溃疡性结肠炎患者食物特异性抗体的检测和剔除过敏食物对临床疗效的影响

Detection of serum food allergen-specific IgG and impact of allergic food elimination on the treatment of ulcerative colitis patients

目的探讨食物过敏与溃疡性结肠炎的关系。方法用ELISA法检测121例溃疡性结肠炎患者及85例健康对照者的血清食物特异性抗体IgG(sIgG)水平。将血清食物特异性抗体检测阳性的溃疡性结肠炎患者(n=79)随机分为饮食控制组(n=40)和非饮食控制组(n=39)。饮食控制组患者给予常规治疗并忌食IgG阳性食物,非饮食控制组患者仅给予常规治疗,不予饮食干预。随访2个月观察其临床疗效。结果 121例溃疡性结肠炎患者中出现食物sIgG阳性者达79例,阳性率为65.29%。85名健康对照者出现食物sIgG阳性者15例,阳性率为17.65%;两组阳性率比较,差异有统计学意义(P<0.01)。饮食控制组2个月总有效率达85.0%,非饮食控制组2个月总有效率43.6%,二组比较,差异有统计学意义(P<0.05)。结论剔除溃疡性结肠炎患者饮食中的IgG阳性食物,有助于提高临床疗效,血清食物特异性抗体IgG水平升高与溃疡性结肠炎发病有关。

Objective To investigate the relationship between ulcerative colitis （UC） and food allergy. Methods The serum food allergen-specific IgG （slgG） level was detected in 121 patients with ulcerative colitis and 85 health controls by enzyme-linked immunosorbent assay （ELISA）. The UC patients who had slgG-positivity （n = 79） were divided into the diet control group（ n = 40）and the non-diet control group（ n = 39 ）. Patients in the diet control group were treated with 5-aminosalicylic acid and prednisone, with their daily diets eliminating the IgG-positive food. Patients in the non-diet control group were treated with 5-aminosalicylic acid and prednisone, without diet restriction. After two months of follow-up, the efficacy in the diet control group and the non-diet control group was observed and compared. Results The slgG-positive rate in 121 UC patients was 65.29% （79/121）, while in the 85 health controls was 17.65% （15/ 85 ）. and there was a great statistical significance between the two groups（ P 〈0.01 ）. The total response rate in the diet control group was 85.0% during two months of follow-up, while that in the non-diet control group was 43.6%, and there was a significant difference between the two groups （P 〈 0.05 ）. Conclusions Eliminating the IgG-positive food from UC patients＇ diet would be helpful to improve the therapeutic efficacy. High level of serum food allergen-specific IgG may be relative to incidence of UC.