Investigation of the cell composition and gene expression in the delayed-type hypersensitivity tuberculin skin test

Dear Editor,The tuberculin skin test(TST)reagents have continuously improved,with the ESAT6-CFP10(EC)test having recently been introduced,but are seldom based on the direction of the delayed-type hypersensitivity(DTH)mechanism.Previous studies only partially showed the infiltration and activation of immune cells and the production of cytokines of the skin induration[1,2],and lack the detailed measurements of cell proportions and gene expression in the DTH response.Therefore,in this study,we revealed the comprehensive characteristics of DTH by single-cell RNA sequencing(scRNA-seq)in the guinea pig tuberculosis(TB)model[Experimental Animal Welfare Ethics Committee,Beijing Tuberculosis and Thoracic Tumor Research Institute(2021-064)].

Evaluation of Interferon-Gamma Release Assay Testing and Tuberculin Skin Test for Early Diagnosis of Tuberculosis in Children and Adolescents

Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.

Performance and correlation of QuantiFERON-TB Gold, T-SPOT.TB and tuberculin skin test in young children with or exposed to tuberculosis

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in Bacillus Calmette-Guerin vaccinated young children.Methods:A cross-sectional study was conducted in healthy children younger than 5 years who were recently diagnosed with tuberculosis or had recent exposure to active tuberculosis.QuantiFERON-TB Gold,T-SPOT.TB and tuberculin skin test were performed in each patient.Results:Of the 60 children,median age 3.3 years,17 had tuberculosis and 43 had recent tuberculosis exposure.Overall,15(25.0%)children had tuberculin skin test reaction≥10 mm;8(13.3%)were positive by QuantiFERON-TB Gold In-Tube test,and 12(20.0%)by T-SPOT.TB.Nineteen(31.7%)children had at least one positive test.There was a moderate agreement between interferon gamma release assays and tuberculin skin test.Conclusions:The positive rates of interferon gamma release assays and tuberculin skin test were low in young children who were infected with tuberculosis,supporting the management strategy of not testing children younger than 5 years.

Performance and correlation of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.

Indications, Interpretation and Clinical Consequences of Tuberculin Skin Tests in Resource Limited Settings

Objective: to evaluate the policy of TST testing in Suriname. As there is no gold standard to diagnose latent tuberculosis infection (LTBI), the tuberculin skin test (TST) is used to diagnose LTBI. However, internationally, the cut-off values of the TST are not uniform and depend on local tuberculosis (TB) epidemiology and guidelines for test initiation. In Suriname, where currently several indications exist for TSTs, cut-off values are set at 5 mm or 10 mm, depending on the age and/or medical history of the patient. LTBI classification is performed by pulmonologists primarily based on the American Thoracic Society targeted TB testing guidelines. Method: retrospective analysis of outpatient TST data between 2011 and 2019 from Suriname’s sole pulmonary medicine clinic. Result: 1373 patients were evaluated. 590 patients were from the screening group of whom 253 had a positive TST result, 46 of whom were classified as LTBI. In the contact tracing group of 649 patients, 616 had a positive TST, 352 of whom were classified as LTBI. In the medical condition group of 134 patients, 96 had a positive TST, 38 of whom were classified as LTBI. Eventually, positive TST results were found for 965 tested patients: 436 patients were classified as LTBI and 529 non-LTBI patients were not prescribed chemoprophylaxis. None of the non-LTBI TST-positive patients were diagnosed with active TB, including 174 patients with a TST result of 15 mm or greater and in need of IPT, but not prescribed by judgement of the pulmonologist or because of loss to follow-up. Conclusion: the overrepresentation of positive TST results in Suriname is attributable to stringent cut-off values, especially among patients who do not disclose TB risk factors. In our opinion the TST cut-off value for such patients in Suriname and other similar settings could be set at 15 mm. We also promote that for all patients with a TST result of 15 mm or greater, offering IPT should be considered (after excluding active TB).

Comparison between Quanti-FERON-TB Gold In-Tube test and tuberculin skin test for diagnosis of latent tuberculosis in children: A cross-section study

Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.

Relationship between Serum Specific IgE and Allergen Skin Test in Allergic Patients of Wuhan Area

Summary: In order to study the relationship between serum specific IgE (sIgE) and allergen skin test, allergen skin tests and detections of sIgE in 220 allergic patients of Wuhan area were analyzed. The coherent rate of the two methods was beyond 70 % (P<0.01). It was concluded that the in vitro and in vivo detection methods of allergens have a high coherence and can be used as the effective ways to diagnose the allergic diseases in clinical practice.

