Dudek Wojciech, Wittczak Tomasz, Walusiak Jolanta, Krakowiak Anna, Pałczyński Cezary
Z Ośrodka Alergii Zawodowej i Srodowiskowej, Instytutu Medycyny Pracy im. prof. J. Nofera, Lodzi.
Med Pr. 2004;55(5):379-87.
The aim of the study was to evaluate the usefulness of skin prick tests and serum allergen-specific IgE determination in diagnosis of occupational airway allergies.
The study group comprised 152 patients with suspected occupational asthma and occupational allergic rhinitis. In all subjects, skin prick tests (SPT) to occupational allergens and specific challenge test were performed, and serum allergen-specific IgE (as-IgE) was determined. The sensitivity, specificity and predictive values of SPT and serum as-IgE were evaluated for different types of allergens (flour, grain, natural rubber latex and cotton).
SPT sensitivity ranged from 22.2 to 68.2%, and specificity from 74.1 to 88.2%, depending on the allergen. Positive predictive values for SPT ranged from 30 to 68.2% and negative predictive values from 74 to 82.4%. As-IgE sensitivity was evaluated from 42.8 to 83.3%, and specificity from 57.1 to 81.5%. Positive predictive values for as-IgE ranged from 35.7 to 76.2% and negative predictive values from 72.4 to 92.3%.
The results showed that neither SPT nor serum as-IgE determination indicated sufficient sensitivity and specificity to play a key role in diagnosis of occupational asthma and rhinitis. The sensitivity, specificity and predictive values varied depending on the type of allergen. During the diagnostic process of occupational asthma and rhinitis the specific inhalant challenge test should be taken into consideration to confirm the final diagnosis.
本研究的目的是评估皮肤点刺试验和血清过敏原特异性IgE测定在职业性气道过敏诊断中的效用。
研究组包括152例疑似职业性哮喘和职业性变应性鼻炎患者。对所有受试者进行了针对职业过敏原的皮肤点刺试验(SPT)和特异性激发试验,并测定了血清过敏原特异性IgE(as-IgE)。针对不同类型的过敏原(面粉、谷物、天然橡胶乳胶和棉花)评估了SPT和血清as-IgE的敏感性、特异性和预测值。
根据过敏原的不同,SPT的敏感性范围为22.2%至68.2%,特异性范围为74.1%至88.2%。SPT的阳性预测值范围为30%至68.2%,阴性预测值范围为74%至82.4%。as-IgE的敏感性评估为42.8%至83.3%,特异性为57.1%至81.5%。as-IgE的阳性预测值范围为35.7%至76.2%,阴性预测值范围为72.4%至92.3%。
结果表明,SPT和血清as-IgE测定均未显示出足够的敏感性和特异性以在职业性哮喘和鼻炎的诊断中起关键作用。敏感性、特异性和预测值因过敏原类型而异。在职业性哮喘和鼻炎的诊断过程中,应考虑进行特异性吸入激发试验以确诊。