皮试与 CAP 系统检测吸入性变应原血清免疫球蛋白 E 的比较。
Comparison between skin prick test and serum immunoglobulin E by CAP system to inhalant allergens.
机构信息
Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
出版信息
Ann Allergy Asthma Immunol. 2017 May;118(5):608-613. doi: 10.1016/j.anai.2017.03.005.
BACKGROUND
Skin prick tests (SPTs) and measurements of serum specific immunoglobulin E (sIgE) antibodies are the most commonly used diagnostic tools for confirming sensitization. However, disagreement between the tests has been observed.
OBJECTIVE
To compare SPT and the CAP system for diagnosis of sensitization to common inhalant allergens.
METHODS
Subjects included 2,635 patients 10 to 90 years old who underwent analyses by SPT and CAP at the Dong-A University Hospital (Busan, Korea) from June 2011 through May 2016. The 2 test results were compared for 17 inhalant allergens.
RESULTS
Agreement between the SPT and sIgE level was 75.3%. Overall agreement was moderate (κ = 0.59), with strong agreement for house dust mites and birch (κ > 0.7) and weak agreement for Tyrophagus putrescentiae and dog (κ < 0.3). When CAP was compared with SPT as the reference, the sensitivity was 75.8% and the specificity was 75.2%. Mean wheal size by SPT showed a positive correlation with sIgE levels (r = 0.59), which decreased with age.
CONCLUSION
There was a discrepancy between SPT and CAP for diagnosing allergic sensitization among inhalant allergens. The allergic sensitization and correlation between the tests decreased with age. Cautious interpretation of the clinical relevance of allergen sensitization based on SPT and CAP results is required, especially in older patients.
背景
皮肤点刺试验（SPT）和血清特异性免疫球蛋白 E（sIgE）抗体测量是确认致敏最常用的诊断工具。然而，测试之间存在分歧。
目的
比较 SPT 和 CAP 系统对常见吸入性过敏原致敏的诊断。
方法
2011 年 6 月至 2016 年 5 月，在韩国釜山的东亚大学医院，对 2635 名 10 至 90 岁的患者进行 SPT 和 CAP 分析。将这两种测试结果针对 17 种吸入性过敏原进行比较。
结果
SPT 和 sIgE 水平之间的一致性为 75.3%。总体一致性为中度（κ=0.59），屋尘螨和桦树具有较强的一致性（κ>0.7），而腐食酪螨和狗具有较弱的一致性（κ<0.3）。当 CAP 与 SPT 作为参考进行比较时，灵敏度为 75.8%，特异性为 75.2%。SPT 的平均风团大小与 sIgE 水平呈正相关（r=0.59），并随年龄下降。
结论
SPT 和 CAP 诊断吸入性过敏原致敏存在差异。过敏致敏和测试之间的相关性随年龄下降。需要谨慎解释 SPT 和 CAP 结果的临床相关性，尤其是在老年患者中。
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