Hauk P, Otto J, Schwab K O, Kaufmehl K, Urbanek R, Eichler H G, Forster J
University Children's Hospitals, Freiburg, Germany.
Pediatr Res. 1995 Dec;38(6):998-1002. doi: 10.1203/00006450-199512000-00028.
To investigate the role of basal catecholamine levels and the response of the adrenergic system to expected bee stings, plasma catecholamines were measured before and 1 and 2 min after bee-sting challenges. Twenty-one children (aged 4-15 y) with bee-sting allergies were selected for sequential challenges to establish the need for venom immunotherapy. The time interval between the challenges varied from 2 to 6 wk. Epinephrine, norepinephrine, and dopamine plasma levels were measured using a simultaneous single-isotope radioenzymatic assay. On the first challenge, 33% of the children experienced a normal local reaction, 29% a large local reaction, and 38% a systemic reaction. On the second challenge in 18 out of 21 subjects, 67% experienced a normal normal local reaction, 22% a large local reaction, and 11% a systemic reaction. Epinephrine and norepinephrine plasma levels increased significantly on the first and second challenges. Dopamine plasma levels showed a significant increase on the first challenge only. Plasma catecholamine levels after the second challenge revealed a significant positive correlation between epinephrine increases measured 1 and 2 min after the challenge and the concomitant sting reaction. Basal epinephrine, norepinephrine, and dopamine plasma levels did not differ significantly between patients who experienced different types of sting reactions. Based on our data, we conclude that clinical reactions to in-hospital insect-sting challenges are not affected by early increases in plasma catecholamine levels produced by the expected stress situation.
为了研究基础儿茶酚胺水平以及肾上腺素能系统对预期蜂蜇的反应，在蜂蜇激发前、激发后1分钟和2分钟测量血浆儿茶酚胺水平。选择21名对蜂蜇过敏的儿童（4 - 15岁）进行序贯激发，以确定是否需要进行毒液免疫治疗。激发之间的时间间隔为2至6周。使用同时进行的单同位素放射酶法测量肾上腺素、去甲肾上腺素和多巴胺的血浆水平。在第一次激发时，33%的儿童出现正常局部反应，29%出现大的局部反应，38%出现全身反应。在21名受试者中的18名进行第二次激发时，67%出现正常局部反应，22%出现大的局部反应，11%出现全身反应。在第一次和第二次激发时，肾上腺素和去甲肾上腺素的血浆水平显著升高。多巴胺血浆水平仅在第一次激发时显著升高。第二次激发后的血浆儿茶酚胺水平显示，激发后1分钟和2分钟测量的肾上腺素升高与同时发生的蜇刺反应之间存在显著正相关。经历不同类型蜇刺反应的患者之间，基础肾上腺素、去甲肾上腺素和多巴胺的血浆水平无显著差异。根据我们的数据，我们得出结论，住院期间昆虫蜇刺激发的临床反应不受预期应激情况导致的血浆儿茶酚胺水平早期升高的影响。
