Quantitative skin prick and bronchial provocation tests with platinum salt.

Occupational asthma due to platinum salts is a frequent disease in platinum refineries. The diagnosis is based upon a history of work related symptoms and a positive skin prick test with platinum salts. Bronchial provocation tests have not been performed in epidemiological studies because the skin test is believed to be highly specific and sensitive. As no reliable data about this issue currently exist, this study assesses the use of skin prick and bronchial provocation tests with methacholine and platinum salt in platinum refinery workers. Twenty seven of 35 workers, who were referred to our clinic with work related symptoms and nine control subjects with bronchial hyperreactivity underwent a skin prick test and bronchial provocation with methacholine and platinum salt. For skin prick and bronchial provocation tests with platinum salt a 10(-2)-10(-8) mol/l hexachloroplatinic acid solution, in 10-fold dilutions was used. Four of the 27 subjects and all controls showed neither a bronchial reaction nor a skin reaction. Twenty three subjects were considered allergic to platinum salt; 22 of these showed a fall of 50% or more in specific airway conductance after inhalation of the platinum salt solution. Four workers experienced a positive bronchial reaction despite a negative skin prick test. No correlation of responsiveness to methacholine with responsiveness to platinum salt was found, but the skin prick test correlated with the bronchial reaction to platinum salt (rs = 0.50, p less than 0.023, n = 22). One dual reaction was seen in bronchial provocation tests. Side effects of both skin tests and bronchial provocation tests with platinum salt were rare and were not encountered in workers without a skin reaction to platinum salt. It is concluded that bronchial provocation tests with platinum salts should be performed on workers with work related symptoms but negative skin tests with platinum salts.     

Occupational type bronchial provocation tests: testing with soluble antigens by inhalation.

Thirty-seven patients with asthma or alveolitis thought to result from exposure to materials commonly encountered at their work were tested by inhalation of an aerosol of these materials. Twenty-four (65%) developed an immediate asthmatic reaction, which was followed by a non-immediate reaction in 10, of whom six developed the signs and symptoms of alveolitis. Eighteen (76%) patients with asthmatic reactions to test material were prick test positive to that material while only two our of 13 with a negative inhalation test were prick test positive (15%). Precipitating antibody to test material was measured in 23 and was present in nine (39%) of those with positive inhalation tests, and one (12%) of those with negative tests. It was present in five of the six with a reaction in the gas exchanging portions of the lung.     

湿疹婴儿食物过敏原检测及临床意义

【目的】 通过皮肤点刺试验(skin prick tests,SPT)对湿疹婴儿进行食物过敏原的检测,评价其临床意义。 【方法】 对170名4~12月湿疹婴儿进行六种食物过敏原的皮肤点刺试验,并根据阳性结果进行敏感食物回避8周,并对比食物回避前后的皮肤症状。 【结果】 170名湿疹婴儿中,118名(69.41%)SPT存在阳性结果,阳性食物依次为蛋清(42.35%)、蛋黄 (36.47%)、牛奶(27.06%)、带鱼(18.82%)、海虾(17.65%)、大豆(9.41%)。敏感食物回避8周后,90.68%的患儿皮肤症状缓解。 【结论】 湿疹婴儿多数存在食物过敏,敏感食物回避效果明显。SPT特异性高,方法简单,对湿疹患儿的食物过敏诊断和治疗意义重大。     

支气管激发试验在儿童哮喘管理中的应用

目的 探讨支气管激发试验(BPT)在儿童哮喘管理中的应用价值.方法 选择2018年5月至2019年10月,河北省儿童医院门诊就诊的临床缓解期,并达到良好控制水平至少1年的39例哮喘患儿为研究对象.根据患儿小气道功能,将其分为研究组(n=11,小气道功能下降)及对照组(n=28,小气道功能正常).回顾性分析2组患儿的临床...     

Skin sensitivity tests in Nigerians with bronchial asthma.

Skin sensitivity tests using the prick method were performed on 174 patients with bronchial asthma and 160 controls, using 20 common allergens. The results revealed a high incidence of positive skin test reactions to Dermatophagoides pteronyssinus, grass and flower pollens, feathers, and some ingesta such as cow's milk and fish. The difference in the reactions between the asthmatic patients and the controls was statistically significant. The results suggest that house-dust mite allergy is the most significant factor in the aetiology of bronchial asthma in Nigerians.     

支气管激发试验对青年人胸闷的鉴别价值

目的 探讨对青年人胸闷症状鉴别诊断的有效方法,减少误诊误治的发生.方法 对62例有不明原因胸闷症状的青年患者(青年组)行支气管激发试验检查,并与同期32例中老年不明原因胸闷患者(中老年组)进行对照比较.结果 青年组62例中47例支气管激发试验阳性,阳性率为75.8%,并根据临床特点及治疗反应均诊断为非典型哮喘;中老年组32例中16例支气管激发试验阳性,阳性率为50.0%,其中非典型哮喘15例(46.9%),两组支气管激发试验阳性率和非典型哮喘患病率比较差异均有统计学意义(P＜0.05或＜0.01).结论 有不明原因胸闷症状的青年患者应高度重视非典型哮喘的可能,支气管激发试验是确定其诊断的重要手段,具有较高的应用价值.     

