Kajosaari M, Saarinen U M
Allergy. 1981 Jul;36(5):329-35. doi: 10.1111/j.1398-9995.1981.tb01584.x.
The diagnosis of atopic disease is often difficult in small children because of differences in symptoms and lack of specific and reliable laboratory tests. We evaluated the significance of four commonly used laboratory tests--blood eosinophil count, total serum IgE, and eosinophil and mast cells in the nasal smear--as indicators of atopy in 178 children aged 3 years. The children were followed from birth and examined at the age of 3 years. Symptoms of immediate hypersensitivity including atopic dermatitis, food allergy and pollen or animal allergy were recorded. Severe or obvious atopy correlated with the highest levels of serum IgE. A total serum IgE level higher than 150 U/ml was found to be strongly suggestive of atopic disease. A blood eosinophil count higher than 600 X 10(9)/l as well as an increased number of eosinophil and mast cells in the nasal smear were associated with atopy. On the other hand, normal levels of these laboratory tests did not exclude atopic disease. In other words, all of the tests were high in specificity, but low in sensitivity. Consequently, when small children's atopic disease is being diagnosed, emphasis can be laid on the elevated levels of serum total IgE, blood eosinophil count and eosinophil and mast cells in the nasal smear, all of which separately, but especially together, give valuable information on atopy.
由于症状存在差异且缺乏特异性和可靠的实验室检查，幼儿特应性疾病的诊断往往很困难。我们评估了四项常用实验室检查——血液嗜酸性粒细胞计数、血清总IgE以及鼻涂片嗜酸性粒细胞和肥大细胞——作为178名3岁儿童特应性指标的意义。这些儿童从出生起就进行随访，并在3岁时接受检查。记录了速发型超敏反应的症状，包括特应性皮炎、食物过敏以及花粉或动物过敏。严重或明显的特应性与血清IgE的最高水平相关。发现血清总IgE水平高于150 U/ml强烈提示特应性疾病。血液嗜酸性粒细胞计数高于600×10⁹/L以及鼻涂片中嗜酸性粒细胞和肥大细胞数量增加与特应性有关。另一方面，这些实验室检查结果正常并不能排除特应性疾病。换句话说，所有这些检查特异性高，但敏感性低。因此，在诊断幼儿特应性疾病时，可以重点关注血清总IgE水平升高、血液嗜酸性粒细胞计数以及鼻涂片中嗜酸性粒细胞和肥大细胞数量，所有这些单独来看，但尤其是综合起来，都能提供有关特应性的有价值信息。