Performance of Comparative Cervical Tuberculin Test and Serological Methods with Culturing of Nasal Swab in Diagnosis of Bovine Tuberculosis in Cross Breed Cattle Baghdad Iraq: A Comparative Evaluation

This study was designed to assess the diagnostic value of Rapid Antigen bovine TB antibody test kit (RAT) and any association with cervical comparative tuberculin test (CCTT), (iELISA) and nasal swabs culturing, among based detection of M. bovis infection. A herd of 21 animals aged 1 - 8 years cross bread cattle of college of veterinary medicine. 19 (90.47%) animals had good body condition scores, two bulls included, and 2 (9.52%) cows were fair. Serum samples were collected, analyzed for anti-bovine TB antibody using RAT and iELISA. Also the herd was screened by CCTT. The tests were carried out twice, more than ten month interval, and twelve nasal swabs were taken within second survey. The first survey results revealed prevalence rate: 4 (19.04%) animals considered positive results (one positive and 3 suspected results) for CCTT, while the prevalence rate according to RAT was 10 (47.61%). The difference between the two prevalence rate was significant (McNemar chi-statistic = 4.50, p-value = 0.03) Kappa = 0.215 95% confidence interval: from -0.128 to 0.558;the strength of agreement is considered to be “fair”. The study interprets: sensitivity 30%;specificity 99%. The second survey results revealed prevalence rate according to CCTT was 4 (36.36%), while prevalence rate according to RAT was 5 (45.45%). The difference between the two prevalence was not significant (McNemar chi-statistic = 0.33, p-value = 0.56). Kappa = 0.441 95% confidence interval: from -0.087 to 0.968;the strength of agreement is considered to be “moderate”;sensitivity: 60%;specificity: 83%. All serum samples and nasal swabs gave negative results for iELISA and culturing respectively. The study concluded that RAT was highly specific, easy, labor and time saving, suggesting its use as screening test in bovine tuberculosis, and CCTT could be used to confirm positive animals screened by RAT, while there was no association between RAT, CCTT with body condition scores, iELISA and nasal swabs culture results.

Analysis of the chemoprophylactic effect on close contacts of patients with active tuberculosis and positive tuberculin skin tests

Objective:The current study analyzed the chemoprophylactic effect of isoniazide on close contacts of patients with active tuberculosis and positive tuberculin skin tests(TSTs).Methods:A total of 1206 close contacts of patients with active tuberculosis and strongly-pos-itive TSTs were enrolled.The patients had chest X-ray examinations.Patients without tuberculosis and other diseases were divided into the following groups:90 patients in the prophylaxis group,who were given 300 mg of isoniazid qd(3-5 mg/kg for children)over a 10-month treatment course;and 89 patients in the control group without drug therapy.Both groups were followed for 10 years.Results:(1)There were 568 patients with negative results and 638 with positive results,includ-ing 445 with ordinarily-and moderately-positive results,and 193 with strongly-positive results(a positive rate of 52.9%[638/1206]and a strongly-positive rate of 16.0%[193/1206]).Fourteen tuber-culosis patients were identified(tuberculosis detection rate of 1.1%).(2)During the 3-year period of follow-up,there were 4 patients in the prophylaxis group and 12 patients in the control group who acquired tuberculosis(a morbidity rate of 4.7%[4/84]and 13.4%[12/89],respectively),and the dif-ference was statistically significant(χ^(2)=3.916,P=0.048).Six patients in the prophylaxis group,all of whom were children,discontinued medication use during the course of treatment due to adverse drug reactions,for an adverse drug reaction occurrence rate of 6.6%(6/90),a medication completion rate of 93.3%(84/90),and a 3-year protection ratio of 64.6%.(3)During the 4-6 year period,there were two patients in the prophylaxis group and three patients in the control group who acquired tubercu-losis(a morbidity rate of 2.5%[2/78]and 4.1%[3/73],respectively),two in the prophylaxis group and four in the control group who were lost to follow-up(a loss to follow-up rate of 2.5%[2/80]and 5.1%[4/77],respectively),and the difference was not statistically significant(χ^(2)=0.006,P=0.940;χ^(2)=0.215,P=0.643).(4)During the 7-10 year study,there was one patient in the prophylaxis group and two patients in the control group who acquired tuberculosis(a morbidity rate of 1.3%[1/72]and 3.1%[2/64],respectively),and four in the prophylaxis group and six in the control group who were lost to follow-up(a loss to follow-up rate of 5.2%[4/76]and 8.5%[6/70],respectively),and the dif-ference was not statistically different(χ^(2)=0.011,P=0.918;χ^(2)=0.176,P=0.675).(5)Within 10 years,there were 7 patients in the prophylaxis group and 17 patients in the control group who acquired tu-berculosis(a morbidity rate of 8.3%[7/84]and 21.5%[17/79],respectively;χ^(2)=4.770,P=0.029),and 6 in the prophylaxis group and 10 in the control group were lost to follow-up(the loss to follow-up rate was 7.1%[6/84]and 11.2%[10/89],respectively;χ^(2)=0.863,P=0.353).Conclusion:Close contacts of patients with active tuberculosis are at high-risk for acquir-ing tuberculosis.It is safe and effective for patients with strongly-positive TST results to undergo isoniazid chemoprophylaxis for 10 months.

