广州地区0～5岁支气管哮喘儿童8种食物变应原特异性IgE分析

Analysis of specific IgE against 8 food allergens in asthmatic children aged 0 to 5 years in Guangzhou area

目的探讨广州地区0～5岁支气管哮喘（简称哮喘）儿童8种常见食物变应原血清特异性IgE（sIgE）阳性率及不同阳性级别的分布情况。方法人选小儿呼吸门诊0～5岁持续性哮喘儿童584例，采用德国FOOKEALLERGY-O-LIQ变应原检测系统，通过酶联免疫捕获法测定血清牛奶、全蛋、花生、小麦、玉米、大豆、螃蟹和虾共8种食物变原的sIgE水平。对可疑的过敏食物结合饮食回避试验进行食物过敏确诊。结果584例哮喘儿童中至少一种食物变应原sIgE阳性的比率为55．8％（326／584），sIgE阳性率从高到低依次为牛奶47．1％（275／584）、全蛋28．6％（167／584）、小麦粉6．2％（36／584）、花生5．0％（29／584）、大豆2．2％（13／584）、虾1．4％（8／584）、玉米粉1．2％（7／584）和螃蟹0．9％（5／584）。各年龄sIgE阳性率排在前2位的均是牛奶和全蛋，牛奶、全蛋和花生sIgE的阳性率在各年龄间差异具有统计学意义（χ2=20．038、12．248和10．842，P〈o．05）。至少一种变应原sIgE为3级以上的患儿比率为18．7％（109／584）。67例（11．5％）最后诊断为食物过敏，其中63例sIgE水平在3级以上。结论广州地区0～5岁哮喘儿童常见食物变应原sIgE阳性率高达55．8％，牛奶和全蛋是各年龄最主要的两种食物变应原。11．5％的患儿诊断为有临床症状的食物过敏，其sIgE大多为3级以上。

Objective To evaluate the positive rates and the distribution of specific serum IgE （sIgE） levels against 8 food allergens in persistent asthmatic children aged 0-5 years in Guangzhou area. Methods Five hundred and eighty-four cases were included in this study from pediatric out＇patient department. Serum-specific IgE levels to 8 common food allergens including cow＇s milk, egg, peanut, wheat,corn,soybean,crab and shrimp was measured using enzymes immune sobent capture medthod by ALLERG-O-LIQ system. A trial of avoidance diet was performed in children with suspected food allergy. Results 55.8% （326/584） of the children had positive sIgE to at least one food allergen. The positive rates of the 8 food allergens were cow＇ s milk （47.1%, 275/584）, egg （28.6 %, 167/584）, wheat flour （6.2%,36/584）,peanut （5.0%,29/584）,soybean （2.2%, 13/584）,shrimp （1.4%,8/584）,corn flour （1.2% ,7/584） and crab （0.9% ,5/584）. The top two in different ages children were all cow＇s milk and egg,and the sIgE positive rates of milk, egg and peanut were significantly different among the five age groups,respectively （2% 20. 038,12. 248 and 10. 842, P d0.05）. The percentages of high level sIgE above grade 3 to at least one food was 18.7% （109/584）. Sixty-seven （11.5%） asthmatic children were diagnosed symptomati% food allergy, of them 63 cases showed high level sIgE. Conclusions The sIgE positive rate of 0 % 5 years asthmatic children to 8 common food allergens was high up to 55.8% in Guangzhou area. Cow＇s milk and egg are the two important allergens in different ages. 11.5%/% asthmatic children were diagnosed symptomatic food allergy,most of them showed high level sIgE above grade 3.