Verstege A, Mehl A, Rolinck-Werninghaus C, Staden U, Nocon M, Beyer K, Niggemann B
Department of Pediatric Pneumology and Immunology, University Children's Hospital Charité of Humboldt University, Augustenburger Platz 1, 13353 Berlin, Germany.
Clin Exp Allergy. 2005 Sep;35(9):1220-6. doi: 10.1111/j.1365-2222.2005.2324.x.
The skin prick test (SPT) is regarded as an important diagnostic measure in the diagnostic work-up of food allergy. Objective To evaluate the diagnostic capacity of the SPT in predicting the outcome of oral food challenges, and to determine decision points for the weal size and the skin index (SI) that could render double-blind, placebo-controlled food challenges unnecessary.
In 385 children (median age 22 months), 735 controlled oral challenges were performed with cow's milk (CM), hen's egg (HE), wheat and soy. Three hundred and thirty-six of 385 (87%) children suffered from atopic dermatitis. SPT was performed in all children. Diagnostic capacity, receiver-operator characteristics (ROC) curves and predictive decision points were calculated for the mean weal size and the calculated SI.
Three hundred and twelve of 735 (43%) oral food challenges were assessed to be positive. Calculation of 95% and 99% predicted probabilities using logistic regression revealed predictive decision points of 13.0 and 17.8 mm for HE, and 12.5 and 17.3 mm for CM, respectively. However, using the SI, the corresponding cut-off levels were 2.6 and 3.7, respectively, for HE, and 2.7 and 3.7 for CM. For wheat, 95% and 99% decision points of 2.2 and 3.0 were found in children below 1 year of age.
Predictive decision points for a positive outcome of food challenges can be calculated for HE and CM using weal size and SI. They may help to avoid oral food challenges.
皮肤点刺试验（SPT）被视为食物过敏诊断检查中的一项重要诊断措施。目的：评估SPT预测口服食物激发试验结果的诊断能力，并确定风团大小和皮肤指数（SI）的判定点，以使双盲、安慰剂对照食物激发试验不再必要。
对385名儿童（中位年龄22个月）进行了735次针对牛奶（CM）、鸡蛋（HE）、小麦和大豆的对照口服激发试验。385名儿童中有336名（87%）患有特应性皮炎。对所有儿童均进行了SPT。计算了平均风团大小和计算得出的SI的诊断能力、受试者操作特征（ROC）曲线及预测判定点。
735次口服食物激发试验中有312次（43%）被评估为阳性。使用逻辑回归计算95%和99%的预测概率，得出HE的预测判定点分别为13.0和17.8毫米，CM的预测判定点分别为12.5和17.3毫米。然而，使用SI时，HE的相应临界值分别为2.6和3.7，CM的相应临界值分别为2.7和3.7。对于小麦，1岁以下儿童的95%和99%判定点分别为2.2和3.0。
使用风团大小和SI可计算出食物激发试验阳性结果的预测判定点。它们可能有助于避免口服食物激发试验。
