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食物抗原特异性IgE测定在预测特异性皮炎患儿食物过敏发生风险的价值 预览

The Value of Food Antigen-Specific IgE in Predicting The Risk of Food Allergy in Children with Atopic Dermatitis
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摘要 目的:检测特异性皮炎(atopic dermatitis,AD)患儿食物抗原特异性免疫球蛋白E(sIgE)的浓度能否预测临床过敏的发生。方法:纳入兰州市第一人民医院招募的婴儿患者(1~18个月)327名,在24个月的随机双盲阶段后,是持续12个月的开放标签(OL)阶段,再进行食物的过敏发展。此外,在基线、双盲和OL阶段结束时,测量牛奶、蛋清、花生、小麦、海鲜混合物和大豆的sIgE。结果:到OL阶段结束时,15.9%的AD患儿发生至少1种食物过敏,最常见的食物过敏是花生、牛奶和蛋清,分别占6.6%、4.3%和3.9%[17]。海鲜、大豆和小麦过敏比较罕见。牛奶、鸡蛋和花生的sIgE水平随AD的严重程度而增加。牛奶、花生、蛋清和海产品混合物的基线sIgE值与这些食物发生过敏的风险在统计学上具有相关性(P<0.05)。AD的严重程度较高(IGA)也可以预测食物过敏的发生。ROC值下的面积显示,基线sIgE预测花生、牛奶和蛋清的食物过敏的准确率高,但不适用于海鲜、小麦或大豆。结论:在有大量发生食物过敏风险的婴儿中,sIgE水平对于预测食物过敏的发展无临床意义。 Objective To determine whether the concentration of food antigen-specific immunoglobulin E(sIgE)in children with atopic dermatitis(AD)can predict the occurrence of clinical allergies.Method A total of 327 infants(1 to 18 months)enrolled in our hospital were enrolled in the open-label(OL)phase of 12 months after the 24-month randomized double-blind phase and then developed food allergies.In addition,the sIgE of milk,egg whites,peanuts,wheat,seafood mixes and soybeans was measured at the end of baseline,double-blind and OL phases.Result By the end of the OL phase,at least 1 food allergy occurred in 15.9%of AD children.Peanut allergy was the most common(6.6%),followed by milk(4.3%)and egg white(3.9%).Seafood,soy and wheat allergy was relatively rare.The specific IgE levels of milk,eggs and peanuts increased with the severity of AD.Baseline-specific IgE values for milk,peanut,egg white,and seafood mixtures were statistically associated with the risk of developing allergies to these foods(P<0.05).Higher severity of AD(IGA)also predicted food allergy.The area under the ROC value showed that baseline-specific IgE predicts high sensitivity to food allergies in peanuts,milk and egg white,but not seafood,wheat,or soy.Conclusion In infants at high risk of food allergy,sIgE levels are not clinically significant for predicting the development of food allergies.
作者 王玲 张玉珏 杨晓娟 WANG Ling;ZHANG Yu-yu;YANG Xiao-juan(The Department of Pediatrics,The First People s Hospital of Lanzhou City,Lanzhou 730050,China)
出处 《中国食物与营养》 2019年第1期26-31,共6页 Food and Nutrition in China
基金 兰州市科技计划项目社会发展(医药卫生)(项目编号:2014-1-53)。
关键词 食物抗原特异性IgE 特异性皮炎 食物过敏 food-antigen-specific IgE specific dermatitis food allergy
作者简介 王玲(1971—),女,副主任医师,研究方向:早产儿。
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