特应性皮炎常见食物过敏原的特应性斑贴试验结果分析

发布时间：2019-05-09 11:27

【摘要】：目的评价特应性斑贴试验(APT)在特应性皮炎(AD)患者食物过敏原诊断中的价值,探讨不同蛋白浓度过敏原对APT的影响。方法选择2010年1月-2012年12月本科门诊的102例特应性皮炎患者进行5种常见的食入性过敏原(鸡蛋清、牛奶、黄豆、海虾、小麦)的特应性斑贴试验,同时进行这5种过敏原的血清特异性IgE测定及皮肤点刺试验(SPT),以sIgE作为金标准,比较APT与SPT敏感度、特异度及阳性预测值;并比较3组不同浓度过敏原(1∶5,1∶10,1∶20)APT的结果。结果 APT/SPT检测鸡蛋清、牛奶、黄豆、海虾和小麦的敏感度分别为62.50%/89.58%,71.11%/93.33%,68.42%/84.21%,69.39%/87.76%和85.71%/90.48%;特异度分别为90.74%/96.30%,92.98%/92.98%,95.31%/95.31%,90.57%/92.45%和92.59%/96.30%;阳性预测值分别为85.71%/86.36%,88.87%/90.30%,89.66%/91.43%,87.18%/91.49%和75.00%/86.36%。另外,其3种不同浓度的阳性率分别为42.16%/34.31%/25.49%,44.12%/35.29%/26.47%,36.27%/28.43%/18.63%,46.08%/38.24%/28.43%和28.43%/23.53%/12.75%,各浓度组间APT阳性率差异均有统计学意义(P均0.05)。结论 APT诊断食物过敏原的特异度及阳性预测值较高,增加过敏原蛋白浓度可提高APT阳性率,反之会降低APT阳性率。
[Abstract]:Objective to evaluate the value of atopic patch test (APT) in the diagnosis of food allergens in patients with atopic dermatitis (AD) and to explore the effect of allergens of different protein concentrations on APT. Methods from January 2010 to December 2012, 102 patients with atopic dermatitis were selected and tested for 5 common allergens (egg white, milk, soybean, prawn, wheat). At the same time, the sensitivity, specificity and positive predictive value of APT and SPT were compared by serum-specific IgE assay and skin prick test (SPT),). SIgE was used as gold standard to compare the sensitivity, specificity and positive predictive value between APT and SPT. The results of three groups with different concentrations of allergens (1? 5, 1? 10, 1? 20) APT were compared. Results the sensitivity of APT/SPT for egg white, milk, soybean, prawn and wheat were 62.50%, 89.58%, 71.11%, 93.33%, 68.42%, 84.21%, respectively. 69.39% / 87.76% and 85.71% / 90.48%; The specificity was 90.74% / 96.30%, 92.98% / 92.98%, 95.31% / 95.31%, 90.57% / 92.45% and 92.59% / 96.30%, respectively. The positive predictive values were 85.71% / 86.36%, 88.87% / 90.30%, 89.66% / 91.43%, 87.18% / 91.49% and 75.0% / 86.36%, respectively. In addition, the positive rates of the three concentrations were 42.16%, 34.31%, 25.49%, 44.12%, 35.29%, 26.47%, 36.27%, 28.43%, 18.63%, respectively. 46.08%, 38.24%, 28.43% and 28.43%, 23.53%, 12.75%, respectively. There was significant difference in the positive rate of APT among different concentration groups (P0.05). Conclusion the specificity and positive predictive value of APT in the diagnosis of food allergens are high. Increasing the concentration of allergen protein can increase the positive rate of APT, and conversely, it will decrease the positive rate of APT.
【作者单位】：辽宁医学院附属第一医院病理科;辽宁医学院附属第一医院皮肤科;
【基金】：辽宁省医学高峰建设工程重点科研项目之过敏性疾病专科建设项目(200930)
【分类号】：R758.2

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