过敏原皮肤点刺试验在小儿喘息性疾病中的应用

目的:探讨过敏原皮肤点刺试验在小儿喘息性疾病中的应用价值。方法:呼吸道感染患儿579例,其中喘息性疾病193例为病例组,非喘息性呼吸道感染386例为对照组,按年龄分为婴儿组(~1岁)、幼儿组(1~3岁)、学龄前组(3~6岁)和学龄组(6~14岁),进行皮肤过敏原点刺试验(SPT)。比较各组过敏原阳性率。结果:病例组总阳性率82.4%,对照组53.1%,病例组阳性率较对照组高,差异有统计学意义(P<0.01);病例组中各年龄段阳性率有差异,除婴儿组外,另3组阳性率随年龄增长而升高,差异有统计学意义(P<0.01);病例组各年龄段阳性程度不同,差异有统计学意义(P<0.01),3岁以下患儿弱阳性(+)为主,3岁以上阳性、强阳性(++、+++、++++)为主;病例组常见过敏原为粉尘螨和屋尘螨;吸入性过敏原SPT阳性率较食物性过敏原高,差异有统计学意义(P<0.01)。结论:喘息性疾病患儿SPT检测过敏原阳性率较非喘息患儿高;SPT可用于小儿喘息性疾病的病因诊断,对变态反应性疾病的早期诊断和早期防治起到一定的作用。     

从化地区哮喘患儿变应原皮肤点刺试验的临床研究

【目的】 了解从化地区支气管哮喘发病相关的主要致敏变应原及其特点,指导选择特异性免疫治疗对象。 【方法】 对382 例支气管哮喘缓解期患儿,用德国默克公司生产的阿罗格食入组及吸入组点刺试剂进行皮肤点刺试验,组胺液为阳性对照,生理盐水为阴性对照。 【结果】 哮喘患儿皮肤点刺试验阳性率为 88.5%。吸入变应原总阳性率为81.2%,吸入变应原中以粉尘螨和屋尘螨阳性率居高,分别为77.2%和71.2%;食入变应原总阳性率为32.7%,居前两位的为小虾19.9%,花生6.3%。在吸入变应原中高龄组与低龄组比较差异有统计学意义(P<0.05),食入变应原中高龄组与低龄组比较差异无统计学意义(P>0.05)。哮喘或哮喘并鼻炎患儿均以螨类过敏最常见,两组间螨类、霉菌类、动物皮毛类、蟑螂及杂草变应原阳性率差异均无统计学意义。 【结论】 从化地区支气管哮喘患儿发病相关的吸入变应原主要是粉尘螨、屋尘螨,食入变应原主要是小虾、花生。3~14岁儿童哮喘患儿随着年龄增长,对吸入性变应原更为敏感。哮喘与哮喘并鼻炎患者共同的变应原主要是螨类,其次为霉菌类、动物皮毛类,为哮喘的防治提供了指导作用。     

儿童食物皮肤点刺试验结果分析与过敏控制

目的:分析皮肤点刺试验(skin prick test,SPT)阳性结果,指导家长在喂养过程中控制由食物引起的过敏反应。方法:随机收集2009年6月～2010年10月在南京市妇幼保健院儿保门诊接受健康体检的6个月～2岁儿童195例(排除各种急性期疾病及中、重度湿疹),进行牛奶、鸡蛋、鱼、虾、小麦5种常见食物的SPT,对其阳性结果进行分析。结果:轻微湿疹儿童对食物过敏的有50.75%,正常儿童对食物过敏的有11.47%,轻微湿疹患儿食物过敏发生率高于正常儿童,两者有显著差异(P<0.05)。不同食物过敏原阳性率在各月龄组儿童均表现为鸡蛋>虾>鱼>牛奶>小麦,且随着年龄增长食物过敏阳性率有降低趋势。结论:食物过敏在儿童中发生率较高,尤其是患有轻微湿疹的儿童,根据儿童过敏的特点,应早期避免接触食物过敏原,在辅食添加的过程中逐一添加、循序渐进,从而有效控制食物过敏的发生。     

花粉症皮肤点刺试验和血清特异性IgE检测的对比分析

目的 对比分析皮肤点刺试验（skin prick test, SPT）和血清特异性IgE(specific IgE,sIgE)检测在花粉症中的诊断特性。方法 收集内蒙古毕克齐花粉症高发人群中376例受试者行SPT和血清sIgE检测,采集蒿属样本并鉴定物种,SPSS 22.0统计分析。结果 花粉症患病率32.78%（376/1147）,SPT总阳性率43.62%,血清slgE检测总阳性率58.78%,其中艾蒿阳性率最高（分别41.75%和48.67%）;蒿种鉴定样本与Artemisia lavandulifolia、Artemisia sieversiana、Artemisia annua、Artemisia argyi和Artemisia scoparia的相似性分别为99.74%、99.79%、100%、99.30%和100%;在诊断艾蒿过敏中SPT和血清sIgE检测有较好一致性（Kappa=0.754,P＜0.001）,诊断葎草、豚草、蟑螂和尘螨过敏中一致性较差（分别Kappa=0.093,0.239,0.102和0.315,P＜0.05）;诊断艾蒿花粉症的敏感性、特异性、阳性预测值、阴性预测值、Youden指数,SPT分别为86.6%、96.1%、94.9%、89.5%和82.7%,血清slgE检测分别为94.8%、90.2%、89.1%、95.3%和85.0%,差异有统计学意义（P＜0.05）。结论 SPT和血清sIgE检测在诊断艾蒿花粉症中具有较好一致性,血清sIgE检测的敏感性、阴性预测值及Youden指数高,诊断价值大于SPT。