新生儿首次应用青霉素是否一定要作皮试

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我院自1971年以来,共收治新生儿57676例,每个患儿在应用青霉素前均需做皮肤试验,其结果全部呈阴性反应,至今没有发现一例是阳性反应,其中假阳性者有1060例,应用青霉素后,也没有产生过敏反应。通过多年的临床观察,笔者认为为新生儿做青霉素皮试,参考价值不大,理由是: 1.过敏反应发病机理,主要是指IgE产生,转移和结合到靶细胞上的过程。青霉素过敏反应中,以速发型过敏反应最为严重,而IgE是速发型过敏反应中的主要抗体,然而,新生儿体内IgE是缺乏的,也是体内五种免疫球蛋白(IgG,IgM,IgA,IgD,IgE)中,出现最晚的一种,只占免疫球蛋白含量的0.002%,同时,母体的IgE不能通过胎盘进入胎儿体内,而新生儿自身体内也尚难以形成IgE,直到出 Our hospital since 1971, a total of 57676 cases of newborns were treated, each application of penicillin in children are required before the skin test, the results were all negative, so far found no positive reaction, of which 1060 false positives , The application of penicillin, it did not produce allergic reactions. Through years of clinical observation, I believe that penicillin skin test for newborns, the reference value is not small, the reasons are: 1. The pathogenesis of allergic reactions, mainly refers to the production of IgE, transfer and binding to target cells on the process. In penicillin hypersensitivity reactions, the most frequent anaphylactic reactions are allergic reactions, whereas IgE is the major antibody in immediate-onset hypersensitivity reactions. However, IgE in neonates is deficient in vivo and is also responsible for five immunoglobulins (IgG, IgM, IgA, IgD , IgE), the latest one, only 0.002% of immunoglobulin content, at the same time, the mother of IgE can not enter the fetus through the placenta, but the body itself is still difficult to form IgE, until out
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