 76.99%.The positive rate of SPT was higher than that of serum sIgE(χ^2=50.50,P<0.05).The house dust mite SPT response intensity was positively correlated with sIgE grade(r=0.764,P<0.05);the acaroid mites SPT response intensity was positively correlated with sIgE grade(r=0.789,P<0.05).The specificity and positive predictive value(90.91%,94.12%)of the house dust mite test when using“++and above”as the SPT diagnostic criteria were higher than those when using“+and above”as the SPT diagnostic criteria(56.10%,80.22%).In the detection of acaroid mites,the specificity(80.25%)with“++and above”as the SPT diagnostic standard was higher than that with“+and above”as the SPT diagnostic standard(78.26%).Conclusions The SPT was more sensitive than serum specific IgE detection in patients with allergic diseases allergen and the combined detection could improve the detection rate.Two methods had a good correlation.It was suggest that combined detection of SPT and serum specific IgE should be used in allergic diseases.