Mata E, Guéant J L, Moneret-Vautrin D A, Bermejo N, Gérard P, Nicolas J P, Laxenaire M C
Equipe de Biochimie-Immunologie, INSERM U 308, Faculté de Médecine, Nancy, France.
Allergy. 1992 Oct;47(5):471-6. doi: 10.1111/j.1398-9995.1992.tb00667.x.
We have evaluated the in vitro leukocyte histamine release tests for the diagnosis of allergy to muscle relaxant drugs in 40 patients (Group A) and a control group of 44 subjects with negative leukocyte histamine release (Group B). Non-IgE dependent histamine release, expressed as a percentage of the total blood histamine, was 3.94% +/- 0.49 in Group B. The upper limit of positivity was estimated to be 5% (mean + 2 SD). Leukocyte histamine release tests were positive in 65% of the patients from Group A. The concordance between LHR and QAS-RIA was 64%. The maximal histamine release was observed at dilutions of 10(-2)-10(-4) in 20 of the 26 positive cases. The maximal histamine release was 43.8% +/- 23.3. The spontaneous histamine release was as low as 1.7% +/- 1.1. Cross-reactivity among the 5 different muscle relaxant drugs has been investigated and compared by intradermal testing. The muscle relaxant drugs which gave the lower skin reaction (M2) and the drug responsible for shock (M1) were selected for the study of in vitro leukocyte histamine release. Of 20 M2. All of the 10 cases had negative ID tests with M2. Three of these patients subsequently underwent general anesthesia with the muscle relaxant chosen as harmless (M2) without any clinical reaction.
我们对40例患者（A组）进行了体外白细胞组胺释放试验，以诊断对肌肉松弛药物的过敏反应，并与44例白细胞组胺释放阴性的受试者组成的对照组（B组）进行了比较。B组中非IgE依赖性组胺释放占全血组胺的百分比为3.94%±0.49%。阳性上限估计为5%（平均值+2个标准差）。A组65%的患者白细胞组胺释放试验呈阳性。白细胞组胺释放试验（LHR）与放射免疫分析法（QAS-RIA）的一致性为64%。在26例阳性病例中的20例中，在10^(-2)-10^(-4)的稀释度下观察到最大组胺释放。最大组胺释放为43.8%±23.3%。自发组胺释放低至1.7%±1.1%。通过皮内试验研究并比较了5种不同肌肉松弛药物之间的交叉反应性。选择引起较低皮肤反应的肌肉松弛药物（M2）和导致休克的药物（M1）进行体外白细胞组胺释放研究。在20例M2中。所有10例对M2的皮内试验均为阴性。其中3例患者随后使用被选为无害的肌肉松弛药物（M2）进行全身麻醉，未出现任何临床反应。
