血清类胰蛋白酶：荧光素血管造影术后过敏反应的一个指标。
Serum tryptase: an indicator of anaphylaxis following fluorescein angiography.
作者信息
Butrus S I, Negvesky G J, Rivera-Velazques P M, Schwartz L B
机构信息
Department of Ophthalmology, Washington National Eye Center, DC, USA.
出版信息
Graefes Arch Clin Exp Ophthalmol. 1999 May;237(5):433-4. doi: 10.1007/s004170050256.
BACKGROUND
Anaphylaxis is a potentially fatal complication of fluorescein angiography. It is diagnosed by clinical signs. Serum beta-tryptase serves as a specific indicator of mast cell activation and of anaphylactic shock that can be detected by radioimmunoassay.
METHOD
This is a report on a 48-year-old woman who developed anaphylaxis during fluorescein angiography. This study investigates the role of beta-tryptase in anaphylactic shock resulting from intravenous fluorescein angiogram.
RESULTS
A serum sample of beta-tryptase collected at the time of an adverse reaction to fluorescein angiography was determined by radioimmunassay to be elevated above 20 ng/ml (normal level <1 ng/ml). This indicates massive mast cell activation and anaphylactic shock.
CONCLUSION
This case is the first in which elevated levels of beta-tryptase in serum indicated that the systemic adverse reaction to fluorescein was mast cell dependent. Additionally, beta-tryptase levels can be assayed to detect anaphylactic reactions several hours after a precipitating event.
背景
过敏反应是荧光素血管造影术的一种潜在致命并发症。它通过临床症状进行诊断。血清β-色氨酸酶作为肥大细胞活化和过敏性休克的特异性指标，可通过放射免疫测定法检测。
方法
本文报告了一名48岁女性在荧光素血管造影术中发生过敏反应的病例。本研究调查了β-色氨酸酶在静脉注射荧光素血管造影所致过敏性休克中的作用。
结果
通过放射免疫测定法测定，在对荧光素血管造影术出现不良反应时采集的β-色氨酸酶血清样本高于20 ng/ml（正常水平<1 ng/ml）。这表明存在大量肥大细胞活化和过敏性休克。
结论
该病例首次表明血清中β-色氨酸酶水平升高提示对荧光素的全身不良反应依赖于肥大细胞。此外，在诱发事件发生数小时后，可通过检测β-色氨酸酶水平来检测过敏反应。
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