CAJ | 학술논문

目的：通过对特异性IgE与开放性食物激发试验的相关性研究，获得具有确诊食物过敏价值的特异性IgE界值点，为简化临床诊断程序提供依据。方法选择徐州市妇幼保健院可疑食物过敏儿童289例，通过进行皮肤点刺试验、特异性I gE的测定及开放性食物激发试验确诊食物过敏患儿。应用SPSS 13.0软件包分析特异性I gE的敏感度、特异度、阳性预测值、阴性预测值；通过受试者工作特征曲线的曲线下面积评价特异性IgE对食物过敏的诊断价值，并获得特异性I gE的100%诊断界值点。结果蛋白、蛋黄、牛奶皮肤点刺试验的受试者工作特征曲线的曲线下面积分别为0.810、0.807及0.819。当蛋白、蛋黄、牛奶特异性IgE分别≥8.5 kU/L、3.5 kU/L、5.0 kU/L时，特异性I gE对食物过敏的诊断准确率可达100%。结论特异性IgE对食物过敏的临床诊断准确性较好，通过其100%诊断界值点，可避免部分可疑食物过敏患儿进行食物激发试验。
목적：통과대특이성IgE여개방성식물격발시험적상관성연구，획득구유학진식물과민개치적특이성IgE계치점，위간화림상진단정서제공의거。방법선택서주시부유보건원가의식물과민인동289례，통과진행피부점자시험、특이성I gE적측정급개방성식물격발시험학진식물과민환인。응용SPSS 13.0연건포분석특이성I gE적민감도、특이도、양성예측치、음성예측치；통과수시자공작특정곡선적곡선하면적평개특이성IgE대식물과민적진단개치，병획득특이성I gE적100%진단계치점。결과단백、단황、우내피부점자시험적수시자공작특정곡선적곡선하면적분별위0.810、0.807급0.819。당단백、단황、우내특이성IgE분별≥8.5 kU/L、3.5 kU/L、5.0 kU/L시，특이성I gE대식물과민적진단준학솔가체100%。결론특이성IgE대식물과민적림상진단준학성교호，통과기100%진단계치점，가피면부분가의식물과민환인진행식물격발시험。
Objective Serum food-specific IgE is the most common used parameter after skin prick test. We aimed to investigate the diagnostic capacity of serum food-specific IgE according to the outcome of oral food challenge, and to determine the cut-off points that could render food challenges unnecessary. Methods 289 children referred to the Maternal and Child Health of Xuzhou for the evaluation of suspected food allergy were prospectively studied. Children underwent skin prick test, serum food-specific IgE and open food challenge to the relevant food (s) in clinic. Diagnostic capacity (sensitivity, specificity, positive predictive value and negative predictive value), area under curves (AUC) of the receiver operator characteristics (ROC) and predictive decision points were calculated by SPSS 13.0 package for the serum food-specific IgE. Results In 250 children, 160 skin prick test were performed with egg white, egg yolk and cow milk. The AUC of serum food-specific IgE was 0.810 for egg white, 0.807 for egg yolk and 0.819 for cow’s milk. We also defined serum food-specific IgE that were 100%diagnostic for allergy to egg white (≥8.5 kU/L), egg yolk (≥3.5 kU/L), cow milk (≥5.0 kU/L). Conclusion Predictive decision points for a positive outcome of food challenges can be calculated for egg and cow’s milk using mean diameter. It may help to simplify the diagnostic procedure of food allergy.