Tuberculin Skin Reaction among Healthy People and Patients with Arthritis in the Southern Israeli Region

Introduction: Reactivation of latent tuberculosis is a major complication of tumor necrosis factor alpha (TNF-alpha) inhibitors. Therefore, screening for latent TB is recommended before initiation of this treatment. The aim of the study was to compare Tuberculosis skin test (TST) size reaction between healthy people and patients, with Rheumatoid arthritis (RA), Ankylosising spondylitis (AnS) and Psoriatic arthritis (PsA). Patients and Methods: Results of TST of 133 healthy subjects were compared with the results of TST of 79 patients, suffering from RA, AnS and PsA. A χ2 test was used to compare the difference between the groups. A value of p 0.05 was considered significant. Active tuberculosis (TB) was excluded by chest X-ray and through patient’s history. The results of TST reaction were grouped according to the CDC’s (Centers for Disease Control and prevention) recommendation, e.g. 0 - 4 mm, 5 - 9 mm, 10 - 15 mm and >15 mm. Results: Among RA patients 80% received Methotrexate (MTX), 50% Prednisone and 20% other DMARDs. 20% of patients suffering from AnS received MTX, 80%—NSAIDs, and among patients with PsA 70% received MTX, 30%—Salazopirin. There was no significant difference in history of bacilli Calmette-Guerine vaccination between the groups. There was no significant difference in TST reaction distribution between healthy subjects and patients with RA—p > 0.5. TST reaction distribution differed significantly between healthy people and AnS (p 0.05) and PsA (p 0.001) patients. The overall tendency in these two patients’ groups was towards high positive TST, especially among PsA patients. Conclusion: Our results showed that RA patients may present TST reaction as healthy people. The high percent of our AnS and PsA patients that showed TST reaction above15 mmneed further exploration. We conclude that it may be not appropriate to use TST to recognize LTBI in our population.

Inhibitory effect of Phlai capsules on skin test responses among allergic rhinitis patients:a randomized,three-way crossover study

BACKGROUND： Zingiber cassumunar Roxb., commonly known as Phlai in Thai, has been used as a traditional medicine in Thailand for the treatment of various diseases, including inflammation and chronic airway disease. OBJECTIVE： The purpose of this study was to assess the antihistaminic effect of Phlai on skin testing DESIGN, SETTING, PARTICIPANTS AND INTERVENTION： This was a randomized, open-label, three- way crossover study. Twenty allergic rhinitis （AR） patients were enrolled. In randomized sequence, patients received a single dose of Ph/ai capsules （100 or 200 mg） or Ioratadine （10 mg） with a washout period of 1 week between each treatment. MAIN OUTCOME MEASURES： Skin prick testing for histamine and common aeroallergen （house dust mite） were performed before treatment and after 1,2, 3, 4, 6, 8, 12 and 24 hours of treatment. The main treatment outcomes were the mean wheal and flare responses to the skin prick test after treatment. RESULTS： Both 100 mg and 200 mg Phlai doses suppressed wheal and flare responses to house dust mite allergen, but only 200 mg of Phlai capsules significantly suppressed wheal and flare responses to histamine. Repeated measures analysis of variance showed that Ioratadine caused more wheal and flare suppression than Phial capsules in responses to the histamine skin prick test. However, there were no significant differences among the effects of 100 mg Phlai capsules, 200 mg Phlai capsules and Ioratadine in suppression of wheal and flare induced by the mite skin prick test. Both doses of Phlai were well-tolerated with no adverse events.CONCLUSION： Both 100 mg （compound D 4 mg） when taken as a single therapeutic dose, inhibited AR patients. and 200 mg （compound D 8 mg） Phlai capsules, skin reactivity to histamine and mite skin prick tests in TRIAL REGISTRATION： Thai clinical trial registry （TCTR20160510001）

Food intolerance and skin prick test in treated and untreated irritable bowel syndrome

