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。
Objective To evaluate the diagnostic value of atopy patch test （APT） for food allergen in atopic dermatitis patients, then to explore the influence of different allergen protein concentration of APT. Methods One hundred and two AD subjects selected from our outpatient service from January 2010 to December 2012 were enrolled in the study of atopy patch test regarding five food allergens （ egg, milk, soybean, prawn and wheat）. All subjects were also tested with specific serum IgE and skin-prick test （SPT） with the same five food allergens. Taking sIgE as the gold standard, the sensitivity, specificity and positive predictive value be- tween APT and SPT was compared ; Besides, the results of APT under different protein concentrations （ 1 ： 5, 1： 10,1：20）were also compared. Results The sensitivity of APT/SPT in diagnosis of egg, milk, soybean, prawn and wheat allergies were 62. 50%/89. 58%, 71.11%/93.33%, 68.42%/84. 21%, 69. 39%/ 87.76% and 85.71%/90.48%, respectively; The specificity were 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 value were 85.71%/86. 36% ,88. 87%/90. 30% ,89. 66%/91.43% ,87.18%/91.49% and 75.00%/86. 36%, respectively. In addition, the positive rates of its three different concentrations were 42. 16%/34. 31%/ 25.49%, 44. 12%/35.29%/26.47%, 36. 27%/28.43%/18.63%, 46. 08%/38.24%/28.43% and 28.43%/23.53%/12. 75%, respectively. The positive expression rates of APT have significant difference among different allergen protein concentration（ P 〈 0.05 ）. Conclusion The specificity and positive predic- tive value of APT in the diagnosis of food allergen is relatively high, and increasing concentration of the aller- gen protein can induce more positive results, whereas less concentration will lead to lower positive result rate.
出处
《中国皮肤性病学杂志》
CAS
北大核心
2014年第5期485-487,495,共4页
The Chinese Journal of Dermatovenereology
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)
