食物不耐受和青少年腺周口疮的相关性

Correlation betw een food intolerance and major adolescent oral ulcer

目的探讨青少年腺周口疮与食物不耐受之间的关系。方法调查2008年到2014年45例腺周口疮患儿饮食习惯,ELISA法检测患儿血清中14种食物特异性Ig G抗体,同时进行免疫学检测。选取20例轻型复发性口腔溃疡患儿作为对照。结果青少年腺周口疮好发年龄为6-12岁,男性患儿明显多于女性,好发部位为舌尖及颊脂垫尖。溃疡体积大,凹陷深,无明显充血,痛感明显。患儿均有偏食习惯。腺周口疮患儿和轻型复发性口腔溃疡患儿食物不耐受总阳性率分别为90.6%和45%,均为鸡蛋阳性率最高,其中腺周口疮患儿食物不耐受总阳性率明显高于轻型复发性口腔溃疡患儿（P〈0.05）,且腺周口疮患儿与轻型复发性口腔溃疡患儿对鸡蛋不耐受差异具有统计学意义（P〈0.05）。腺周口疮患儿免疫功能基本正常,CD4＋T细胞低于正常的占55.6%。其病理表现为：固有层慢性炎细胞浸润,部分血管壁增厚。经过饮食调整及药物辅助治疗,44例患儿病情得到控制,治疗总有效率为97.8%。结论青少年腺周口疮与食物不耐受有密切关系,不耐受食物以鸡蛋、牛奶为主,禁食不耐受食物及药物辅助治疗可改善大部分患儿病情。

Objective To investigate the relationship between food intolerance and major adolescent oral ulcer.Methods Eating habits of 45 children with major adolescent oral ulcer were investigated during 2008 and 2014. The levels of Ig G against 14 common food were measured by ELISA. Immunology detection was conducted. Another 20 children with minor recurrent oral ulcer were selected as controls. Results Major adolescent oral ulcer often presented in patients aged 6 to 12 years and boys were more vulnerable. The tongue tip and buccal fat pad were the preferred sites. The ulcer was big and deep. The center was in depression surrounded by pale,uplifted tissues. The patients felt severe pain. All children with major adolescent oral ulcer ate unbalanced diet. Total positive rate of serum food-intolerant Ig G antibodies was 90. 6% and 45% in children with major adolescent oral ulcer and children with minor recurrent oral ulcer. Among these 14 food,the positive rate of egg was the highest,and it was higher in major adolescent oral ulcer than in minor recurrent oral ulcer with statistical significance（ P〈0. 05）. The immunity of children with major adolescent oral ulcer was almost normal,and 55. 6% children had CD4＋T cell lower than normal. The pathology was infiltration of chronic inflammatory cells and the thickening of vessel walls. After diet changes and drug treatment,44children＇s ulcer was under control,the total effective rate being 97. 8%. Conclusion Major adolescent oral ulcer is closely related to food intolerance. Egg and milk are the most common intolerant food. Avoiding the intolerant food and drug treatment showacceptable efficacy in the treatment of most children with major adolescent oral ulcer.