户尘螨皮试液诊断户尘螨过敏的临床价值

目的评价户尘螨皮试液用于诊断户尘螨过敏的有效性和安全性。方法 选择2009年2月10日至2009年7月10日在北京协和医院变态反应科就诊并已完成户尘螨过敏原皮内试验和户尘螨过敏原血清特异性IgE检测的患者。登记检测结果并由变态反应专科医生做出临床综合特异性诊断。分别以临床综合特异性诊断和UniCap sIgE诊断为金标准,分析户尘螨皮试液进行皮内试验的有效性。登记入组当天由变态反应专科医生询问患者在完成皮内试验之后是否出现不良反应并记录,从而对户尘螨皮试液的临床应用做出安全性评价。结果以临床综合特异性诊断为金标准,以皮试结果≥＂＋＂为诊断界值时,户尘螨变应原皮试液用于皮内试验的灵敏度为0.9633、特异度为0.6208,阳性预测值为0.7448、阴性预测值为0.9365、准确度为0.8039。以UniCap sIgE诊断为金标准,以皮内试验结果≥＂＋＂为诊断界值时,户尘螨变应原皮试液用于皮内试验的灵敏度为0.9781、特异度为0.5120、阳性预测值为0.8369、阴性预测值为0.9014、准确度为0.8472。与户尘螨皮试液可能有关的皮内试验发生的不良反应有7例,占总人数的0.67%。结论户尘螨皮试液具有良好的有效性和安全性,可通过皮内试验用于户尘螨过敏的特异性诊断。

Clinical Value of Dermatophagoides pterronyssinus Extract for the Diagnosis Dermatophagoides pterronyssinus Allergy

Objective To evaluate the effectiveness and safety of Dermatophagoides pterronyssinus（Der p） extract in the diagnosis of Der p allergy.Methods Patients who consulted in Department of Allergy,Peking Union Medical College Hospital from 2009 February 10th to 2009 July 10th were selected and then were prescribed intradermal skin test（IDT） by Der p extract.Der p sIgE detection（UniCAP,Phadia AB） was detected in all patients.All the data were collected and the clinical diagnosis was made by allergists based on illness history,IDT and sIgE results.Clinical diagnosis and UniCAP sIgE detection were established as gold standard respectively in order to analyze the effectiveness of Der p extract in IDT.The adverse reaction data were collected and recorded after IDT to evaluated the safty of Der p extract in IDT by doctors.Results When using clinical diagnosis as gold standard and the skin test results ≥ ＂＋＂ as the threshold value,of Der p extract in IDT was sensitivity（0.9633）,specificity（0.6208）,positive predictive value（0.7448）,negative predictive value（0.9365） and efficiency（0.8039）,respectively.When using UniCAP sIgE detection as gold standard and the skin test results ≥ ＂＋＂ as the threshold value,of Der p extract in IDT was sensitivity（0.9781）,specificity（0.5120）,positive predictive value（0.8369）,negative predictive value（0.9014） and efficiency（0.8472） respectively.Side effect in IDT were shown in 7 cases,the percentage is 0.67%.Conclusion Der p extract was shown good effectiveness and safety in specific diagnosis of Der p allergy by using IDT.