摘要：
目的 应用圆柏花粉变应原注射原液1:100稀释液进行皮内试验,评价其诊断圆柏花粉过敏的临床应用价值和安全性.方法 回顾性分析2009年2月至7月北京协和医院1043例门诊患者皮内试验结果,将用圆柏花粉变应原注射原液1:100稀释液进行皮内试验的结果分别与变态反应专科医师临床综合诊断及Thermo Fisher公司Immuno CAP系统血清特异性IgE(specific IgE,sIgE)检测结果进行对比,分别计算用皮内试验诊断圆柏花粉过敏的特异度和灵敏度,以及其与变态反应专科医师临床综合诊断和血清sIgE检测结果的一致性.同时记录圆柏花粉变应原注射原液1:100稀释液用于皮内试验的不良反应.结果 以变态反应专科医师临床综合诊断为金标准,以皮内试验结果≥(+)为诊断界值时,圆柏花粉变应原注射原液1:100稀释液皮内试验的灵敏度为0.9574,特异度为0.7145,阳性预测值为0.4018,阴性预测值为0.9882,准确度为0.7550;ROC曲线下面积为0.891,95％可信区间为(0.864,0.918).以Uni-CAP sIgE诊断为金标准,以皮内试验结果≥(+)为诊断界值时,皮内试验的灵敏度为0.9549,特异度为0.1505,阳性预测值为0.6165,阴性预测值为0.7000,准确度为0.6239.与圆柏花粉变应原注射原液1:100稀释液皮内试验有关的全身不良反应1例,属轻度,占0.0959％.结论 使用圆柏花粉变应原注射原液1:100稀释液进行皮内试验,可以安全有效地诊断圆柏花粉变应原引起的过敏性疾病.%Objective To evaluate the accuracy and safety of Sabina chinensis pollen extract which was used for intradermal test ( IDT) in the diagnosis of Sabina chinensis pollen allergy .Methods 1043 Patients were collected and reviewed from Department of Allergy , Peking Union Medical College Hospital since 2009 Feb to 2009 Jul.All patients were prescribed IDT with Sabina chinensis pollen extract and sIgE detection of Juniperus sabinoides ( t6, UniCAP , Phadia ) .The IDT results were recorded and clinical integrated diagnosis was made by allergists .The accuracy of IDT with Sabina chinensis pollen ex-tract was evaluated by using clinical integrated diagnoses of allergists and sIgE detection results as golden standards respectively .Adverse reactions were also recorded for the evaluation of safety .Results IDT results≥ (+) was defined as the cutoff threshold for diagnosing .Sensitivity , specificity , positive predictive value , negative predictive value , accuracy , and area under ROC curve , were 0.9574 , 0.7145, 0.4018, 0.9882, 0.7550 and 0.891, 95％confidence interval (0.864, 0.918) respective-ly by using clinical integrated diagnoses of allergists as gold standard .Whereas sIgE results ≥0.35 kUA/L was defined as the cutoff threshold for diagnosing , sensitivity , specificity , positive predictive value , nega-tive predictive value, and accuracy were 0.9549, 0.1505, 0.6165, 0.7000, and 0.6239 respective-ly.Only 1 (0.0959％) case was attacked by type Ⅰmild systemic adverse reaction during IDT with Sa-bina chinensis pollen extract .Conclusion IDT with Sabina chinensis pollen extract is an accuracy and safe tool for the diagnosis of Sabina chinensis pollen allergy .
