屋尘螨变应原结膜激发试验在上下气道变态反应性疾病的临床比较

目的比较在上、下气道变态反应性疾病患者中屋尘螨变应原结膜激发试验（CPT）结果的差异,为在下气道变态反应性疾病诊断中屋尘螨变应原结膜激发试验的临床应用提供依据。方法选择2006至2008年在我科就诊的符合变应性鼻炎、结膜炎和（或）支气管哮喘诊断的患者178例,分为3组：单纯支气管哮喘组45例、支气管哮喘＋变应性鼻炎和（或）结膜炎组50例、变应性鼻炎和（或）结膜炎组83例。所有入选者均进行屋尘螨变应原结膜激发试验,采用北京协和医院眼结膜激发试验评估标准分别记录,同时进行屋尘螨变应原皮肤点刺试验（SPY）以及血清屋尘螨变应原特异性免疫球蛋白E（d1-sIgE）检测。结果3组随着皮肤点刺试验“＋”的递增,屋尘螨变应原结膜激发试验结果＋＋＋以上患者比例逐渐增加,差异无统计学意义（P〉0．05）。结论屋尘螨变应原结膜激发试验不受变应性疾病累及器官的影响,在不伴上气道变态反应性疾病的下气道变态反应性疾病的诊断中亦存在一定的诊断价值。

Clinical application of conjunctival provocation tests with Dermatophagoides pteronyssinus in 178 patients with alergic disorders

Objective To provide application basis in clinic for allergen conjunctival provocation tests （CPT） with Dermatophagoides pteronyssinus （ Der p） in diagonosis of lower airway allergy diseases by comparing the results between upper and lower airways. Methods One hundred and seventy-eight allergic outpatientes were observed. The patientes were divided into three groups ： simple bronchial asthma group （ n = 45 ）, asthma with allergic rhino-conjunctivitis group （ n = 50） and allergic rhino-conjunctivitis group （ n = 83 ）. All the patientes received CPT with Der p and their scores according to their disease extent were recorded. Skin prick tests （SPT） and serum specific immunoglobulin E （d1 - sIgE） determinations were performed at the same time. Results The larger the SPT wheal, the more positive CPT cases. There was no significant diffrence among the three groups （ P 〉 0. 05）. Conclusion Allergen conjunctival provocation test with Dermatophagoides pteronyssinus （Der p） is a useful method in the diagnosis of upper and lower airway allergy diaeases.