Jung Y G, Kim K H, Kim H Y, Dhong H J, Chung S K
Department of Otorhinolaryngology - Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, Republic of Korea.
J Int Med Res. 2011;39(6):2209-16. doi: 10.1177/147323001103900617.
This study identified cut-off values for allergy markers for use in the diagnosis of allergic rhinitis in the absence of other allergic diseases. Total immunoglobulin E (IgE), eosinophil cationic protein (ECP) and the numbers of eosinophils were measured in serum samples from 442 patients with typical symptoms of allergic rhinitis. A definite diagnosis was made on the basis of the presence of specific IgE levels. Cut-off values with a maximal discrimination to diagnose allergic rhinitis were found to be 98.7 IU/ml, 24.7 μg/ml and 4.0% for total IgE, ECP and eosinophils, respectively. Sensitivity, specificity and odds ratio for these values were 75.2%, 69.7% and 6.93, respectively, for total IgE, 55.7%, 74.4% and 3.70 for ECP, and 57.5%, 72.0% and 3.47 for eosinophils. A composite score representing positive results for all three markers had a positive predictive value of 85.3%, with an odds ratio of 8.55. It was concluded that total serum IgE, ECP and eosinophil percentage are strong predictors of allergic rhinitis and the determination of cut-off values for these markers can aid in the diagnosis of allergic rhinitis in the clinical setting.
本研究确定了在无其他过敏性疾病情况下用于诊断变应性鼻炎的过敏标志物临界值。对442例有典型变应性鼻炎症状患者的血清样本检测了总免疫球蛋白E（IgE）、嗜酸性粒细胞阳离子蛋白（ECP）和嗜酸性粒细胞数量。根据特异性IgE水平进行明确诊断。发现诊断变应性鼻炎的具有最大鉴别力的临界值分别为：总IgE为98.7 IU/ml、ECP为24.7 μg/ml、嗜酸性粒细胞为4.0%。这些值的敏感性、特异性和比值比分别为：总IgE为75.2%、69.7%和6.93；ECP为55.7%、74.4%和3.70；嗜酸性粒细胞为57.5%、72.0%和3.47。代表所有三种标志物阳性结果的综合评分的阳性预测值为85.3%，比值比为8.55。得出结论：血清总IgE、ECP和嗜酸性粒细胞百分比是变应性鼻炎的有力预测指标，确定这些标志物的临界值有助于临床诊断变应性鼻炎。