AIM： To correlate the clinical features of treated and untreated patients with irritable bowel syndrome （IBS） to the results of skin prick test （SPT） for food and inhalant allergens. METHODS： We recruited 105 subjects to form three different target groups： treated group （n=44） undergoing treatment for IBS, untreated group （n =31） meeting the Rome Ⅱ criteria without treatment for IBS, control group （n = 30） with no IBS symptoms. RESULTS： SPT results were different among the three groups in which SPT was positive in 17 （38.6%） treated patients, in 5 （16.1%） untreated patients and in 1 （3.3%） control （P〈0.01）. The number of positive SPTs was greater in the IBS group than in the control group （P〈 0.001）. The number of positive food SPTs was higher in the treated IBS group than in the untreated IBS group （P= 0.03）. CONCLUSION： Positive food SPT is higher in IBS patients than in controls.

Skin Sensitive Difference of Human Body Sections under Clothing— Smirnov Test of Skin Surface Temperatures' Dynamic Changing

Skin sensitive difference of human body sections under clothing is the theoretic foundation of thermal insulation clothing design. By a new method of researching on clothing comfort perception, the skin temperature live changing procedure of human body sections affected by the same cold stimulation is inspected. Furthermore with the Smirnov test the skin temperatures dynamic changing patterns of main human body sections are obtained.

Discrepancies between the responses to skin prick test to food and respiratory antigens in two subtypes of patients with irritable bowel syndrome

AIM:To compare the response to skin prick tests (SPTs) to food antigens (FAs) and inhalant allergens (IAs) in patients with two subtypes of irritable bowel syndrome (IBS) and healthy controls. METHODS:We compared the results of SPTs for IAs and FAs in 87 volunteers divided into three groups:diarrhea predominant IBS (D-IBS) GroupⅠ(n = 19), constipation predominant IBS (C-IBS) Group Ⅱ (n = 17), and normal controls Group Ⅲ (n = 51). RESULTS:Of the 285 tests (171 for FAs and 114 for IAs) performed in GroupⅠwe obtained 45 (26.3%) positive responses for FA and 23 (20.1%) for IA. Of the 153 tests for FA in Group Ⅱ, we obtained 66 (20.1%) positive responses, and of the 102 tests for IA, we obtained 20 (19.6%) positive responses. Of the 459 tests for FA performed in Group Ⅲ, we obtained 39 (84%) positive responses, and of the 306 for IA, we obtained 52 (16.9%) positive responses. The numbers of positive responses were not significantly different between the three groups, but in the D-IBS group, the number of SPTFA responses differed significantly from those for the other two groups (P < 0.01). CONCLUSION:Despite the small number of cases studied, the higher reactivity to FAs in GroupⅠcompared to Groups Ⅱ and Ⅲ adds new information, and suggests the presence of a possible alteration in intestinal epithelial function.

Comparison and Evaluation of Several Dermatophagoides Pteronyssinus Allergen Extracts for Skin Prick Test

Objective To evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test(SPT) in patients allergic to Dermatophagoides pteronyssinus.Methods Two hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen.Three kinds of house dust mite allergen extracts were used for SPT,including the Dermatophagoides pteronyssinus extract prepared by our laboratory(group A),standardized Dermatophagoides pteronyssinus extract(group B),and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae(group C).Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy.The receiver operating characteristic(ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.Results SPT results showed that the median wheal diameter of group A,group B,and group C was 0.43,0.35,and 0.28 cm,respectively,with significant difference among three groups(P<0.05).The difference was significant between group A and B(P<0.01) as well as group A and C(P<0.01),but not between group B and C(P>0.05).There was no local urticaria or systemic allergic reactions following the procedure of SPT.Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A.As for group B and C,local reaction occurred in 3 cases and delayed reaction in 2 cases in each group.The area under ROC curve of SPT with extract in group A,group B,and group C was 0.765,0.801,and 0.782,respectively.Based on the detection results of serum specific IgE,the sensitivity of SPT in diagnosis of Dermato-phagoides pteronyssinus allergy with extract of group A,group B,and group C was 92.4%,87.0%,and 81.5%,and the specificity was 60.6%,73.2%,and 74.8%,respectively.Conclusion The Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts,and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.

Anaphylaxis to Skin Prick Testing in a 29-Year-Old Woman

Introduction: Skin prick testing (SPT) is a common test to diagnose IgE sensitization and the rate of adverse reactions is very low. Case Presentation: 29-year-old woman with anaphylactic reaction to routine SPT with 11 allergens (aero and food). Discussion: Allergy profile included multiple food and inhalant allergies, polysensitization, prior episode of anaphylaxis to mushrooms, active eczema and active hay fever but not active asthma. Conclusion: Anaphylaxis to SPT, although a rare event, is unpredictable necessitating availability of appropriate personnel and adequate resuscitation facilities for all testing.

