Segalen C, Hiéblot C, Claquin C, Lavigne F, Benveniste J
Ann Fr Anesth Reanim. 1986;5(4):356-60. doi: 10.1016/s0750-7658(86)80004-1.
The human basophil degranulation test (HBDT) studies the allergic response of effector cells. In this work, it was used in the diagnosis of anaphylactoid reactions during anaesthesia. Thirteen patients having had an anaphylactoid shock during general anaesthesia were investigated. An HBDT was performed with every suspected drug used during the anaesthesia. Ten patients had a positive HBDT and in five cases the drug involved was suxamethonium. In one case, the IgE-dependency of the accident was asserted by the ability of the plasma to sensitize in vitro alien basophils. These sensitized basophils degranulated in the presence of Althesin and suxamethonium. Passive sensitization was abolished when using plasma heated for 2 h at 56 degrees C. Two patients had a negative HBDT to 11 drugs tested. To assess the validity of these results, and to rule out unspecific degranulation, thirteen control patients who were to undergo general anaesthesia were investigated. HBDT was performed immediately before anaesthesia in a double-blind method with every drug to be used during the anaesthesia. The twelve patients who had a negative HBDT to every drug had an uneventful anaesthesia. One patient had a positive test to thiopentone and displayed bronchospasm and generalized urticaria during the anaesthesia. In conclusion, the HBDT appears to be a reliable test in the diagnosis of anaphylactoid reactions during anaesthesia.
人类嗜碱性粒细胞脱颗粒试验（HBDT）用于研究效应细胞的过敏反应。在本研究中，该试验被用于麻醉期间类过敏反应的诊断。对13例在全身麻醉期间发生类过敏性休克的患者进行了调查。对麻醉期间使用的每种可疑药物都进行了HBDT试验。10例患者HBDT试验呈阳性，其中5例涉及的药物为琥珀胆碱。在1例中，通过血浆在体外使异体嗜碱性粒细胞致敏的能力确定了该意外事件与IgE的相关性。这些致敏的嗜碱性粒细胞在阿耳忒辛和琥珀胆碱存在的情况下发生脱颗粒。当使用在56℃加热2小时的血浆时，被动致敏作用消失。2例患者对11种测试药物的HBDT试验呈阴性。为了评估这些结果的有效性并排除非特异性脱颗粒，对13例拟接受全身麻醉的对照患者进行了调查。在麻醉前采用双盲法对麻醉期间使用的每种药物进行HBDT试验。12例对每种药物HBDT试验均为阴性的患者麻醉过程顺利。1例患者对硫喷妥钠试验呈阳性，在麻醉期间出现支气管痉挛和全身性荨麻疹。总之，HBDT似乎是诊断麻醉期间类过敏反应的一项可靠试验。
