越南南部慢性呼吸道疾病患者尘螨致敏筛查的皮肤点刺试验评估

Evaluation of skin prick test to screen dust mite sensitization in chronic respiratory diseases in Southern Vietnam.

作者信息

Chu Ha Thi, Godin Isabelle, Phương Nguyễn Thanh, Nguyen Lan Huu, Hiep Tran Thi Mong, Xuan Ngo Minh, Corazza Francis, Michel Olivier

机构信息

Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam.

School of Public Health, Université Libre de Bruxelles - ULB, Brussels, Belgium.

出版信息

Asia Pac Allergy. 2018 Oct 23;8(4):e39. doi: 10.5415/apallergy.2018.8.e39. eCollection 2018 Oct.

DOI:10.5415/apallergy.2018.8.e39

PMID:30402406

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6209603/

Abstract

BACKGROUND

In the view of the epidemic growth of sensitization to indoor allergens in Southern Vietnam, there is a requirement to screen large population.

OBJECTIVE

To evaluate skin prick tests (SPTs) as predictors of positive specific IgE (sIgE) to dust allergens, among patients with chronic respiratory diseases (CRDs).

METHODS

The sensitization to (Blo t), (Der p), and allergens (Bla g) were evaluated among 610 CRD, both SPT (≥4 mm) and sIgE by immuno-CAP (≥0.7 kU/L).

RESULTS

Based on sIgE, 45%, 32%, and 33% of patients with CRD were sensitized to Blo t, Der p, and Bla g, respectively, compared to 19%, 18%, and 13% by SPT. The association between SPT and sIgE was statistically significant, though the Kappa factor was fair (i.e., 0.39 to 0.23). While the specificity of SPT to detect sensitization (compared to sIgE) was >90% among the whole population, the sensitivity was only 34%, 41%, and 24% for Bo t, Der p, and Bla g, suggesting that SPT was not enough sensitive to screen the indoor allergen sensitization. Though, among the <10 pack-year (PY) smokers, the sensitivity was 43% for Blo t, 52% for Der p, and 61% for Blo t and/or Der p, compared to 27%, 30%, and 35% among the ≥10 PY smokers. The sensitivity/specificity was not associated with the diagnosis of asthma compared to chronic obstructive pulmonary disease.

CONCLUSION

In the present circumstance, SPT to dust mites allergens can be used to detect a sensitization among CRD population in Southern Vietnam.

摘要

背景

鉴于越南南部对室内过敏原致敏情况呈流行增长态势，有必要对大量人群进行筛查。

目的

评估皮肤点刺试验（SPT）作为慢性呼吸道疾病（CRD）患者对粉尘过敏原特异性IgE（sIgE）阳性预测指标的价值。

方法

对610例CRD患者进行了对屋尘螨（Blo t）、粉尘螨（Der p）和德国小蠊过敏原（Bla g）的致敏评估，采用皮肤点刺试验（≥4 mm）和免疫CAP法检测sIgE（≥0.7 kU/L）。

结果

基于sIgE，分别有45%、32%和33%的CRD患者对Blo t、Der p和Bla g致敏，而皮肤点刺试验的相应比例分别为19%、18%和13%。皮肤点刺试验与sIgE之间的关联具有统计学意义，尽管kappa系数一般（即0.39至0.23）。虽然在整个人群中，皮肤点刺试验检测致敏（与sIgE相比）的特异性>90%，但对Blo t、Der p和Bla g的敏感性仅分别为34%、41%和24%，这表明皮肤点刺试验对筛查室内过敏原致敏不够敏感。不过，在吸烟量<10包年（PY）的吸烟者中，对Blo t的敏感性为43%，对Der p为52%，对Blo t和/或Der p为61%，而在吸烟量≥10 PY的吸烟者中相应比例分别为27%、30%和35%。与慢性阻塞性肺疾病相比，敏感性/特异性与哮喘的诊断无关。