目的：探讨青霉素皮肤试验（皮试）与特异性IgE的相关性。方法：采用放射过敏原吸附试验（RAST）测定青霉素过敏病人血清特异性IgE抗体。结果：根据皮试与抗体测定时间间隔分为4个时间段：即刻、30 d内、30 d至2年和2年以上，皮试阳性患者各时间段IgE抗体阳性率分别为42.9%、28.6%、18.8%和10.5%。当皮试阳性反应程度≥“+”时，IgE抗体阳性率为8.3%，皮试与RAST的符合率为66.7%；当反应程度≥“++”时，IgE抗体阳性率为60%，二者符合率为77.8%，皮试程度与血清特异性IgE抗体呈显著相关（P0.05）；当皮试≥“+++”时，皮试与RAST完全相符。结论：青霉素皮试的准确性与皮试反应程度及时间有关，RAST可作为青霉素过敏反应体外诊断的一种重要辅助方法。
Abstract
OBJECTIVE To study the relativity between skin test and specific IgE antibodies in penicillins allergic patients.METHODS In patients with positive skin test, specific IgE antibodies were determined with radioallergosobent test （RAST）.RESULTS Specific IgE antibodies were determined immediately, in 30 days, 30 days～2years or over 2 years after skin test, and the positive rates of specific IgE antibodies were 42.9%, 28.6%, 18.8% and 10.5%, respectively. The better the positive reaction degree of skin test, the higher the positive rate of specific IgE antibodies. If the positive reaction of skin test was over “+” as positive criterion, the coincidence between RAST and skin test would be 66.7%. If the positive reaction of skin test was over “++” as positive criterion, the coincidence between RAST and skin test would be 77.8%, and the positive reaction degree of skin test correlated significantly with specific IgE antibodies（P0.05）. The coincidence between RAST and skin test was 100% when the positive reaction degree of skin test was “+++” or “++++”.CONCLUSIONS The veracity of penicillins skin test relates to the positive reaction degree and period after skin test. RAST is an important method in the evaluation of subjects with allergic to penicillins.
关键词
青霉素 /
过敏反应 /
皮肤试验 /
放射过敏原吸附试验 /
IgE抗体
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Key words
penicillins /
allergy /
skin test /
radioallergosorbent test /
IgE antibodies
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参考文献
[1］乔海灵，赵永星，马统勋.青霉素类抗素过敏反应机制及诊断的新近研究进展［J］.国外医药抗生素分册，2002，23(5)：197.
[2］Sogn DD, Evars R, Shepherd GM, et al. Results of the national institute of allergy and infectious diseases collaborative clinical trial to test the predictive value of skin testing with major and minor penicillin devivatives hospitalized adults［J］. Arch Inter Med,1992,152(5):1025.
[3］朱大勋，赵京莉，张天裘. 新型青霉素皮试预报苄青霉素过敏反应［J］. 中华医学杂志,1993,73(8):493.
[4］顾瑞金. 药物变态反应［M］. 北京: 科学出版社, 2001.59.
[5］张均田. 现代药理试验方法［M］. 北京: 北京医科大学协和医科大学联合出版社,1998.757.
[6］乔海灵，赵永星. 放射过敏原吸附试验检测青霉素过敏类病人血清特异性IgE抗体［J］. 中国抗生素杂志，2002，27（8）.
[7］Sullivan TJ，Wedner HJ，Shatz GS，et al. Skin testing to detect penicillin allergy.J Allergy Clin Immunol,1981,68(3):171.
[8］Blanca M, Torre MJ, Garcia JJ, et al. National evolution of skin sensitivity in patients allergic to beta-lactam antibiotics［J］. J Allergy Clin Immunol,1999,103(5,pt1),918.
[9］Torres MJ, Blanca M, Fernandez J, et al. Selection allergic reaction to oral cloxacillin［J］. Clin Exp Allergy,1996,26(1):108.
[10］Wide L, Juhlin L. Detection of penicillin allergy of the immediate type by radioimmunoassay of reagins(IgE) to penicilloyl congates［J］. Clin Allergy,1971,1(2):171.
[11］Kraft D, Wide L. Clinical patters and results of radioallergosorbent test (RAST) and skin test to penicillin allergy［J］. Br J Dermatology,1976,94(6):593.
[12］Wolff G, Castro CC, Gagliardi RJ, et al. Study of the frequency of skin test reactions to side-chain penicillin determinants［J］. J Allergy Clin Immunol,1998,101(part2):136.
[13］Vega JM, Blanca M, Garcia JJ，et al. Immediate allergic reactions to amoxicillin［J］. Allergy,1994,49（5）:317.
[14］Zhu DX, Joans A, Anna-Tora M, et al. Diagnostic capatilities of penicillin-based structures as tools in the invitro diagnosis of penicillin allergy［J］. J Invest Allergol Clin Immunol,1992,2(5):240.
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脚注
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基金
河南省自然科学基金资助项目 项目编号：0211040100
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