Koshibu T, Kishida M, Suzuki I, Nagayama T, Kabayama H, Saito Y, Aoki T, Iikura Y
Department of Pediatrics, Ohashi Hospital, Toho University.
Arerugi. 1997 Dec;46(12):1227-34.
To investigate the new criteria for skin prick test (SPT) of seventy-four atopic infants (2-5 months of age at the first visit, Mean 3.8 months, M:F = 54:20) to diagnose for hypersensitivity to egg white. It was classified into three groups by reaction type of SPT in the first visit. Group A were the infants who seemed only late (6 hours) or delayed (48 hours) reaction (n = 26). Group B were seemed immediate (15 minutes) and late or delayed reactions (n = 26), Group C were seemed only immediate reaction (n = 23). Atopic infants and controlled infants without no symptom but have any atopic disease a relative in the third degree, agreed to undergo SPT in the first visit, the prior were undergo 9-12 months of age, too. Serum total IgE (RIST), serum specific IgE antibody of egg white (EWRAST) and peripheral eosinophil counts in the blood (Eo. counts) were determined at the same time of SPT in atopic infants. The best criterion for SPT was the longest diameter of a erythema were greater than 3 mm at late and/or delayed reaction (Sensitivity: 100%, Specificity: 60%) in group A. Two third of infants in group. A were seemed immediate reaction and EWRAST levels were increased to larger than gread two at 9-12 months (p < 0.001). RIST levels and Eo. counts at the first visit were increased compared with the normal levels in the all groups, the prior and EWRAST levels in group B were higher than group A or C (p < 0.05, p < 0.05). RIST and EWRAST levels in group A at 9-12 months were higher than the first visit (p < 0.05, p < 0.01). In conclusion, SPT in atopic early infants were seemed several reactions at the first visit, but all reactions were useful for diagnose for hypersensitivity to egg white.
为研究74例特应性婴儿(首次就诊时年龄为2 - 5个月,平均3.8个月,男:女 = 54:20)皮肤点刺试验(SPT)诊断蛋清过敏的新标准。首次就诊时根据SPT反应类型将其分为三组。A组为仅出现迟发(6小时)或延迟(48小时)反应的婴儿(n = 26)。B组为出现即刻(15分钟)以及迟发或延迟反应的婴儿(n = 26),C组为仅出现即刻反应的婴儿(n = 23)。特应性婴儿以及无任何症状但有三级亲属患特应性疾病的对照婴儿,同意在首次就诊时接受SPT,之前也在9 - 12个月龄时接受过检查。在特应性婴儿进行SPT的同时测定血清总IgE(RIST)、蛋清特异性IgE抗体(EWRAST)以及外周血嗜酸性粒细胞计数(嗜酸性粒细胞计数)。A组中SPT的最佳标准是迟发和/或延迟反应时红斑最长直径大于3 mm(敏感性:100%,特异性:60%)。A组中有三分之二的婴儿出现即刻反应,且9 - 12个月时EWRAST水平升高至大于2级(p < 0.001)。所有组首次就诊时RIST水平和嗜酸性粒细胞计数均高于正常水平,B组之前的RIST水平和EWRAST水平高于A组或C组(p < 0.05,p < 0.05)。A组9 - 12个月时的RIST和EWRAST水平高于首次就诊时(p < 0.05,p < 0.01)。总之,特应性早期婴儿首次就诊时SPT似乎出现多种反应,但所有反应均有助于诊断蛋清过敏。