Adinoff A D, Rosloniec D M, McCall L L, Nelson H S
Department of Pediatrics, National Jewish Center for Immunology and Respiratory Medicine, University of Colorado Health Sciences Center, Denver 80206.
J Allergy Clin Immunol. 1989 Aug;84(2):168-74. doi: 10.1016/0091-6749(89)90321-7.
Six devices commonly used for immediate hypersensitivity epicutaneous skin testing were compared with regard to precision and diagnostic accuracy. Fifteen subjects were tested on the back to 10 mg/ml of histamine phosphate and 50% glycerosaline by prick technique with a smallpox needle (SN), bifurcated needle (BN), Greer "pen" (GP), and blood lancet, and by puncture with the Morrow-Brown needle (MB) and Multi-Test (MT). Five devices were tested in quintuplicate to histamine and once to glycerosaline in each subject; with MT, five histamine and three glycerosaline sites were used. Analysis of the wheal areas obtained with SN, BN, GP, and MB demonstrated comparable degrees of precision (coefficient of variation). The precision of MT was less than the other devices (p less than 0.05). The blood lancet demonstrated intermediate precision. Twenty-two of 45 (49%) of the glycerosaline skin tests performed with MT were falsely positive, significantly more than the other devices (p = 0.0001). We conclude that MB, BN, GP, and SP are comparable devices for use in immediate hypersensitivity skin testing. The low precision and reliability of MT used for testing on the back would appear to make this device less than adequate for diagnostic or research studies. Its high rate of false positive reactions requires caution in interpretation of results when it is used in the clinical diagnosis of allergy.
对常用于速发型超敏反应皮内皮肤试验的六种设备的精度和诊断准确性进行了比较。采用痘苗针（SN）、分叉针（BN）、格里尔“笔”（GP）和采血针，通过点刺技术，以及采用莫罗-布朗针（MB）和多重试验（MT）进行穿刺，在15名受试者的背部对10mg/ml磷酸组胺和50%甘油盐水进行测试。对每种设备在每名受试者身上对组胺进行五次重复测试，对甘油盐水进行一次测试；对于MT，使用五个组胺部位和三个甘油盐水部位。对用SN、BN、GP和MB获得的风团面积分析显示精度（变异系数）程度相当。MT的精度低于其他设备（p<0.05）。采血针显示出中等精度。用MT进行的45次甘油盐水皮肤试验中有22次（49%）为假阳性，显著多于其他设备（p = 0.0001）。我们得出结论，MB、BN、GP和SP是用于速发型超敏反应皮肤试验的可比设备。用于背部测试的MT精度低且可靠性差，这似乎使得该设备不太适合用于诊断或研究。当将其用于过敏的临床诊断时，其高假阳性反应率需要在结果解释时谨慎对待。
