目的评价1岁以下食物过敏(FA)婴儿皮肤点刺试验(SPT)疹团平均直径(MD)的诊断意义。方法 2012年5月至9月选择中山市博爱医院儿科及儿保科门诊可疑FA婴儿[平均月龄(7.35±2.94)个月]91例为研究对象,进行家族史询问、SPT及开放性食物激发试验(OFC),测量并记录SPT疹团MD及阳性对照疹团MD。以OFC为金标准,计算SPT疹团MD诊断FA的敏感度、特异度,通过受试者工作特征曲线(ROC)及曲线下面积对其诊断价值进行评价,获取确诊FA的SPT疹团MD临界值,同时计算SPT与OFC符合率,并对不同家族史患儿的上述指标分别进行计算,所有数据均采用SPSS13.0软件包进行统计学分析。结果 91例婴儿共进行128例次OFC,其中OFC阳性109例次、阴性19例次;共79例(86.8%)婴幼儿被确诊为FA。OFC诱发症状主要表现为皮肤症状(70.6%),其次是胃肠道症状(20.2%),其余表现为哭闹、咳嗽、揉眼睛等(9.2%)。当SPT疹团MD≥3mm时,SPT诊断牛奶、蛋黄、蛋白过敏的灵敏度分别为19.0%、60.6%、60.5%;牛奶、蛋黄、蛋白SPT疹团MD的ROC曲线下面积分别为0.718、0.604及0.716;3种食物SPT检测结果与OFC符合率分别为44.4%、53.7%、65.9%,家族史阳性符合率分别为62.5%、58.3%、31.3%;家族史阴性时SPT疹团MD的ROC曲线下面积为0.793;家族史阳性时SPT疹团MD的ROC曲线下面积为0.533。当牛奶、蛋黄、蛋白SPT疹团MD分别≥2.2、5.0、4.7mm或家族史阴性患儿SPT疹团MD≥3.25mm时,SPT对FA诊断特异度可达100%。结论 SPT对诊断FA有一定价值。SPT确诊FA的临界值及与家族史相关性综合分析可提高FA诊断率,避免部分可疑FA婴儿进行OFC,对临床快速诊断FA、减轻患儿及其家庭的风险和负担有重要意义。 Objective To evaluate the diagnostic significance of rash mass mean diameter (MD) in children under 1 year of age with food allergy (FA) prick test (SPT). Methods A total of 91 suspicious FA infants (mean age 7.37 ± 2.94 months) from Pediatrics and Pediatrics department of Pok Oi Hospital of Zhongshan City from May to September 2012 were enrolled in this study. Family history, SPT and open food challenge Test (OFC), measure and record SPR rash group MD and positive control rash group MD. Using OFC as the gold standard, the sensitivity and specificity of FA in diagnosing FA were calculated, and the diagnostic value was evaluated by the receiver operating characteristic curve (ROC) and the area under the curve. Value, at the same time calculate the SPT and OFC coincidence rate, and children with different family history of the above indicators were calculated, all data were used SPSS13.0 software package for statistical analysis. Results A total of 128 cases of OFC were performed in 91 infants. OFC was positive in 109 cases and negative in 19 cases. A total of 79 infants (86.8%) were diagnosed with FA. OFC-induced symptoms were mainly skin symptoms (70.6%), followed by gastrointestinal symptoms (20.2%), and the rest were crying, coughing and rubbing eyes (9.2%). The sensitivity of SPT in diagnosing milk, egg yolk and protein allergy was 19.0%, 60.6% and 60.5%, respectively. The area under the ROC curve of milk, egg yolk and protein SPR rash group was 0.718,0.604 and 0.716. The coincidence rates of SPT test and OFC were 44.4%, 53.7% and 65.9% respectively, and the positive coincidence rates of family history were 62.5%, 58.3% and 31.3% respectively. The ROC curve of SPR rash group with negative familial history The area under the ROC curve was 0.793. The area under the ROC curve of SPR rash group MD with family history positive was 0.533. When the milk, egg yolk, protein SPT rash MD ≥ 2.2,5.0,4.7 mm or family history negative children with SPR rash group MD ≥ 3.25mm, SPT diagnosis of FA specificity of up to 100%. Conclusion SPT has certain value in the diagnosis of FA. SPT diagnosis of the critical value of FA and family history combined analysis can improve the diagnostic rate of FA, to avoid some of the suspected FA infants OFC, rapid diagnosis of clinical FA, reduce the risk and burden of children and their families is important.