一种新型尘螨过敏原激发液在诊断过敏性鼻炎中的应用  

Application of one kind of new house dust mite allergen provocation solutions for diagnosis of allergic rhinitis

作　　者：甘辉 朱政[2] 李欣 曹佳林 叶飞[4] 崔琦 孙宝清[1] GAN Hui;ZHU Zheng;LI Xin;CAO Jialin;YE Fei;CUI Qi;SUN Baoqing(Department of Clinical Laboratory,The Key Laboratory of Advanced Interdisciplinary Studies Center,The First Affliated Hospital of Guangzhou Medical University,National Center for Respiratory Medicine,National Clinical Research Center for Respiratory Disease,Guangzhou 510120,China;Department of Allergy and Clinical Immunology,The Key Laboratory of Advanced Interdisciplinary Studies Center,The First Affliated Hospital of Guangzhou Medical University,National Center for Respiratory Medicine,National Clinical Research Center for Respiratory Disease,Guangzhou 510120,China;Department of dermatology,Zhongnan Hospital of Wuhan Universoty,Wuhan 430071,China;Department of Allergy,Zhongshan People’s Hospital,zhongshan 528400,China)

机构地区：[1]广州医科大学附属第一医院,呼吸疾病全国重点实验室,国家呼吸医学中心,国家呼吸系统疾病临床研究中心,广州呼吸健康研究院,临床检验中心,广州510120 [2]广州医科大学附属第一医院过敏与临床免疫科,广州510120 [3]武汉大学中南医院皮肤科,武汉430071 [4]中山市人民医院过敏反应科,广东中山528400

出　　处：《中华临床免疫和变态反应杂志》2024年第5期452-458,共7页Chinese Journal of Allergy & Clinical Immunology

基　　金：广东省钟南山医学基金会资助项目(ZNSXS-20220017)。

摘　　要：目的探讨利用北京协和医院户尘螨注射液用于鼻激发试验诊断尘螨过敏性鼻炎的有效性和安全性。方法利用国产户尘螨注射液和变应原溶媒配置鼻激发液,纳入尘螨过敏性鼻炎及对照组受试者进行鼻激发试验,应用Lebel评分评估激发试验。结果纳入尘螨过敏性鼻炎受试者84例,对照组23例。以临床诊断为“金标准”,尘螨鼻激发试验诊断过敏性鼻炎的敏感性为92.86%(95%CI:85.1~97.3),特异性为100.0%(95%CI:85.2~100.0),阳性预测值为100.0%(95%CI:94.2~100.0),阴性预测值为79.3%(95%CI:63.9~89.2)。ROC曲线下面积为0.964(95%CI:0.931~0.998)。鼻激发试验后,5例因鼻炎症状使用抗过敏药,2例使用赛洛唑啉鼻喷剂。随访72 h,所有患者均未报告咳嗽、喘息等。结论应用户尘螨注射液开展鼻激发试验具有较好的诊断性能,安全性良好。Objective To evaluate efficacy and safety of nasal provocation test for diagnosis of dust mite allergic rhinitis by using house dust mite injection produced by Peking Union Medical College Hospital.Methods Nasal provocation solutions were prepared by using domestically manufactured house dust mite injection and solvent of allergen.Patients with dust mite allergic rhinitis and control group were included for nasal provocation test.Lebel’s score was used to evaluate the results of provocation test.Results 84 patients with dust mite allergic rhinitis and 23 controls were enrolled in this study.Using clinical diagnosis as gold standard,sensitivity,specificity,positive predictive value and negative predictive value of dust mite nasal provocation test was 92.86%(95%CI:85.10-97.33),100.0%(95%CI:85.2-100.0),100.0%(95.0%CI:94.2-100.0)and 79.3%(95%CI:63.9-89.2)respectively for diagnosis of dust mite allergic rhinitis.The area under ROC curve was 0.964(95%CI:0.931-0.998).Five patients were prescribed anti-allergic medication to alleviate rhinitis symptoms and two were prescribed xylometazoline hydrochloride nasal spray after provocation.All patients followed up for 72 hours without symptoms such as cough and wheezing.Conclusion Nasal provocation test performed by using domestically manufactured dust mite injection demonstrates excellent diagnostic value and safety for diagnosis of dust mite allergic rhinitis.

关 键 词：鼻激发试验 尘螨 过敏性鼻炎 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]