蒿属花粉症的变应原致敏特征及皮肤点刺试验的诊断价值研究

王晓艳; 兰天飞; 孔瑞; 陈艳蕾; 王学艳

doi:10.13201/j.issn.1001-1781.2018.24.004

蒿属花粉症的变应原致敏特征及皮肤点刺试验的诊断价值研究

- 首都医科大学附属北京世纪坛医院变态反应科(北京, 100038)
基金项目:
北京市医管局科研培育计划 (No:PX2017020)

北京市医管局2018年度第四批青苗计划 (No:QML20180702)

北京市医管局扬帆计划 (No:ZYLX201826)

北京市科委首都特色重点课题 (No:Z16110000516006)

详细信息

通讯作者: 王学艳, E-mail:allergy2015@126.com

中图分类号: R765.21

收稿日期: 2018-08-25

The sensitization feature of artemisia allergy and the diagnosis value of skin prick test

- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China

More Information

Corresponding author: WANG Xueyan, E-mail: allergy2015@126.com

Received Date: 25 August 2018

摘要

摘要: 目的: 探讨蒿属花粉的致敏特点以及蒿属花粉皮肤点刺试验(SPT)和血清特异性IgE(sIgE)在疾病诊断中的价值。方法: 将151例夏秋季节鼻结膜炎患者纳入研究,记录其一般临床信息。所有患者均行SPT和血清sIgE抗体检测。以sIgE为参考标准,分析SPT的准确度、灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)、Kappa系数及Youden指数。通过受试者工作曲线(ROC曲线)计算其曲线下面积。结果: 151例患者中,89例sIgE艾蒿阳性,占58.9%。艾蒿sIgE重度患者占阳性人群的59.6%。SPT阳性106例(70.2%),其中SPT 3级占84.0%。艾蒿sIgE级别和大籽蒿SPT级别呈高度正相关(r=0.714,P<0.01)。当SPT 1级时,SPT诊断蒿属花粉症灵敏度为98.9%,NPV为97.8%。当SPT 2级时,SPT筛选蒿属花粉的准确度最高(89.4%),此时灵敏度为97.8%,特异度为77.4%,NPV为96.0%,Kappa系数和Youden指数均为最大值。SPT诊断蒿属花粉症的ROC曲线下面积为0.886(95%CI 0.822~0.949,P<0.01)。结论: 蒿属花粉症多出现重度致敏,SPT与sIgE级别高度相关,SPT 1级时灵敏度高,SPT 2级时对蒿属花粉症的筛查能力最强。
- 艾蒿 /
- 皮肤点刺试验 /
- sIgE /
- 受试者工作特征曲线
Abstract: Objective: The purpose of this study was to explore the sensitization feature of artemisia allergy and to assess the diagnostic value of skin prick test(SPT) compared with specific IgE(sIgE) test. Method: One hundred and fifty-one patients with typical rhino-conjunctivitis symptoms during pollen season were enrolled and general information was recorded in this study. All subjects received SPT and sIgE test of artemisia allergen. The accuracy rate, sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), Kappa index and Youden index of SPT for diagnosing artemisia allergy was analyzed. Receiver operating characteristic curve(ROC curve) and the area under the curve was calculated. Result: Among 151 patients, 89(58.9%) was sIgE positive while severe type was 59.6% in positive group. 106(70.2%) was SPT positive while 84.0% was SPT level 3. SPT level was positively associated with sIgE level(r=0.714, P<0.01). While considering SPT level 1 as positive, the sensitivity of SPT diagnosing artemisia allergy was 98.9% and the NPV was 97.8%. While considering SPT level 2 as positive, the accuracy rate of SPT was highest(89.4%) with sensitivity of 97.8%, specificity of 77.4% and NPV of 96.0%. The Kappa index and Youden index was the highest at SPT level 2 compared with other SPT level. The area under the curve was 0.886(95%CI 0.822-0.949, P<0.01).Conclusion: Artemisia allergy tends to be severe type. Strong correlation exists between SPT and sIgE tests of artemisia. SPT level 1 has the highest sensitivity while SPT level 2 has the strongest screening ability of artemisia allergy.
- artemisia /
- skin prick test /
- specific IgE /
- receiver operating characteristic curve

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