Tian Man, Zhou Ying, Zhang Wenxin, Cui Yubao
Allergy Asthma Proc. 2017 Sep 1;38(5):333-342. doi: 10.2500/aap.2017.38.4073.
A clinical history of allergic symptoms and a skin-prick test with house-dust mite crude extracts are standard diagnostic procedures for Dermatophagoides pteronyssinus allergy. Specific immunoglobulin E (IgE) responses to Der p 1 and Der p 2 allergens have been used for the diagnosis of D. pteronyssinus allergy; however, evaluation of the diagnostic performance of Der p 1 and Der p 2 specific IgE (sIgE) produced inconsistent findings. We sought to evaluate the diagnostic accuracy of Der p 1 sIgE and Der p 2 sIgE measurement in the diagnosis of D. pteronyssinus allergy by performing a systematic review and meta-analysis of previously published studies.
Several medical literature electronic data bases were searched for related literature published through August 1, 2016. A bivariate model was used to pool estimates of sensitivity, specificity, diagnostic odds ratio, and area under the summary receiver operating curves as the main diagnostic measures.
Eight studies, which involved 1095 patients, were included in our analysis. The pooled estimates of sensitivity, specificity, and diagnostic odds ratio for Der p 1 were 0.84, 0.97, and 166.57, respectively. The combined results for Der p 2 were a sensitivity of 0.87, specificity of 1.00, and a diagnostic odds ratio of 17342.35. The areas under the summary receiver operating curves for Der p 1 sIgE and Der p 2 sIgE were 0.94 and 0.98, respectively.
Our results supported the use of Der p 1 and Der p 2 sIgE in the diagnosis of D. pteronyssinus allergy. Both displayed good diagnostic performance and would be useful in a clinical setting in the accurate diagnosis of dust mite allergy.
过敏症状的临床病史以及用屋尘螨粗提物进行皮肤点刺试验是诊断尘螨过敏的标准诊断程序。对Der p 1和Der p 2变应原的特异性免疫球蛋白E（IgE）反应已用于诊断尘螨过敏；然而，对Der p 1和Der p 2特异性IgE（sIgE）诊断性能的评估结果并不一致。我们试图通过对先前发表的研究进行系统评价和荟萃分析，来评估Der p 1 sIgE和Der p 2 sIgE检测在诊断尘螨过敏中的诊断准确性。
检索了多个医学文献电子数据库，以查找截至2016年8月1日发表的相关文献。采用双变量模型汇总敏感性、特异性、诊断比值比以及汇总接受者操作特征曲线下面积的估计值，作为主要诊断指标。
我们的分析纳入了8项研究，涉及1095例患者。Der p 1的敏感性、特异性和诊断比值比的汇总估计值分别为0.84、0.97和166.57。Der p 2的综合结果为敏感性0.87、特异性1.00和诊断比值比17342.35。Der p 1 sIgE和Der p 2 sIgE的汇总接受者操作特征曲线下面积分别为0.94和0.98。
我们的结果支持使用Der p 1和Der p 2 sIgE诊断尘螨过敏。二者均显示出良好的诊断性能，在临床环境中对准确诊断尘螨过敏很有用。
