变应性疾病患儿食物过敏调查及危险因素分析

Analysis of Risk Factors of Food Allergy in Children with Allergic Diseases

目的：了解变应性疾病患儿食物过敏现状及危险因素。方法：选取怀疑食物过敏的变应性疾病患儿401例，通过问卷调查，结合食物特异性免疫球蛋白E（sIgE）检测结果，分析常见食物中蛋清、牛奶、虾、蟹、大豆和花生sIgE的阳性率，患儿食物过敏特征和报告率，食物sIgE阳性率与自述食物过敏报告率及家族过敏史的关系。结果：患儿自述食物过敏报告率为34．4％，诱发过敏反应的食物主要为牛奶（14．7％）、鸡蛋（12．5％）和虾（7．0％）；进食过敏食物后的症状以皮肤症状为主（41．3％）；食物sIgE阳性率与自述食物过敏报告率相比，牛奶、蛋清和花生sIgE阳性率高于自述食物过敏的报告率（P〈0．01），而虾、蟹和大豆sIgE阳性率与自述食物过敏的报告率比较，差异无统计学意义（P〉0．05）；在不同sIgE级别组中，虾和蟹sIgE低级别组和高级别组自述食物过敏报告率高于阴性组（P〈0．05），但蛋清、牛奶、花生和大豆在各组间差异无统计学意义（P〉0．05）；70．6％食物过敏患儿有家族过敏史，有家族过敏史患儿中以男孩患过敏性疾病几率较女孩高（P〈0．01）；父母双方过敏家庭的患儿蛋清sIgE阳性率、仅父亲过敏家庭的患儿牛奶sIgE阳性率均高于无家族过敏史患儿（P〈0．05）；多因素Logistic回归分析显示，父母均过敏的患儿自述食物过敏发生率高于非父母均过敏患儿（OR=1．91，95％CI：1．07～3．42）；春夏出生患儿自述食物过敏报告率低于秋冬出生患儿（OR=0．644，95％CI：0．42～0．99）。结论：有家族过敏史的婴幼儿是食物过敏高风险人群，这些家长应加强食物过敏的防范意识，尽早发现和干预，阻断或减缓变应性疾病的进程。

Objective ： To investigate the status and risk factors of food allergy in children with aller- gic diseases. Methods： 401 cases of children with allergic diseases suspected of food allergy were se- lected and enrolled in the study. Through the questionnaire survey, combined with food specific immu- noglobulin E （slgE） test results, the food sIgE positive rate in common food such as in egg white, milk, shrimp, crab, soybean and peanut, food allergy characteristics and reporting rate in children were observed and analyzed. Then, the relationship between positive rate of food sIgE and self-repor- ting rate of food allergy and family history of allergic were also analyzed. Results： The self-reporting rate of food allergy of children with allergic disease was 34.4%. The food for inducing an allergic reac- tion were mainly cow＇s milk （ 14.7% ）, egg （ 12.5% ） and shrimp （7.0%）. The main symptomswere skin symptom after eating allergic food（41.3% ）, such as urticaria and eczema. The sIgE posi- tive rate of eow＇s milk, egg white and peanut were higher than self-reporting allergy rate （P 〈 0.01 ）. There were no statistically＇significant differences between sIgE positive rate of shrimp, crab and soybean and self-reporting allergy rate （P 〉 0.05）. The self-reporting allergy rate of shrimp and crab was sig- nificantly higher in sIgE low and high level group than in negative group （ P 〈 0.05 ） but there were no statistically significant differences in self-reporting allergy rate of egg white, cow＇s milk, peanut and soybean between different sIgE level groups （P 〉0.05 ）. 70.6% of the children with allergic diseases had family history of allergies. For children who had family history of allergies, the rate of boys suffer- ing from allergic disease was significantly higher than that of girls. The sIgE positive rate of egg white was significantly higher in the children of parental allergy than in the children who had no family histo- ry of allergies （P 〈0.05）. The sIgE positive rate of cow＇s milk was higher in the children of only fa- ther allergic family than in the children who had no family history of allergies （P 〈 0.05 ）. Multivari- able logistic regression analysis showed that the percentage of self-reporting food allergy in children with parental allergy was significantly higher than in the children without parental allergy （ OR = 1.91, 95% CI： 1.07 -3.42 ） and the percentage of self-reporting food allergy was significantly lower in chil- dren born in summer＆spring than those born in autumn＆winter （ OR = 0. 644, 95% CI： 0. 42 0. 99）. Conclusion： The children with family history of allergies have high risk of suffering food aller- gy. The parents should strengthen the awareness of the prevention of food allergy, detect and inter- vene, block or slow the progression of allergic diseases as early as possible.