洋白蜡花粉皮试液诊断洋白蜡花粉过敏的临床价值  

Clinical Evaluation Value of Fraxinus pennsylvanica Pollen Extract in Diagnosing Fraxinus pennsylvanica Pollen Allergy

作　　者：于静淼[1,2] 孙劲旅[1] 尹佳[1] 王良录[1] 李宏[1] 文利平[1] 顾建青[1] 关凯[1] 青曼丽[1] 程璇[1] 张宏誉[1] 岳凤敏[1] 何海娟[1] 王瑞琦[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院变态反应科,北京100730 [2]北京积水潭医院B超室

出　　处：《中华临床免疫和变态反应杂志》2011年第4期291-297,共7页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的评价洋白蜡花粉皮试液诊断洋白蜡花粉过敏的有效性和安全性。方法选择2009年2月10日至7月10日在北京协和医院变态反应科就诊并已完成洋白蜡花粉过敏原皮内试验和洋白蜡花粉过敏原血清特异性IgE检测的患者1021例。登记检测结果并由变态反应专科医生做出临床综合特异性诊断。分别以临床综合特异性诊断和Uni-CapsIgE诊断为金标准,分析洋白蜡花粉皮试液进行皮内试验的有效性。登记入组当天由变态反应专科医生询问患者在完成皮内试验后是否出现不良反应并记录,从而对洋白蜡花粉皮试液的临床应用做出安全性评价。结果以临床综合特异性诊断为金标准,以皮试结果≥"+"为诊断界值时,洋白蜡花粉变应原皮试液用于皮内试验的灵敏度为0.9519、特异度为0.6889、阳性预测值为0.3028、阴性预测值为0.8333、准确度为0.7216。以Uni-CapsIgE诊断为金标准,以皮内试验结果≥"+"为诊断界值时,洋白蜡花粉变应原皮试液用于皮内试验的灵敏度为0.9659、特异度为0.5120、阳性预测值为0.8369、阴性预测值为0.9902、准确度为0.8472。与洋白蜡花粉皮试液可能有关的皮内试验发生的不良反应有3例,占总数的0.2938%。结论洋白蜡花粉皮试液具有良好的有效性和安全性,可通过皮内试验用于洋白蜡花粉过敏的特异性诊断。Objective The aim of this study is to evaluate the effectiveness and safety of Fraxinus pennsylvanica（Fra p） pollen extract in diagnosing of Fra p pollen allergy.Methods 1 021 patients were included in this study from department of allergy,PUMC hospital between February 10th,and July 10th 2009,who had finished Fra p pollen intradermal skin test（IDT） and sIgE detection.IDT and sIgE detection results were recorded and made clinical specific diagnosis was made by allergists.The effectiveness of Fra p pollen used in IDT was analyzed,by using clinical specific diagnosis made by allergists as well as sIgE detection results as gold standards respectively.The adverse reactions of IDT were also enquired and recorded to evaluate the safety of Fra p pollen extract used in IDT.Results The sensitivity,specificity,PV＋,PV-and accuracy of Fra p pollen extract used in IDT were 0.9 519,0.6 889,0.3 028,0.9 902,0.7 216 respectively,by using clinical specific diagnosis as gold standard and the skin test results ≥ ＂＋＂ as the threshold.The sensitivity,specificity,PV＋,PV-and accuracy of Fra p pollen extract used in IDT were 0.9 659,0.1 293,0.4 570,0.8 333,0.4 902 respectively,by using sIgE detection result as gold standard and the IDT results ≥ ＂＋＂ as the threshold.Adverse reaction related to Fra p pollen IDT was found in 3 patients,the incidence was 0.2 938%.Conclusion Fra p pollen extract used in IDT was shown good effectiveness and safety in diagnosing of Fra p pollen allergy.

关 键 词：洋白蜡花粉 特异性诊断 皮内试验 有效性 安全性 

分 类 号：R593[医药卫生—内科学]