Wang X Y, Lan T F, Kong R, Chen Y L, Wang X Y
Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Dec;32(24):1860-1864. doi: 10.13201/j.issn.1001-1781.2018.24.004.
The purpose of this study was to explore the sensitization feature of artemisia allergy and to assess the diagnostic value of skin prick test(SPT) compared with specific IgE(sIgE) test. One hundred and fifty-one patients with typical rhino-conjunctivitis symptoms during pollen season were enrolled and general information was recorded in this study. All subjects received SPT and sIgE test of artemisia allergen. The accuracy rate, sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), Kappa index and Youden index of SPT for diagnosing artemisia allergy was analyzed. Receiver operating characteristic curve(ROC curve) and the area under the curve was calculated. Among 151 patients, 89(58.9%) was sIgE positive while severe type was 59.6% in positive group. 106(70.2%) was SPT positive while 84.0% was SPT level 3. SPT level was positively associated with sIgE level(=0.714, <0.01). While considering SPT level 1 as positive, the sensitivity of SPT diagnosing artemisia allergy was 98.9% and the NPV was 97.8%. While considering SPT level 2 as positive, the accuracy rate of SPT was highest(89.4%) with sensitivity of 97.8%, specificity of 77.4% and NPV of 96.0%. The Kappa index and Youden index was the highest at SPT level 2 compared with other SPT level. The area under the curve was 0.886(95% 0.822-0.949, <0.01). Artemisia allergy tends to be severe type. Strong correlation exists between SPT and sIgE tests of artemisia. SPT level 1 has the highest sensitivity while SPT level 2 has the strongest screening ability of artemisia allergy.
本研究旨在探讨蒿属过敏的致敏特征,并评估皮肤点刺试验(SPT)与特异性IgE(sIgE)检测相比的诊断价值。本研究纳入了151例在花粉季节出现典型鼻结膜炎症状的患者,并记录了其一般信息。所有受试者均接受了蒿属过敏原的SPT和sIgE检测。分析了SPT诊断蒿属过敏的准确率、敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)、Kappa指数和Youden指数。计算了受试者工作特征曲线(ROC曲线)及曲线下面积。151例患者中,89例(58.9%)sIgE阳性,阳性组中重度类型占59.6%。106例(70.2%)SPT阳性,其中84.0%为SPT 3级。SPT级别与sIgE水平呈正相关(r = 0.714,P < 0.01)。将SPT 1级视为阳性时,SPT诊断蒿属过敏的敏感性为98.9%,NPV为97.8%。将SPT 2级视为阳性时,SPT的准确率最高(89.4%),敏感性为97.8%,特异性为77.4%,NPV为96.0%。与其他SPT级别相比,SPT 2级的Kappa指数和Youden指数最高。曲线下面积为0.886(95%CI 0.822 - 0.949,P < 0.01)。蒿属过敏倾向于重度类型。蒿属的SPT与sIgE检测之间存在强相关性。SPT 1级敏感性最高,而SPT 2级对蒿属过敏的筛查能力最强。