Eiken P A, Biering I, Mosbech H
Medicinsk afdeling B, Hillerød Sygehus.
Ugeskr Laeger. 1993 May 31;155(22):1712-5.
Thirty-six Danish bee-keepers were clinically investigated by means of a questionnaire before and after the bee season 1990. Their serum was assayed for IgE and IgG antibody reacting with bee venom, and skin prick tests were performed prior to the season. Thirty-six percent had previously reacted abnormally, either with a systemic reaction (SR) (25%) or a large local reaction (LLR) (11%). Retrospectively, eight of the nine bee-keepers with SR had upon re-exposure developed a normal reaction, in spite of the fact that seven of them had specific IgE and/or a positive prick test at subsequent examination. At follow up 38% of the persons who had previously had a SR reacted with a SR or a LLR on the first sting in the season. Two of eight with previous SR reacted with SR during the observation period in spite of a negative prick test and no specific IgE. Of the bee-keepers who had previously only reacted normally there were no systemic of large localised reactions during the observed period, although six showed signs of IgE-sensitization. The results confirm the problems of identifying patients where immunotherapy is superfluous in the group with previous SR and IgE sensitization.
1990年蜜蜂季节前后，通过问卷调查对36名丹麦养蜂人进行了临床调查。检测他们血清中与蜂毒反应的IgE和IgG抗体，并在季节开始前进行皮肤点刺试验。36%的人之前有过异常反应，包括全身反应（SR）（25%）或大的局部反应（LLR）（11%）。回顾性分析发现，9名有全身反应的养蜂人中，有8人再次接触蜂毒后出现了正常反应，尽管其中7人在后续检查中有特异性IgE和/或点刺试验阳性。随访时，之前有过全身反应的人中，38%在季节中的首次蜇刺时出现了全身反应或大的局部反应。8名之前有全身反应的人中，有2人在观察期内尽管点刺试验阴性且无特异性IgE，但仍出现了全身反应。在之前仅反应正常的养蜂人中，观察期内没有出现全身或大的局部反应，尽管有6人显示出IgE致敏迹象。结果证实了在之前有全身反应和IgE致敏的人群中识别出免疫治疗多余的患者存在问题。
