Grzybowski Mary, Ownby Dennis R, Rivers Emanuel P, Ander Douglas, Nowak Richard M
Department of Emergency Medicine, School of Medicine, and the Center for Healthcare Effectiveness Research, Wayne State University, Detroit, MI, USA.
Ann Emerg Med. 2002 Oct;40(4):411-9. doi: 10.1067/mem.2002.128144.
Since the first report of immediate hypersensitivity to latex was documented in 1979, latex allergy has been increasingly recognized as a medical problem in patient populations. However, there are no data available regarding the seroprevalence of latex sensitization in patients presenting to the emergency department. The overall aim of this study was to determine the prevalence of latex IgE seropositivity (L-IgE) in ED patients.
We measured latex-specific IgE antibodies among a convenience sample of 1,027 patients using the AlaSTAT assay. We also measured serum IgE antibodies specific for 12 common inhalant allergens using the AlaTOP Microplate Allergy Screen assay. Demographic data were collected. Two questions related to latex allergy were queried. Descriptive statistics are presented. Point estimates and 95% confidence intervals (CIs) were calculated for each seroprevalence test. Odds ratios (ORs) and 95% CIs were used to assess the relationship between sex, race, and seropositivity to inhalant allergens and L-IgE.
The participation rate was 90% (1,027). The mean age of the patients was 46.9 years, 47.6% (489) were male, and 13.9% (143) were white. Eighty-four (8.2%; 95% CI 6.5% to 10.0%) had positive L-IgE results, and 23.8% (20) of patients with positive L-IgE results were classified as having strongly positive results. Bivariate analyses showed that being nonwhite (OR 4.7; 95% CI 1.5 to 15.1) and being seropositive for inhalant allergens (OR 7.4; 95% CI 4.2 to 13.1) were associated with L-IgE.
The prevalence of latex sensitization in our sampling is substantial and higher than previously estimated in the general adult population. The clinical significance of seropositivity requires further evaluation.
自1979年首次报告对乳胶的速发型超敏反应以来,乳胶过敏在患者群体中日益被视为一个医学问题。然而,关于急诊科就诊患者中乳胶致敏血清流行率的数据尚无可用资料。本研究的总体目标是确定急诊科患者中乳胶IgE血清阳性(L-IgE)的患病率。
我们使用AlaSTAT检测法在1027例患者的便利样本中检测了乳胶特异性IgE抗体。我们还使用AlaTOP微孔板过敏筛查检测法检测了针对12种常见吸入性过敏原的血清IgE抗体。收集了人口统计学数据。询问了两个与乳胶过敏相关的问题。给出了描述性统计数据。对每种血清流行率检测计算了点估计值和95%置信区间(CI)。使用优势比(OR)和95%CI来评估性别、种族以及对吸入性过敏原的血清阳性与L-IgE之间的关系。
参与率为90%(1027例)。患者的平均年龄为46.9岁,47.6%(489例)为男性,13.9%(143例)为白人。84例(8.2%;95%CI 6.5%至10.0%)L-IgE检测结果为阳性,L-IgE检测结果为阳性的患者中有23.8%(20例)被归类为强阳性结果。双变量分析显示,非白人(OR 4.7;95%CI 1.5至15.1)以及对吸入性过敏原血清阳性(OR 7.4;95%CI 4.2至13.1)与L-IgE相关。
我们样本中乳胶致敏的患病率相当高,高于之前在一般成年人群中的估计。血清阳性的临床意义需要进一步评估。