基于开放性口服食物激发试验评价皮肤点刺试验和血清特异性IgE在儿童牛奶蛋白诊断中的应用价值  

Evaluation of skin prick test and sIgE detection in diagnosis of milk protein allergy in children: based on open oral food challenge test

作　　者：刘玲[1] 周薇[1] 王良录 王红梅[1] LIU Ling;ZHOU Wei;WANG Liang-lu;WANG Hong-mei(Department of Pediatrics,Peking University Third Hospital,Beijing 100191,China;Department of Allergy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease,National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID),Beijing 100730,China)

机构地区：[1]北京大学第三医院儿科,北京100191 [2]中国医学科学院北京协和医学院北京协和医院变态(过敏)反应科,北京100730

出　　处：《中华临床免疫和变态反应杂志》2021年第1期21-26,共6页Chinese Journal of Allergy & Clinical Immunology

基　　金：国家卫生和计划生育委员会科技教育司公益性行业科研专项(201502012)。

摘　　要：目的以开放性口服食物激发(OFC)试验为金标准,评估皮肤点刺试验(SPT)、血清特异性IgE(sIgE)在儿童牛奶蛋白过敏诊断中的价值。方法回顾性分析2015年12月至2018年7月北京大学第三医院51例确诊或疑似牛奶蛋白过敏患儿的病例资料。行开放性口服牛奶蛋白激发试验73例次,行SPT 64例次,测量风团直径大小。使用Phadia 250进行牛奶蛋白血清sIgE检测54例次。采用SPSS23.0软件包进行统计学分析。结果73例次患儿总体性别比男∶女=54∶19;根据年龄分组,64例次进行SPT和OFC试验患儿,分为1岁以下年龄组42例次和1岁及以上组22例次;1岁以下组平均年龄为(5.1±2.5)月龄,1岁及以上组(2.2±1.4)岁。两组分别进行皮肤点刺风团直径与开放性OFC试验相关性分析,1岁以下组SPT与OFC试验相关系数0.332,P值>0.05。ROC曲线分析P=0.118,两者差异无统计学意义;而1岁及以上组相关系数0.564,ROC曲线分析P=0.053,两者差异无统计学意义。牛奶蛋白血清sIgE检测,54例次检测中1岁以下年龄组26例次,1岁及以上年龄组28例次。两组分别进行牛奶蛋白血清sIgE与开放性OFC试验相关性分析,1岁以下组血清sIgE与OFC试验相关系数为0.410,P=0.042;ROC曲线分析P=0.045,两者差异有统计学意义;而1岁及以上组相关系数0.338,P=0.073;ROC曲线分析P=0.074,两者差异无统计学意义。结论牛奶蛋白血清sIgE对于1岁以下儿童牛奶蛋白过敏有一定诊断意义。牛奶蛋白血清sIgE与SPT对于1岁及以上儿童牛奶蛋白过敏均无明确诊断意义。Objective The aim of this study is to evaluate the value of skin prick test(SPT)and specific immunoglobulin E(IgE)detection in diagnosis of milk protein allergy in children,by using open oral food challenge test as gold standard.Methods The clinical data of 51 children with suspected or confirmed diagnosis of milk protein allergy were analyzed retrospectively,who were admitted to Peking University Third Hospital between December 2015 and July 2018.73 open oral milk protein challenge tests were conducted.Skin prick test was performed among 64 cases,and diameter of wheal was measured.The serum specific IgE of milk protein was detected using Phadia 250 in 54 cases.Statistical analyses were performed using SPSS 23.0 software.Results The overall sex ratio of 73 cases was 54∶19(male∶female).There were 42 cases in under 1 year-old group and 22 cases in 1 year-old and above group,among 64 cases that finished skin prick test.The average age was(5.1±2.5)month-old in under 1 year-old group and(2.2±1.4)year-old in 1 year-old and above group respectively.The correlation between the results of skin prick test and open oral food challenge test in two groups were analyzed respectively.The coefficient of correlation between skin prick test and oral food challenge test was 0.332(P>0.05)and 0.564 in under 1 year-old group and 1 year-old and above group respectively.Receiver operating characteristic curve analysis was performed in both group,and the P value was 0.118(>0.05)and 0.053 in under 1 year-old group and 1 year-old and above group respectively,which indicated that there was no statistical correlation between the results of skin prick test and oral food challenge test in both group.There was 26 cases in under 1 year old group and 28 cases in 1 year old and above group,among 54 cases that finished serum specific IgE test.The correlation between serum specific IgE of milk protein and open oral food challenge test was also analyzed in two groups.The coefficient of correlation between serum specific IgE and oral food challe

关 键 词：儿童 婴儿 牛奶蛋白过敏 皮肤点刺试验 血清特异性IGE 开放性口服食物激发试验 

分 类 号：R725.9[医药卫生—儿科]