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尘螨相关过敏性疾病:皮肤点刺试验、特应性斑贴试验和 RAST 在诊断不同过敏表现中的作用。

House dust mite-related allergic diseases: role of skin prick test, atopy patch test, and RAST in the diagnosis of different manifestations of allergy.

机构信息

Paediatric Allergy Service, ASL FG, 9/A, Via Aspromonte, San Severo, Foggia, Italy.

出版信息

Eur J Pediatr. 2010 Jul;169(7):819-24. doi: 10.1007/s00431-009-1118-6. Epub 2009 Dec 8.

Abstract

The atopy patch test (APT) was recently defined as an important tool in diagnosis of atopic dermatitis (AD) and also of rhinitis and asthma caused by hypersensitivity to the house dust mites. We evaluated 465 children (279 males and 186 females) aged 0.4-17.6 years (mean 6.6 +/- 3.8 years), by dividing them into four groups: group A, current AD (40 patients); group B, current AD with respiratory symptoms (156 patients); group C, past AD with respiratory symptoms (203 patients); and the control group, respiratory symptoms with no history of AD (66 patients). The APT was significantly more frequently positive in groups with current AD (groups A and B) or past AD (group C) than in the control group, while skin prick test (SPT) and radioallergosorbent test (RAST) were significantly more frequently positive in the control group. With multivariate analysis, for APT, significant differences were found in the comparison between group A vs group B (odds ratio (OR) 1.55) and between group A vs group C (OR 1.81). The mean age was significantly lower in group A than in groups B, C, and the control group and with less significance in groups C vs D. Children sensitized to mites with current or past AD, with or without respiratory symptoms, have a different response to diagnostic tests, which is characterized by a highly significantly more frequent positive APT in comparison with subjects who have respiratory symptoms but a negative history for AD, who show the common response to SPT and RAST.

摘要

特应性斑贴试验(APT)最近被定义为诊断特应性皮炎(AD)以及由尘螨过敏引起的鼻炎和哮喘的重要工具。我们评估了 465 名 0.4-17.6 岁(平均 6.6 +/- 3.8 岁)的儿童,将他们分为四组:A 组,当前 AD(40 例);B 组,当前 AD 伴有呼吸道症状(156 例);C 组,过去有呼吸道症状的 AD(203 例);对照组,无 AD 病史但有呼吸道症状(66 例)。当前 AD(A 组和 B 组)或过去 AD(C 组)的 APT 明显比对照组更常呈阳性,而皮肤点刺试验(SPT)和放射过敏原吸附试验(RAST)在对照组中明显更常呈阳性。多变量分析显示,对于 APT,A 组与 B 组(优势比(OR)1.55)和 A 组与 C 组(OR 1.81)之间的比较存在显著差异。A 组的平均年龄明显低于 B、C 组和对照组,C 组与对照组之间的差异较小。当前或过去有 AD 且有或无呼吸道症状的螨致敏儿童对诊断测试有不同的反应,其特征是 APT 明显比有呼吸道症状但 AD 病史阴性的患者更常呈阳性,后者对 SPT 和 RAST 有共同的反应。

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