摘要
目的 以荧光酶联免疫法的Immuno CAP系统为标准方法,探讨免疫印迹法的Allergy Screen系统的检验效能及在不同系统疾病诊疗中的临床应用价值。方法 收集2017年至2022年就诊于首都医科大学附属北京儿童医院过敏反应科的过敏原致敏患者血清样本4 525份,根据疾病类型分为呼吸系统疾病组、消化系统疾病组、多系统疾病组和其他系统疾病组。采用Allergy Screen系统检测血清中的户尘螨、粉尘螨、烟曲霉、猫毛、狗毛、豚草、艾蒿、葎草、鸡蛋、牛奶、蟹、虾过敏原sIgE。对Allergy Screen系统的检验效能、可靠性、级别一致性和不同疾病系统组的应用进行评价。结果 在检验效能上,Allergy Screen系统猫毛过敏原灵敏度最高为0.75,特异性为0.95。其次为蟹过敏原,灵敏度为0.57,特异性为0.89。Allergy Screen法检测各过敏原的Kappa值在0.122~0.866之间。豚草一致性好,Kappa值为0.866。Allergy Screen系统的Spearman相关分析结果显示,对粉尘螨、艾蒿、猫毛等级相关性均>0.7,关系非常紧密。其中粉尘螨相关性最佳,为0.757。Allergy Screen系统检测不同过敏原中,总体一致率为65.6%~90.3%,阴性符合率一致率为81.5%~97.9%,阳性一致率为9.1%~70.5%。在不同系统疾病组间检验效能比较,特异性在各系统组间差异无统计学意义。结论 Allergy Screen系统具有较高的诊断效能,适用于临床过敏原筛查检测。
Objective To evaluate the diagnostic efficiency of Allergy Screen system and its clinical application value in different systematic disease types,when compared to ImmunoCAP system.Methods A total of 4525 serum samples were collected from allergic patients in the Department of Allergy,Beijing Children’s Hospital Affiliated to Capital Medical University from 2017 to 2022.According to clinical diagnosis,four groups were divided among these patients:respiratory system disease group,digestive system disease group,multi-system disease group and other system disease group.Aeroallergen and food allergen were measured by Allergy Screen system,including mites(Dermatophagoides pteronyssinus and Dermatophagoides farinae),fungus(Aspergillus fumigatus),animal dander(cat dander and dog dander),pollen(ragweed,mugwort,Japanese hop)and food allergen(egg,milk,crab and shrimp).The efficiency,reliability and consistency were compared between the Allergy Screen system and ImmunoCAP system in different groups.Results In Allergy Screen system,cat dander(0.75)showed the highest sensitivity,followed by crab allergen(0.57),while their specificity were 0.95 and 0.89,respectively.The kappa values of allergens detected by Allergy Screen method were between 0.122 and 0.866,among which ragweed showed a good consistency(kappa value=0.866).The Spearman correlation analysis results of Allergy Screen system showed that the rank correlation of dust mite,mugwort and cat dander was>0.7,suggesting a close relationship.Among them,Dust mites showed the best correlation(0.757).The overall concordance rate of Allergy Screen for different allergens was 65.6%-90.3%,while the negative concordance rate and positive concordance rate were 81.5%-97.9%and 9.1%-70.5%,respectively.There was no significant difference in specificity between different groups.Conclusion Allergy Screen system has a high diagnostic performance and is suitable for clinical allergen screening tests.
作者
张旭东
向莉
李启亮
李珍
任亦欣
王燕
ZHANG Xudong;XIANG Li;LI Qiliang;LI Zhen;REN Yixin;WANG Yan(Department of Allergy,National Clinical Research Center for Respiratory Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045 China;Department of Clinical Laboratory Center,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)
出处
《标记免疫分析与临床》
CAS
2024年第1期151-156,175,共7页
Labeled Immunoassays and Clinical Medicine
基金
基于互联网医疗的儿童哮喘管理体系的建设(编号:YGLZ2022001)
基于口服激发试验评价变应原组分诊断在牛奶过敏诊断中的应用价值(编号:BCRW20210-17)。
