基础医学与临床 ›› 2009, Vol. 29 ›› Issue (6): 631-635.

• 临床园地 • 上一篇    下一篇

几种户尘螨过敏原点刺液的临床评价

孙劲旅 王瑞琦 尹佳 王良录 张宏誉 李宏 文利平   

  1. 中国医学科学院 北京协和医学院 北京协和医院 北京协和医院变态反应科 北京协和医院变态反应科 北京协和医院变态反应科 北京协和医院变态反应科
  • 收稿日期:2009-03-24 修回日期:2009-04-29 出版日期:2009-06-25 发布日期:2009-06-25
  • 通讯作者: 孙劲旅

Evaluation of several Dermatophagoides pterronyssinus Allergen extracts for Skin Prick Test

Jin-lu SUN, Rui-qi WANG, Jia YIN, Liang-lu WANG, Hong-yu ZHANG, Hong LI, Li-ping WEN   

  1. Peking Union Medical College Hospital, CAMS & PUMC
  • Received:2009-03-24 Revised:2009-04-29 Online:2009-06-25 Published:2009-06-25
  • Contact: Jin-lu SUN,

摘要: 评价户尘螨过敏原点刺皮试液用于诊断和筛查尘螨过敏的意义。方法:对219例患者进行户尘螨过敏原点刺试验和户尘螨sIgE检测。点刺试验所用点刺液为本课题组研制的点刺液(A 组)、ALK公司的户尘螨点刺液(B组)和ALK公司的混合螨(户尘螨和粉尘螨)点刺液(C组),以sIgE为诊断标准。统计分析采用SPSS 11.0软件,对三组户尘螨过敏原点刺试验进行ROC曲线评价。结果:A、B和C组风团平均直径中位数为0.43cm、0.35cm和 0.28cm。所有入选者点刺试验后1h,A组有5例点刺试验后出现局部反应,2h左右自行缓解;有2例出现迟发反应,需1天左右才消退;B组和C组各有3例点刺试验后出现局部反应,B组和C组各有2例有迟发反应。所有患者均无局部皮疹、全身性不良反应。三组户尘螨过敏原点刺试验的ROC曲线下面积分别为0.765、0.801、0.782,说明户尘螨过敏原点刺皮试液对诊断户尘螨过敏具有较高准确性。以户尘螨sIgE为标准的点刺试验灵敏度和特异度:A、B 和C组点刺液的灵敏度分别为92.4%、87.0%和81.5%,特异度分别为60.6%、73.2%和74.8%。结论:户尘螨点刺液可作为用于尘螨过敏的诊断试剂,有良好的灵敏度和特异度,具有临床筛查和诊断意义。

关键词: 户尘螨, 过敏原, 点刺液, ROC曲线

Abstract: Objective To evaluate the significance of several different house dust mite allergen extracts with skin prick test (SPT) in allergic patients to Dermatophagoides pteronyssinus. Methods 219 patients underwent SPT and serum specific IgE assay to house dust mite. 3 kinds of house dust mite allergen extracts were used for SPT, respectively. Extract A group was prepared by our laboratory, extract B group was extract of Dermatophagoides pteronyssinus manufactured by ALK Corporation, and extract C group was mixed extract of Dermatophagoides pteronyssinus and Dermatophagoides farinae manufactured by ALK Corporation. Human serum specific IgE was regarded as reference of allergy to Dermatophagoides pteronyssinus. Evaluate the ROC curves of these three groups. Results 1. The medium of wheal diameter of SPT with A group, B group and C group was 0.45cm, 0.35cm and 0.30cm, respectively. 2. There was no local urticaria and systemic urticaria, no running nose and sneezing, no cough and asthma, no allergic shock observed. Local reactions after SPT were observed in 5 ( group A), 3 ( group B), 3 patients ( group C).. The delayed reactions were observed in 2 patients of each group. The area under ROC curve of SPT with extract A group, B group and C group was 0.765、0.801、0.782. The coefficient of linear correlation was 0.771, 0.786 and 0.784, respectively (P<0.01), the coefficient was statistically significant. 4. Based on serum specific IgE, the sensitivity of SPT with extract A group, B group and C group was 92.4%, 87.0% and 81.5%, and the specificity was 60.6%, 73.2% and 74.8%, respectively. Conclusion The house dust mite allergen extract prepared in our laboratory was a proper extract for diagnosing of house dust mite allergy. The sensitivity and specificity of the extract was good, and it can be used in clinical diagnosis.

Key words: Dermatophagoides pteronyssinus, allergen, extract, ROC curve