Brown R, Bancewicz J, Hamid J, Patel N J, Ward C A, Farrand R J, Pumphrey R S, Irving M
Br Med J (Clin Res Ed). 1982 Mar 20;284(6319):851-3. doi: 10.1136/bmj.284.6319.851.
Delayed hypersensitivity skin reactions to a battery of recall antigens, haemoglobin and albumin concentrations, arm-muscle circumference, and percentage of ideal weight were determined before operation in 244 patients undergoing elective major surgery. Depressed skin reactions were found in 70 patients (28%), but this group did not have significantly higher sepsis or mortality rates when compared with patients with normal reactions. Significant associations were found between depressed skin reactions and increasing age, anaemia, hypoalbuminaemia, low arm-muscle circumference, and low weight. Patients with benign and malignant disease had similar distributions of skin reactions. Hypoalbuminaemia was associated with a higher rate of serious postoperative sepsis, and hypoalbuminaemia, low arm-muscle circumference, and low weight were all associated with a higher mortality. These results suggest that the routine use of delayed hypersensitivity skin testing in the preoperative assessment of surgical patients is not justified.
对244例接受择期大手术的患者在术前测定了其对一系列回忆抗原的迟发型超敏皮肤反应、血红蛋白和白蛋白浓度、上臂肌肉周长以及理想体重百分比。70例患者（28%）出现皮肤反应低下，但与反应正常的患者相比，该组患者的败血症或死亡率并未显著升高。皮肤反应低下与年龄增加、贫血、低白蛋白血症、上臂肌肉周长减小和体重降低之间存在显著关联。良性和恶性疾病患者的皮肤反应分布相似。低白蛋白血症与术后严重败血症的发生率较高相关，低白蛋白血症、上臂肌肉周长减小和体重降低均与较高的死亡率相关。这些结果表明，在手术患者的术前评估中常规使用迟发型超敏皮肤试验是不合理的。