Ineffectiveness of Skin Tests in Predicting Allergic Reactions Induced by Chinese Herbal Injections

Objective:To evaluate whether skin tests are suitable to predict the allergy reactions induced by Chinese herbal injections(CHIs).Methods:The skin tests including skin prick tests(SPT),intradermal tests(IDT)and provocation tests including subcutaneous tests and intravenous tests were administered to 249 healthy subjects and 180 allergic patients for 3 CHIs,including ginkgolide injection,diterpene ginkgolide meglumine injection and Salvianolate lyophilized injection.The results of the provocation tests were used as the"gold standard"to determine the sensitivity and specificity of the skin tests.Results:The results did not show any significant differences between the healthy and allergy groups in both skin tests and provocation tests(P>0.05).The specificities of SPT and IDT were 0.976 and 0.797,respectively,and the sensitivities of both SPT and IDT were 0.Conclusion:Skin tests are insufficient to predict the likelihood of allergic reactions resulting from CHIs.(ChiCTR-CPC-15006921)

Preliminary Observation and Significance of Changes on Rash of Skin Prick Test during SLIT

Objective: To observe the changes on skin wheal and erythema of skin prick test for the patients with allergic rhinitis during SLIT. Methods: Since March 2010 the 103 cases of SLIT attacked by allergic rhinitis patients, divided into four age groups, respectively measured the diameter of skin wheal and erythema before treatment, six months, one year and 2 years after SLIT. The data were analyzed by analysis of variance method;P Results: The results showed that the most changes of skin erythema diameter were statistically significant in N1, N2, N3 age group during test observation compare with the data before SLIT (p Conclusion: Although most of the skin test wheal did not change significantly during the treatment of SLIT, the erythema reaction decreased to a certain extent, indicating that the intensity of histamine release may be reduced during the treatment.

Effectiveness of Virtual Reality for Pediatric Pain and Anxiety Management during Skin Prick Testing

This study investigated the effectiveness of virtual reality (VR) distraction, compared to comic book distraction and no distraction, in reducing pain and anxiety during a medical procedure in a pediatric population: the skin prick test. Although this test has many advantages and is considered to be minimally invasive, it causes anxiety and painful discomfort in children. Ninety-two children aged 7 to 17 years consulting for an allergic test received VR distraction, comic book distraction, or no distraction. Outcome measures included pain score, level of anxiety, and VR measures. The results showed that there were no significant differences between the three groups regarding sex, age, and preprocedural anxiety level. In the distraction groups (VR and comic book), children reported significantly lower pain and procedural anxiety scores than children with no distraction;VR distraction had a more significant effect than comic book distraction. A decrease in anxiety before and during the skin prick test is significantly more significant in VR distraction. This study suggested the effectiveness and feasibility of VR to reduce pain and anxiety during the pediatric skin prick test.

Multi-Test Ⅱ点刺器在儿童过敏原皮肤点刺试验中的应用评价

目的初步评价Multi-TestⅡ点刺器在儿童过敏原皮肤点刺试验(SPT)中的适用性。方法选取2017年3～9月就诊的87例过敏性疾病患儿为研究对象,均进行6种吸入性过敏原的SPT和血清特异性IgE(sIgE)测定。分别应用单点刺针及Multi-TestⅡ点刺器于患儿左、右前臂进行SPT的测定,应用荧光酶联免疫法进行血清s IgE浓度的测定。用视觉模拟评分(VAS)标尺评估患儿接受SPT的疼痛程度。比较3种方法 6种过敏原的阳性检出率分布差异及Multi-TestⅡ点刺器的灵敏度和特异度。结果 Multi-TestⅡ法、单点刺针法、荧光酶联免疫法3种方法检出6种过敏原的阳性率比较差异无统计学意义(P>0.05)。与单点刺针法比较,Multi-TestⅡ法灵敏度为72.7%,特异度为78.2%;与荧光酶联免疫法比较,Multi-TestⅡ法灵敏度为73.4%、特异度为77.5%。Multi-TestⅡ法较单点刺针法疼痛程度低,差异有统计学意义(P<0.05)。结论 Multi-TestⅡ法灵敏度及特异度较高且易被患儿接受,但测定结果需同时与患儿的临床病史相结合,必要时结合血清特异性IgE测定结果。