Phadiatop检测对哮喘吸入性过敏原筛查的应用价值

Value of Phadiatop test in screening of aeroallergens among asthmatics

目的探讨Phadiatop检测对安徽地区哮喘患者常见吸入性过敏原sIgE的诊断效率。方法采用ImmunoCAP过敏原检测系统对130例哮喘患者和60例非哮喘患者先行混合吸入性过敏原sIgE(包括屋尘混合hx2、霉菌混合mx2、杂草类花粉混合wx5和动物皮毛屑混合ex1)检测,再行Phadiatop检测,比较检测结果的差异,评价Phadiatop的诊断价值。结果130例哮喘患者中,混合吸入性过敏原sIgE阳性率为41.5%,Phadiatop阳性率为43.8%,诊断的符合率为92.2%,阳性预测值、阴性预测值为分别为88.1%、97.2%。Phadiatop检测对hx2(97.9%)、wx5(100%)、ex1(100%)这三种过敏原混合物的敏感性较高,而对mx2(69.2%)的敏感性偏低。Phadiatop浓度与混合吸入性过敏原sIgE浓度显著相关(r=0.902,P<0.001),与单个sIgE浓度亦呈正相关,其中hx2 sIgE相关性最高(r=0.908,P<0.001)。ROC曲线显示Phadiatop以0.465kUA/L作为cut-off值,可优化Phadiatop检测对吸入性过敏原的诊断效率,对应的灵敏度为92.6%、特异度为90.8%。结论Phadiatop检测与吸入性过敏原sIgE检测诊断一致性高,且能节省医疗资源,应作为哮喘患者吸入性过敏原的一线筛查推广应用。

Objective To evaluate the diagnostic value of Phadiatop test for inhaled aeroallergens SIgE of asthma patients in Anhui area.Methods Phadiatop test was performed for serum samples from 130 asthmatics and 60 non-asthmatics previously tested with ImmunoCAP for house dust mix(hx2),molds and yeasts mix(mx2),weed mix(wx5)and animal dander mix(ex1).Results Aeroallergen mix positivity was shown in 41.5%of 130 asthmatic patients,Phadiatop positivity was 43.8%,and the concordance rate was 92.2%.The positive predictive value was 88.1%,and the negative predictive value was 97.2%.The sensitivity of Phadiatop test was high for hx2(97.9%),wx5(100%)and ex1(100%),but low for mx2(69.2%).The Phadiatop sIgE level was correlated with the ImmunoCAP sIgE levels for all aeroallergens mixes combined(r=0.941,P<0.001),and it was also correlated with each allergen mix,particularly the hx2(r=0.924,P<0.001).ROC curves showed 0.465 kUA/L as a cut-off value would optimize the diagnostic performance of Phadiatop testing,showing 92.4%of sensitivity and 90.8%of specificity.Conclusion Compared with the aeroallergens mixes,Phadiatop test has higher diagnostic accuracy and better consistency,and it can save medical resource,which should be used as the first-line in screening of aeroallergens among asthmatics.