风团长径是评价皮肤点刺试验的最佳检测指标
2010/02/23
背景：平均直径和长径是最常用的评价皮肤针刺试验（SPT）中风团反应的指标。本试验比较上述两项金标准指标与风团表面积在针刺试验中的作用。
患者与方法：对吸入过敏原产生可疑过敏反应的患者采用Pan-European GA(2)LEN SPT 进行皮肤针刺试验。15分钟后，用笔标记出肉眼观察风团和潮红反应，同时使用透明胶带将风团大小转到纸上。将上述标记扫描入电脑，采用图像识别软件测量最大垂直直径和长径。计算风团表面积与平均直径（rho平均）和长径（rho长径）的相关系数（Spearman’s rho），并进行比较。
结果：在74例患者中共进行1554次SPT。264次试验出现肉眼能观察的风团和潮红反应。平均直径和长径与风团表面积显著相关。但当风团表面积大于17 mm2时，rho长径显著大于rho平均（rho长径> 0.860 vs. rho平均< 0.660; P < 0.05）。且在该表面积下，最大直径约为7 mm，平均直径约为6 mm。因此，风团表面积越大时更适合采用长径。
结论：与平均直径相比，风团长径是风团表面积更好的替代标志物。而且，风团长径能更容易、更快被检测。因此，我们认为可采用风团长径作为评价SPT的理想指标。
（林江涛 审校）
Int Arch Allergy Immunol. 2009 Oct 22;151(4):343-345.
The Longest Wheal Diameter Is the Optimal Measurement for the Evaluation of Skin Prick Tests.
Konstantinou GN, Bousquet PJ, Zuberbier T, Papadopoulos NG.
Background: Mean diameter or longest diameter are the 2 most frequently used parameters for wheal response assessment after skin prick testing (SPT). We aimed to compare these 2 parameters taking as gold standard the surface of the wheal skin response.
Patients and Methods: Patients suspected of having an allergic reaction against inhalant allergens have been skin prick tested using the Pan-European GA(2)LEN SPT panel. Fifteen minutes later, macroscopically evident wheal and flare reactions were marked with a pen and transferred to paper with a transparent scotch tape. Each paper-transferred wheal was scanned with an ordinary scanner, and its surface-corresponding maximum perpendicular diameters and longest diameters were measured using a computer software application for image recognition, developed for this purpose. Correlation coefficients (Spearman’s rho) between surfaces and respective mean (rho(mean)) or longest (rho(longest)) diameters were calculated and subsequently compared.
Results: 1,554 SPTs were performed in 74 patients. In 264, a macroscopically evident wheal and flare response was observed. Both mean and longest diameters correlated significantly with the wheal surfaces. However, rho(longest) was statistically significantly larger than rho(mean) when the surface of the wheal was >17 mm(2) (rho(longest) > 0.860 vs. rho(mean) < 0.660; p < 0.05).Such a surface corresponds to a maximum diameter of approximately 7 mm and a mean diameter of approximately 6 mm. Thus, the larger the surface of the wheal, the more appropriate the usage of the longest diameter.
Conclusions: The longest wheal diameter alone seems to be a better surrogate marker of the wheal surface in comparison with the mean diameter. In addition, it is easier and faster to measure. Therefore, we propose this as the optimal methodology to evaluate SPTs.
Int Arch Allergy Immunol. 2009 Oct 22;151(4):343-345.
患者与方法：对吸入过敏原产生可疑过敏反应的患者采用Pan-European GA(2)LEN SPT 进行皮肤针刺试验。15分钟后，用笔标记出肉眼观察风团和潮红反应，同时使用透明胶带将风团大小转到纸上。将上述标记扫描入电脑，采用图像识别软件测量最大垂直直径和长径。计算风团表面积与平均直径（rho平均）和长径（rho长径）的相关系数（Spearman’s rho），并进行比较。
结果：在74例患者中共进行1554次SPT。264次试验出现肉眼能观察的风团和潮红反应。平均直径和长径与风团表面积显著相关。但当风团表面积大于17 mm2时，rho长径显著大于rho平均（rho长径> 0.860 vs. rho平均< 0.660; P < 0.05）。且在该表面积下，最大直径约为7 mm，平均直径约为6 mm。因此，风团表面积越大时更适合采用长径。
结论：与平均直径相比，风团长径是风团表面积更好的替代标志物。而且，风团长径能更容易、更快被检测。因此，我们认为可采用风团长径作为评价SPT的理想指标。
（林江涛 审校）
Int Arch Allergy Immunol. 2009 Oct 22;151(4):343-345.
The Longest Wheal Diameter Is the Optimal Measurement for the Evaluation of Skin Prick Tests.
Konstantinou GN, Bousquet PJ, Zuberbier T, Papadopoulos NG.
Background: Mean diameter or longest diameter are the 2 most frequently used parameters for wheal response assessment after skin prick testing (SPT). We aimed to compare these 2 parameters taking as gold standard the surface of the wheal skin response.
Patients and Methods: Patients suspected of having an allergic reaction against inhalant allergens have been skin prick tested using the Pan-European GA(2)LEN SPT panel. Fifteen minutes later, macroscopically evident wheal and flare reactions were marked with a pen and transferred to paper with a transparent scotch tape. Each paper-transferred wheal was scanned with an ordinary scanner, and its surface-corresponding maximum perpendicular diameters and longest diameters were measured using a computer software application for image recognition, developed for this purpose. Correlation coefficients (Spearman’s rho) between surfaces and respective mean (rho(mean)) or longest (rho(longest)) diameters were calculated and subsequently compared.
Results: 1,554 SPTs were performed in 74 patients. In 264, a macroscopically evident wheal and flare response was observed. Both mean and longest diameters correlated significantly with the wheal surfaces. However, rho(longest) was statistically significantly larger than rho(mean) when the surface of the wheal was >17 mm(2) (rho(longest) > 0.860 vs. rho(mean) < 0.660; p < 0.05).Such a surface corresponds to a maximum diameter of approximately 7 mm and a mean diameter of approximately 6 mm. Thus, the larger the surface of the wheal, the more appropriate the usage of the longest diameter.
Conclusions: The longest wheal diameter alone seems to be a better surrogate marker of the wheal surface in comparison with the mean diameter. In addition, it is easier and faster to measure. Therefore, we propose this as the optimal methodology to evaluate SPTs.
Int Arch Allergy Immunol. 2009 Oct 22;151(4):343-345.
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