皮肤点刺试验和改良挑刺试验对比研究

目的对皮肤点刺试验和改良挑刺试验进行方法学对比,为临床应用提供数据。方法用磷酸组织胺和生理盐水（normalsaline,NS）点刺液同时进行皮肤点刺和改良挑刺试验,观察2种皮肤试验方法的安全性、可重复性及疼痛程度,并评价皮肤划痕征对皮肤反应性的影响。结果 2种方法均较安全,所致疼痛程度大致相当,可重复性均较高。皮肤划痕征阳性组和阴性组的组胺平均风团直径差异无统计学意义,改良挑刺法划痕征阳性组vs阴性组：（8.91±1.26）mmvs（8.83±1.58）mm,P=0.80;点刺法划痕征阳性组vs阴性组：（8.11±1.23）mmvs（7.59±1.56）mm,P=0.11。在皮肤划痕征阴性组,NS点刺和改良挑刺试验的平均风团直径分别为（2.29±1.17）mm和（1.50±0.68）mm,P=0.02;皮肤反应指数分别为0.25±0.11和0.17±0.07,虽差异有显著性,但两者均可判断为阴性。在皮肤划痕征阳性组,NS点刺试验平均风团直径大于改良挑刺试验（4.21±1.38）mmvs（2.29±1.17）mm,P〈0.001;NS点刺试验的反应指数（SI）明显高于改良挑刺试验0.52±0.16vs0.25±0.11,P〈0.001。结论用组织胺和NS进行皮肤点刺试验和挑刺试验安全性和重复度较高,两者疼痛程度大致相当,皮肤划痕征阳性者用改良挑刺试验的风团反应低于皮肤点刺试验。

Comparative Study of Methodology between Skin Prick Test and Modified-puncture Test

Objective To compare the methodology of skin prick test with a modified-puncture test and prickle-puncture test.Methods Skin prick test and prickle-puncture test of normal saline（NS） and histamine were performed at same time.Skin reactivity,as well as the severity of pain caused by the tests was recorded and compared between the two kinds of skin test method.The reproducibility and the safety of the tests were evaluated,and influence of dermatographia on skin reactivity was also assessed.Results Both kinds of skin test were safe without inducing systemic reaction.There was no significant difference between the severities of pain caused by the two kinds of skin test method.The reproducibility was high in both kinds of method.There was no significant difference between the average diameter of wheals induced by histamine in dermatagraphia group and non-dermatagraphia group（prickle-puncture test in dermatographia group vs non-dermatographa group：（8.91±1.26）mm vs（8.83±1.58）mm,P0.05;prick test in dermatographia group vs non-dermatographa group：（8.11±1.23） vs（7.59±1.56）mm,P0.05.In dermatographia group,average diameter of wheals of NS prick test is larger than that of prickle-puncture test（4.21±1.38）mm vs（2.29±1.17）mm,P0.05.Skin index of NS prick test is significantly higher than that of prickle-puncture test（0.52±0.16） vs（0.25±0.11）,P0.001.Although significant difference of NS skin index could be observed between two kinds of skin test method in non-dermatographa group（prick test 0.25±0.11 vs prickle-puncture test：（0.17±0.07）,P0.001,but both were diagnosed as negative.Conclusions Both skin prick and prickle-puncture test are safe and reproducible.The severities of pain are equivalent between the two kinds of skin test method.The average diameter of wheals of prick test is higher than that of prickle-puncture test in dermatographia group.