洋白蜡花粉皮试液诊断洋白蜡花粉过敏的临床价值

摘要

Objective The aim of this study is to evaluate the effectiveness and safety of Fraxinus pennsylvanica (Fra p) pollen extract in diagnosing of Fra p pollen allergy. Methods 1 021 patients were included in this study from department of allergy, PUMC hospital between February 10' , and July 10' 2009, who had finished Fra p pollen intradermal skin test (IDT) and slgE detection. IDT and slgE detection results were recorded and made clinical specific diagnosis was made by allergists. The effectiveness of Fra p pollen used in IDT was analyzed, by using clinical specific diagnosis made by allergists as well as slgE detection results as gold standards respectively. The adverse reactions of IDT were also enquired and recorded to evaluate the safety of Fra p pollen extract used in IDT. Results The sensitivity, specificity, PV + , PV- and accuracy of Fra p pollen extract used in IDT were 0. 9 519, 0. 6 889, 0. 3 028, 0. 9 902, 0. 7 216 respectively, byusing clinical specific diagnosis as gold standard and the skin test results ≥ " + " as the threshold. The sensitivity, specificity, PV + , PV- and accuracy of Fra p pollen extract used in IDT were 0. 9 659," 0. 1 293 , 0. 4 570, 0. 8 333 , 0. 4 902 respectively, by using slgE detection result as gold standard and the IDT results ≥ " + " as the threshold. Adverse reaction related to Fra p pollen IDT was found in 3 patients, the incidence was 0. 2 938%. Conclusion Fra p pollen extract used in IDT was shown good effectiveness and safety in diagnosing of Fra p pollen allergy.%目的 评价洋白蜡花粉皮试液诊断洋白蜡花粉过敏的有效性和安全性.方法 选择2009年2月10日至7月10日在北京协和医院变态反应科就诊并已完成洋白蜡花粉过敏原皮内试验和洋白蜡花粉过敏原血清特异性IgE检测的患者1021例.登记检测结果并由变态反应专科医生做出临床综合特异性诊断.分别以临床综合特异性诊断和Uni-Cap sIgE诊断为金标准,分析洋白蜡花粉皮试液进行皮内试验的有效性.登记入组当天由变态反应专科医生询问患者在完成皮内试验后是否出现不良反应并记录,从而对洋白蜡花粉皮试液的临床应用做出安全性评价.结果 以临床综合特异性诊断为金标准,以皮试结果≥“+”为诊断界值时,洋白蜡花粉变应原皮试液用于皮内试验的灵敏度为0.9 519、特异度为0.6 889、阳性预测值为0.3028、阴性预测值为0.8333、准确度为0.7216.以Uni-Cap sIgE诊断为金标准,以皮内试验结果≥“+”为诊断界值时,洋白蜡花粉变应原皮试液用于皮内试验的灵敏度为0.9 659、特异度为0.5120、阳性预测值为0.8369、阴性预测值为0.9902、准确度为0.8472.与洋白蜡花粉皮试液可能有关的皮内试验发生的不良反应有3例,占总数的0.2938％.结论 洋白蜡花粉皮试液具有良好的有效性和安全性,可通过皮内试验用于洋白蜡花粉过敏的特异性诊断.