评估血清特异性 IgE 对多过敏原过敏性鼻炎的诊断价值。

Evaluation of serum specific IgE for the diagnosis of allergic rhinitis with multi-allergens.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

出版信息

Chin Med J (Engl). 2010 Oct;123(20):2836-41.

PMID:21034593

Abstract

BACKGROUND

Objective evaluation of allergic rhinitis (AR) requires in vivo and in vitro tests. In vitro tests are important to assist or ensure the main allergens in multi-allergen-sensitive patients. The aim of this study was to evaluate the utility of serum specific IgE (sIgE) in the diagnosis of AR patients with multi-allergens in the Chinese population.

METHODS

Combining a positive skin prick test (SPT) and clinical history as the diagnostic reference criteria of AR, we estimated concentrations of sIgE produced in response to the 7 most frequent allergens among 85 AR patients, using the UniCAP assay system.

RESULTS

Among 85 individuals with positive SPT results and allergen-specific nasal symptoms, sIgE concentration correlated well with SPT classes among all the tested allergens. Based on a clinical diagnosis and SPT results using a positive cut-off value of a class 1 score, the CAP test performed well and the sensitivity for different allergens ranged from 0.5 (giant ragweed) to 0.91 (Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f), while specificity ranged from 0.93 (Der f) to 1.0 (animal hair, Der p and mugwort). When the cut-off score was adjusted to class 2, the sensitivity showed an increase overall while the remaining assessed items, including specificity, positive predictive value, negative predictive value and efficiency, showed an unacceptable decline.

CONCLUSIONS

Well-established serum sIgE tests correlated well with SPTs. Setting a class 1 cut-off for positivity of SPT results was better than a class 2 setting for assessing the AR diagnostic value.

摘要

背景

过敏性鼻炎（AR）的客观评估需要进行体内和体外检测。体外检测对于辅助或确定多过敏原敏感患者的主要过敏原非常重要。本研究旨在评估血清特异性 IgE（sIgE）在诊断中国人群多过敏原敏感 AR 患者中的效用。

方法

我们将皮试（SPT）阳性和临床病史结合作为 AR 的诊断参考标准，使用 UniCAP 检测系统评估 85 例 AR 患者对 7 种最常见过敏原的 sIgE 浓度。

结果

在 85 名 SPT 阳性且具有过敏原特异性鼻部症状的个体中，所有检测的过敏原中，sIgE 浓度与 SPT 等级密切相关。基于临床诊断和 SPT 结果，使用 1 级评分的阳性截断值，CAP 检测表现良好，不同过敏原的敏感性范围为 0.5（豚草）至 0.91（屋尘螨[Der p]和粉尘螨[Der f]），而特异性范围为 0.93（粉尘螨[Der f]）至 1.0（动物毛发、屋尘螨[Der p]和艾蒿）。当将截断值调整为 2 级时，整体敏感性增加，而特异性、阳性预测值、阴性预测值和效率等其余评估项目则显示出不可接受的下降。