Bodtger U, Jacobsen C R, Poulsen L K, Malling H-J
Allergy Clinic, National University Hospital, Copenhagen, Denmark.
Allergy. 2003 Nov;58(11):1180-6. doi: 10.1046/j.1398-9995.2003.00323.x.
Long-term reproducibility of the skin-prick test (SPT) has been questioned. The aim of the study was to investigate the clinical relevance of SPT changes.
SPT to 10 common inhalation allergens was performed annually from 1999 to 2001 in 25 nonsensitized and 21 sensitized subjects. An SPT was positive when > or =3 mm, and repeatable if either persistently positive or negative. Clinical sensitivity to birch pollen was used as model for inhalation allergy, and was investigated at inclusion and at study termination by challenge tests, intradermal test, titrated SPT and IgE measurements. Birch pollen symptoms were confirmed in diaries.
The repeatability of a positive SPT was 67%, increasing significantly to 100% when supported by the history. When not supported by history, the presence of specific IgE was significantly associated with a repeatable SPT. Allergen sensitivity was significantly lower in subjects loosing SPT positivity. The repeatability of a negative test was 95%, decreasing significantly to 87% by the presence of other sensitization. Development of a positive SPT was clinically relevant. Elevation of SPT cut-off point did not enhance repeatability.
SPT changes are clinically relevant. Further studies using other allergens are needed. Long-term repeatability of SPT is high in the presence of a supportive history.
皮肤点刺试验（SPT）的长期可重复性受到质疑。本研究的目的是调查SPT变化的临床相关性。
1999年至2001年，每年对25名非致敏和21名致敏受试者进行针对10种常见吸入性变应原的SPT。当SPT结果≥3 mm时为阳性，若持续阳性或持续阴性则为可重复性结果。以桦树花粉临床敏感性作为吸入性过敏的模型，在纳入研究时和研究结束时通过激发试验、皮内试验、滴定SPT和IgE测量进行调查。桦树花粉症状在日记中得到证实。
阳性SPT的可重复性为67%，若有病史支持则显著增至100%。若无病史支持，特异性IgE的存在与可重复性SPT显著相关。失去SPT阳性的受试者变应原敏感性显著降低。阴性试验的可重复性为95%，若存在其他致敏则显著降至87%。SPT转为阳性具有临床相关性。提高SPT的临界点并未增强可重复性。
SPT变化具有临床相关性。需要使用其他变应原进行进一步研究。在有支持性病史的情况下，SPT的长期可重复性较高。
