Montalvo A, Martín S, Mesa A, Cortés C, Rodríguez M, Laso M T
Sección de Alergología, Hospital de la Princesa, Madrid.
Allergol Immunopathol (Madr). 1996 Mar-Apr;24(2):58-64.
Skin Prick Test is considered the cutaneous test of choice in rutinary clinical practice as well as in research. In the last 15 years a large number of lancets for puncture test have been developed looking for a higher level of standardisation and reproducibility. We have compared three lancets, two of them, NeoAbelló (NA) and Dome/Hollister Stier (DHS), used in puncture test and a third one, Blood Lancet (BL), in the modified prick test. Twenty-two patients sensitised to Phleum pratense were tested with the three lancets at three extract concentrations and histamine 10 mg/mL in duplicate. We compared their wheal sizes by means of parallel line assay, their reproducibility, frequency of bleeding wheals, the disturbance for the patient and the correlation between specific IgE and skin response. Wheal size was similar for puncture tests (DHS and NA lancets) and significatively lower than BL, being necessary to increase 1.9 times the extract concentration when using DHS and NA lancets to achieve the same wheal size than when using BL lancets (p < 0.01). Reproducibility with histamine was similar with the three lancets while with the extract was somehow better with puncture tests but without statistical significance. Bleeding was significantly more frequent with BL although this did not influence the results. Less pain was obtained with BL. Finally, correlation with specific IgE was slightly significant for NA and very similar for the other two. With these results in mind we think that any of the three lancets is valid for the diagnostic of the allergic patient. Nevertheless, puncture tests are probably the most suitable at a research level.
皮肤点刺试验在常规临床实践以及研究中都被视为首选的皮肤试验。在过去15年里，为了实现更高水平的标准化和可重复性，已经研发出了大量用于点刺试验的采血针。我们比较了三种采血针，其中两种，即用于点刺试验的NeoAbelló（NA）和Dome/Hollister Stier（DHS），以及第三种用于改良点刺试验的采血针Blood Lancet（BL）。对22名对梯牧草过敏的患者，使用这三种采血针在三种提取物浓度下进行测试，并使用10mg/mL的组胺进行重复测试。我们通过平行线分析法比较了它们的风团大小、可重复性、出血风团的频率、对患者的干扰以及特异性IgE与皮肤反应之间的相关性。点刺试验（DHS和NA采血针）的风团大小相似，且明显低于BL采血针，当使用DHS和NA采血针时，提取物浓度需要提高1.9倍才能达到与使用BL采血针时相同的风团大小（p < 0.01）。三种采血针与组胺的可重复性相似，而与提取物的可重复性在点刺试验中稍好，但无统计学意义。BL采血针的出血频率明显更高，尽管这并不影响结果。使用BL采血针时患者疼痛感较轻。最后，NA与特异性IgE的相关性略有显著，其他两种则非常相似。基于这些结果，我们认为这三种采血针中的任何一种都可用于诊断过敏患者。然而，在研究层面，点刺试验可能是最合适的。
