变应性鼻炎变应原检测方法的对比研究  

Comparison of serum specific IgE detection and skin prick test in patients with allergic rhinitis

作　　者：伍慧卿[1,2] 赵晓明[1,2] 林丽莉[1,2] 刘谦虚[1,2] 孙宝清[3,4] 郑佩燕[3,4] 

机构地区：[1]暨南大学附属第三医院 [2]珠海市人民医院耳鼻咽喉头颈外科,广东珠海519000 [3]广州医学院第一附属医院 [4]广州呼吸疾病研究所,广东广州510230

出　　处：《中国耳鼻咽喉颅底外科杂志》2014年第5期397-402,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：珠海市科技局重大课题(2011B040102031)

摘　　要：目的探讨变应性鼻炎（allergic rhinitis,AR）患者采用皮肤点刺试验（skin prick test,SPT）和血清特异性IgE（specific IgE,sIgE）检测变应原的相关性与优化的酶联免疫法（ELISA）检测sIgE的诊断能力,为AR患者的实验诊断提供更好的变应原检测手段。方法选取2012年4月-2013年3月诊治的AR患者289例,采用SPT及优化的ELISA检测方法对珠海地区具有代表性的变应原屋尘螨、粉尘螨、蟑螂、霉菌、猫毛、狗上皮进行检测,对其结果进行统计学分析。结果两种检验方法对此6种变应原阳性诊断的一致性较高（66.44%-95.16%）,除狗上皮外,其中屋尘螨、粉尘螨及猫毛的血清sIgE的检出率高于SPT,蟑螂、霉菌的血清sIgE的检出率则低于SPT。两种检测方法对此6种变应原阳性强度分级别的检测结果的一致性差（r=-0.053-0.383）。优化ELISA检测的诊断效力波动在96.42%-50.67%。结论两种检验方法的阳性检出率均较高,阳性强度分级一致性稍差,优化ELISA检测AR患者血清sIgE的诊断能力较强,综合运用两种检验方法可获得更为准确的变应原结果。Objective To analyze the clinical application value of skin prick test（ SPT） and serum specific IgE（ sIgE） detection by optimized enzyme-linked immunosorbent assay（ ELISA）. And to find out a preferable allergen detection method for AR. Methods 289 cases suspected with AR were enrolled. SPT and ELISA were adopted to detect the representative allergen in Zhuhai area,including Dermatophagoides pteronyssinus（ Der p）,Dermatophagoides farinae（ Der f）,cockroach,mould,cat hair and dog epithlia. Results of ELISA and SPT were statistically analyzed. Results Consistency of positive rates of 6 allergens by these two methods reached 66. 44 % to 95. 16 %. The positive rates of Der p,Der f and cat hair by ELISA were higher than those by SPT（ P〈0. 05）,while those of cockroach and mould by ELISA were lower than those by SPT（ P〈0. 05）. As for the positive intensity,the consistency of the two detection methods was low（ r =- 0. 053 - 0. 383）. The efficiency of sIgE detection with ELISA fluctuated from 96. 42 % to 50. 67 %. Conclusion The positive rates of both detection methods are rather high with good consistency. But their consistency for positive intensity is poor. The diagnostic ability of sIgE detection with ELISA is favourable. Combined application to both detection methods can benefit reliable results of allergen detection.

关 键 词：变应性鼻炎 血清特异性IGE 皮肤点刺试验 相关性 优化的酶联免疫法 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]