两种常用过敏原筛查方案结果对比分析

A Comparative Analysis of the Results of Two Methods for Screening Allergen

目的对比分析Allergy Screen(敏筛)过敏原特异性IgE抗体和总IgE抗体检测方案与EUROLINE Atopy(欧蒙)过敏原特异性IgE抗体联合Immuno CAP总IgE抗体检测方案结果的一致性,为临床过敏性疾病筛查提供更可靠的试验依据。方法选取136例过敏性疾病患儿血清标本,年龄在3~15岁。应用德国Allergy Screen(敏筛)过敏原sIgE和tIgE抗体检测系统,德国EUROLINE Atopy(欧蒙)过敏原sIgE抗体联合美国Immuno CAP(赛默飞Phadia 250)tIgE抗体检测系统,同时检测患儿血清过敏原sIgE和tIgE,采用SPSS 22.0对结果进行统计分析。结果两种检测方案过敏原豚草、尘螨的sIgE两项结果一致性强,Kappa值分别为1.000、0.813。艾蒿、屋尘、蟑螂、霉菌组合、牛奶、鸡蛋、海鱼组合、虾、蟹九项结果一致性较强,Kappa值分别为0.663、0.796、0.663、0.663、0.681、0.603、0.663、0.657、0.758。猫毛和牛肉两项结果一致性中等,Kappa值分别为0.421、0.553。而狗毛一致性较差,Kappa值为0.142。两种检测方案过敏原tIgE一致性一般,Kappa值为0.362。两种检测方案过敏原sIgE的等级资料Spearman相关性分析显示,艾蒿、豚草、尘螨、屋尘、牛奶、鸡蛋、海鱼组合、虾、蟹的等级相关性非常紧密,Spearman值分别为0.743、0.945、0.864、0.746、0.745、0.703、0.703、0.757、0.858。蟑螂、霉菌组合、牛肉的等级相关性比较紧密,Spearman值分别为0.683、0.649、0.653。猫毛和狗毛的等级相关性一般,Spearman值为0.321、0.242。结论两种检测方案对大部分过敏原sIgE不仅具有较强一致性,还具有非常紧密的等级相关性,但是两种检测方案过敏原总IgE一致性一般,因此,我们更推荐欧蒙过敏原sIgE检测联合Immuno CAP过敏原tIgE检测作为常规过敏性疾病筛查的首选方案。

Objective To compare the Allergy Screen specific immunoglobulin E(sIgE)and total immunoglobulin E(tIgE)detection method with the EUROLINE Atopy sIgE combined with the Immuno CAP tIgE detection method,so to provide an experimental basis for clinical diagnosis and treatment.Methods A total of 136 children serum samples with allergic disease were enrolled for the current study,aged from 3 to 15 years old.Allergy Screen allergen sIgE and tIgE antibody detection system,and EUROLINE Atopy allergen sIgE antibody combined with Immuno CAP tIgE antibody detection system were applied to detect serum allergens sIgE and tIgE at the same time.SPSS22.0 software was used as the statistical package.Results The two schemes for the detection of allergens sIgE ragweed and dust mites were highly consistent,and the Kappa value were 1.000 and 0.813,respectively.The consistency of Artemisia,house dust,cockroach,mold,milk,egg,marine fish,shrimp and crab were strong,and the Kappa values were 0.663,0.796,0.663,0.663,0.681,0.603,0.663,0.657 and 0.758,respectively.The consistency of cat hair and beef were moderate,and the Kappa values were 0.421 and 0.553,respectively.However,the consistency of dog hair was poor,and the Kappa value was 0.142.The consistency of allergen tIgE between the two detection schemes was suboptimal,and the Kappa value was 0.362.The Spearman correlation analysis of allergen sIgE grade data of the two detection schemes showed that there was a very strong correlations among Artemisia argyi,ragweed,dust mite,house dust,milk,egg,marine fish combination,shrimp and crab,with Spearman values of 0.743,0.945,0.864,0.746,0.745,0.703,0.703,0.757 and 0.858,respectively.Cockroach,mold combination and beef were closely related,and the Spearman values were 0.683,0.649 and 0.653,respectively.The correlation between cat hair and dog hair were suboptimal and the Spearman values were 0.321 and 0.242,respectively.Conclusion Most of the allergen sIgE of the two detection schemes not only have a strong consistency,but also have a very close rank correlation,while the tIgE of allergens detected by Allergy Screen is generally consistent with the ImmunoCAP.Therefore,we recommend EUROLINE Atopy allergen sIgE combined with ImmunoCAP allergen tIgE as the first choice for allergen screening among routine patients.