牛奶过敏儿童外周血白细胞和免疫球蛋白分析

Study on Peripheral-blood Leucocytes and Immunoglobulins in Children with Cow＇s Milk Allergy

目的了解牛奶过敏儿童外周血白细胞及免疫球蛋白水平，以及并发其它过敏的变应原的种类，为临床采取合理的诊疗提供科学依据。方法对341例牛奶过敏儿童和192例健康儿童血清35种过敏原特异性IgE、血清免疫珠蛋白IgE，IgG，IgA，IgM和补体C3，C4检测并进行统计学分析。结果①牛奶过敏患儿血细胞分析中嗜酸性粒细胞水平中位数2．85％（1．15％～5．98％），明显高于健康对照组中位数1．90％（1．00％～4．10％），P〈0．05；免疫球蛋白潮定中IgE水平中位数260g／L（107-535．5g／L），明显高于健康对照组中位数27．3g／L（10．2～47．0g／L），P〈0．05。②牛奶过敏患儿并发其它过敏的阳性率前七位变应原分别是：粉尘螨（53．37％），屋尘螨（52．25％），全蛋（40．45％），芝士（39．33％），狗毛（24．72％），黄豆（23．03％）和牛内（18．54％）。结论牛奶过敏符合典型的I型变态反应，患儿容易并发其它过敏，儿童牛奶过敏惠儿应注意回避牛奶及其它常见变应原。

Objective To investigate the levels of peripheral-blood leucocytes and immunoglobulins and to observe constituent ratio of allergens in children with cow＇s milk allergy so as to provide evidence for doctors to diagnose and treat the disease more reasonably. Methods 341 children with cow＇s milk allergy and 192 healthy children as control group were enrolled in our study, 35 kinds of serum allergen specific IgE,serum total IgE,IgG,IgA,IgM and complement C3,C5 were measured. Then data obtained above were analysed statistically. Results （1）The level of eosinophilic granulocyte which was 2.85% （1.15%~5. 98%） by median in hildren with cow＇s milk allergy was significantly higher than that in the control group which was 1.90%（1.00%-4. 10%） （P〈0. 05）. The level of serum total IgE（g/L） which was 260（107- 535.5） by median was statistically higher than that of the control group[27.3（10. 2-47. 0）]（P〈0. 05）. （2）The most seven high positive rate among allergen specific IgE combined with cow＇s milk allergy at the same time were as follows：Dermatophagoides farinae （53.37 % ）, Dermatophagoides pteronyssinus （52. 25 % ）, egg （40. 45 % ）, cheese （39. 33 % ）, dog hair （24.72%） ,soybean（23.03%） ,beef（18. 54%）. Conclusion Cow＇s milk allergy is consistent with type I allergy,which is combined with other allergies easily at the same time and children with cow＇s milk allergy should evade them.