美国新一代总 IgE 参考区间：一项回顾性真实世界分析。
Next-generation reference interval for total IgE in the United States: A retrospective real-world analysis.
机构信息
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Key Laboratory of Children's Important Organ Development and Diseases of Chongqing Municipal Health Commission, Chongqing, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Key Laboratory of Children's Important Organ Development and Diseases of Chongqing Municipal Health Commission, Chongqing, China.
出版信息
Clin Chim Acta. 2024 Sep 15;563:119895. doi: 10.1016/j.cca.2024.119895. Epub 2024 Jul 27.
OBJECTIVE
To establish a next-generation reference interval (RI) for total IgE (tIgE) and evaluate its usefulness.
METHODS
A new allergen-specific IgE (sIgE)-based tIgE RI, including a continuous RI in children, was established using the NHANES 2005-2006 project. The usefulness of the RI was evaluated by sensitivity (Sen), specificity (Spec), positive predictive value (PPV), negative predictive value (NPV), κ coefficient and consistency.
RESULTS
The new tIgE RI showed better performance in identifying allergic sensitization (Sen 0.53, Spec 0.90, PPV 0.83, NPV 0.68, κ 0.44, consistency 0.72) than allergic diseases (Sen 0.37, Spec 0.75, PPV 0.55, NPV 0.60, κ 0.13, consistency 0.59). The 2014 U.S. tIgE RI was more effective in identifying allergic diseases (consistency 0.63 vs. 0.54, P<0.001) but less accurate in identifying allergic sensitization (consistency 0.59 vs. 0.67, P<0.001) in children than in adults. The new RI improved the accuracy of identifying allergic sensitization in children to a level similar to that in adults (consistency 0.72 vs 0.73, P=0.37) and maintained its advantage in identifying allergic diseases in children (consistency 0.64 vs 0.55, P<0.001).
CONCLUSIONS
The established next-generation tIgE RI is useful for identifying allergic sensitization, especially in children.
目的
建立新一代总 IgE（tIgE）参考区间（RI）并评估其有用性。
方法
使用 NHANES 2005-2006 项目，建立了一种新的基于过敏原特异性 IgE（sIgE）的 tIgE RI，包括儿童连续 RI。通过敏感性（Sen）、特异性（Spec）、阳性预测值（PPV）、阴性预测值（NPV）、κ 系数和一致性来评估 RI 的有用性。
结果
新的 tIgE RI 在识别过敏致敏方面表现出更好的性能（Sen 0.53，Spec 0.90，PPV 0.83，NPV 0.68，κ 0.44，一致性 0.72），而不是过敏疾病（Sen 0.37，Spec 0.75，PPV 0.55，NPV 0.60，κ 0.13，一致性 0.59）。2014 年美国 tIgE RI 在识别过敏疾病方面更有效（一致性 0.63 与 0.54 相比，P<0.001），但在识别过敏致敏方面准确性较低（一致性 0.59 与 0.67 相比，P<0.001），儿童与成人相比。新 RI 提高了儿童识别过敏致敏的准确性，达到与成人相似的水平（一致性 0.72 与 0.73 相比，P=0.37），并保持了在儿童中识别过敏疾病的优势（一致性 0.64 与 0.55 相比，P<0.001）。
结论
建立的新一代 tIgE RI 可用于识别过敏致敏，尤其是在儿童中。
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