皮肤点刺试验阴性患者的血清特异性IgE检测结果分析  

Analysis of serum specific IgE tests in the patients with negative skin prick tests

作　　者：尤少华[1] 李玉茹[2] 刘扬[3] 籍灵超[1] 白银[1] 张静[1] 贾红霞[1] 胡红[3] 王洪田[1] 

机构地区：[1]解放军总医院耳鼻咽喉头颈外科,北京100853 [2]解放军总医院检验科,北京100853 [3]解放军总医院呼吸科,北京100853

出　　处：《中国现代医学杂志》2014年第12期99-103,共5页China Journal of Modern Medicine

基　　金：国家自然科学基金资助项目(No:81371074)

摘　　要：目的分析皮肤点刺试验（SPT）阴性患者的血清特异性IgE（sIgE）检测结果,探讨血清sIgE检测的临床意义。方法使用德国默克公司的阿罗格（NHD）24种标准变应原试剂对就诊于本院的211例患者行SPT检测。变应原点刺液与阳性对照所致丘疹直径之比,即皮肤指数（SI）,根据SI将阳性结果分为＂＋＂、＂＋＋＂、＂＋＋＋＂、＂＋＋＋＋＂,皮肤反应与阴性对照相似则标以阴性（-）。用德国欧蒙EUROIMMUN公司产的Euroline中国特应性组合20种标准试剂对SPT阴性患者行血清sIgE和总IgE检测,血清IgE结果分0~6级。结果 SPT检测阴性的83例患者中49例（59.0%）患者血清sIgE检测结果阳性。血清sIgE浓度1级患者30例,2级患者8例,3级患者5例,4级患者5例,5级患者1例,6级患者0例。1种血清sIgE阳性患者19例,2种血清sIgE阳性患者11例,3种血清sIgE阳性患者5例,4种血清sIgE阳性患者2例,5种血清sIgE阳性患者7例,6种血清sIgE阳性患者3例,7种血清sIgE阳性患者2例。血清sIgE阳性的吸入性变应原主要为：螨虫组合（18例）,屋尘（15例）,树木组合3（13例）,动物毛发组合1（13例）;血清sIgE阳性的食入性变应原主要为：淡水鱼组合1（21例）,海洋组合2（15例）,花生/黄豆/小麦/玉米（11例）。83例SPT阴性患者中34例（41.0%）患者血清sIgE检测结果阴性。其中血清sIgE阴性但总IgE阳性患者14例,血清sIgE和总IgE均阴性的患者20例（24.1%）。结论近60%SPT阴性患者血清sIgE呈阳性,SPT检测阴性患者仍需行血清sIgE检测。【Objective】To analyze the results of serum allergen specific IgE（sIgE） tests in patients with negative skin prick tests（SPT） and to explore the clinical significance of serum sIgE.【Methods】Twenty-four standard Allergen extracts（Allergopharma, NHD） were used to detect SPT in 211 patients in our hospital from January to October in 2012. Kin index（SI） was defined as the ratio of the wheal diameter induced by prick liquid to the wheal diameter induced by the positive control. Positive SPT results are marked by ＂＋＂, ＂＋ ＋＂, ＂＋ ＋ ＋＂, ＂＋ ＋ ＋ ＋＂ according SI; Negative SPT reaction was defined as the skin reaction was smallerwith the negative control. Chinese atopic combination of 20 standard reagent（EUROIMMUN Germany） were used to detect the sIgE and total IgE in patients with negative SPT. The results of sIgE and total IgE were marked by 0-6 classes according to the serum concentration. 【Results】Out of 83 subjects with negative SPT, 49 subjects（59.0%） had positive serum sIgE with class 1（30 subjects）, class 2（8 cases）, class 3（5 patients）, class 4（5 patients）, class 5（1 case） and class 6（0 subjects）. 19 patients had 1 kind of positive sIgE, 11 subjects had 2 kinds, 5 subjects had 3 kinds, 2 subjects had 4 kinds, 7 subjects had 5 kinds, 3 subjects had 6 kinds, 2 subjects had 7 kinds. The common positive serum sIgE of inhalation allergen were： mites combination（18 subjects）, house dust（15 cases）, tree combination 3（13 patients）, animal hair combination 1（13 subjects）; the common positive serum sIgE of food allergen were： freshwater fish combination 1（21 subjects）. Marine combination 2（15 cases）, peanut / soybean / wheat / maize（11 patients）. 34（41%） of 83 subjects with negative SPT aslo had negative serum sIgE. 14 subjects had negative sIgE but positive total IgE and 20 subjects had negative sIgE and negative total IgE. 【Conclusions】About 60% patients with negative SPT reactions had positi

关 键 词：皮肤点刺试验 特异性IGE 变应原 非变应性鼻炎 变应性鼻炎 

分 类 号：R765.210.4[医药卫生—耳鼻咽喉科]