摘要
目的对IgE介导的食物过敏的诊断流程进行临床评价,探讨高效的食物过敏诊断程序。方法0～6岁患儿88例,以支气管哮喘、过敏性鼻炎、特应性皮炎以及消化道症状为主要临床表现,进行食物过敏原皮肤点刺试验(skinpricktest,SPT),皮肤试验阳性者检测血清特异性IgE(sIgE)、sIgE阳性者进一步进行双盲安慰剂食物激发试验(doubleblindplacebocontrolfoodchallenge,DBPCFC)证实诊断,sIgE阴性者通过DBPCFC建立或排除诊断。结果88例患儿中SPT(+)者25例,其中SPT(+)sIgE(+)者16例,SPT(+)sIgE(-)者9例;前者经DBPCFC进一步证实为食物过敏的有14例;后者通过DBPCFC建立诊断的3例,排除诊断的6例,根据SPT(+)sIgE(+)或SPT(+)sIgE(-)诊断食物过敏的阳性预计值为87.5%,阴性预计值为77.8%。结论皮肤点刺试验结合sIgE检测有较高的食物过敏确诊率,当前两者不一致时,需要通过DBPCFC建立诊断。
Objectives To evaluate the diagnostic procedures of IgE mediated food allergy. Methods Eightyeight children aged 0 - 6 years suffered from asthma, rhinitis, atopic dermatitis or digestive symptoms were involved in this study. Postive cases were screened by fresh food skin prick-to-prick test first （SPT）, followed by vitro specific IgE （sIgE） determination and double-blind placebo-control food challenge （DBPCFC） tests for confirmation. Resuits SPT （＋） were found in 25 cases. Further sIgE detection within these 25 cases showed 16 sIgE （＋） and 9 sIgE （-） cases. Double-blind placebo-control food challenge were performed to confirm the cases of SPT （＋） sIgE （＋）, and found 14 cases were positive, DBPCFC were performed as well for those 9 SPT （＋） sIgE （-） cases, and 6 cases were excluded for food allergy diagnosis. Hence, the positive and negative predictive value of food allergy diagnosis accordingtoSPT （＋） sIgE （＋） or SPT （＋） sIgE （-） were 87.5 % and 77.8 % , respectively. Conclusions Skin prick tests combined with in vitro sIgE detecting would improve the efficacy of food allergy diagnosis procedures. However, if in vivo and in vitro results were conflicted, DBPCFC should be performed.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2007年第1期23-25,共3页
Journal of Clinical Pediatrics
关键词
IGE
食物过敏
诊断
临床评价
IgE
food allergy
diagnosis
clinical evaluation
