婴幼儿变应原筛查试验与混合变应原试验的相关性  

Correlation between the Results of Phadiatop Infant and Mixed Allergens Test

作　　者：王和平[1] 郑跃杰[1] 刘萍[1] 王莉[1] 汤正珍[1] 

机构地区：[1]深圳市儿童医院呼吸科,广东深圳518026

出　　处：《中华临床免疫和变态反应杂志》2010年第3期196-200,共5页Chinese Journal of Allergy & Clinical Immunology

基　　金：深圳市医学重点学科(2005C03)项目

摘　　要：目的为了评估婴幼儿变应原筛查试验（Phadiatop Infant）的诊断价值,对6岁以下疑是变态反应性疾病儿童同时进行Phadiatop Infant及混合变应原fx5、hx2、ex1和mx2检测。方法临床疑诊为湿疹、哮喘和过敏性鼻炎等可疑变态反应性疾病的0.5-6岁患儿216例,使用法玛西亚UniCAP100系统进行血清Phaditop infant测定,同时进行混合变应原fx5、hx2、ex1和mx2sIgE测定。结果 216例患儿中,116例Phadiatop Infant筛查阳性,其中109例检测出4种混合变应原中一种或一种以上阳性,两者定量检测结果具有高度相关性（r=0.943,P〈0.001）。若以混合变应原阳性患儿为参照标准,Phadiatop Infant筛查试验的阳性预测值为93.9%,阴性预测值为87.0%,仍有13例（10.7%）漏诊。而如果将Phadiatop Infant荧光值阳性标准从170降低至110,则Phadiatop Infant阴性预测值达100%,阳性预测值有所下降,为86.0%。结论 Phadiatop Infant是一种筛查儿童变应原的有效方法,但作为一项筛查试验,其敏感性仍有待于进一步改进。适度下调Phadiatop Infant阳性临界值,可以明显提高其阴性预测值,避免漏诊,更有利于指导临床医生的决策。Objective To evaluate the diagnosis value of Phadiatop Infant, we simultaneously detect 216 children （ below 6 years old and suspect of allergic disease） with Phadiatop Infant, fx5, hx2, ex1 and mx2. Methods 216 children suspected as eczema, asthma and rhinitis were tested by Phadiatop Infant, fx5, hx2, ex1, and mx2 by using a Pharmacia UniCAP100 SystemTM. Results There were 116 whose Phadiatop Infant were positive in 216 children, 109 whose one or several tests of four mixed allergens tests were positive among 116 children. There is significantly positive relationship between IgE quantity detection results of Phadiatop Infant and the sum of mixed allergens （ r = 0.943, P 0.001）. If the positive tests resultes mixed allergens was used as gold standard, the positive and negative predictive values for Phadiatop Infant were 93.9% and 87.0% , respectively, but there were remain 13 children resulted in diagnosis. If the positive fluorescence value of Phadiatop Infant was stepped down to 110, negative predictive values for Phadiatop Infant was increased to 100% , positive predictive value was decreased to 86.0% . Conclusions Phadiatop Infant was an effective screen detection method for children allergens, but being a screen test, its sensitivity should be improved. If the positive fluorescence value of Phadiatop Infant was stepped down appropriately, the negative predictive value will be raised to 100% , thus missed diagnosiswere avoided, and may be benefit to the clinical decision.

关 键 词：婴幼儿变应原筛查试验 变态反应性疾病 婴幼儿 

分 类 号：R725.9[医药卫生—儿科]