牛奶蛋白激发试验与血清IgE抗体检测在牛奶蛋白过敏患儿诊断中的应用

Application of Milk Protein Challenge Test and Serum IgE Antibody Detection in Children with Milk Protein Allergic Diseases

目的研究牛奶蛋白激发试验与血清特异性IgE抗体检测在牛奶蛋白过敏症患儿诊断中的作用。方法选取2013年1月~2015年12月乌鲁木齐市第一人民医院北院收治的76例行牛奶蛋白激发试验患儿为研究对象,分析患儿的临床特征,激发试验与特异性IgE抗体检测结果,以及血常规指标值的变化。结果临床表现以腹泻和血便最常见,其它包括呕吐、呕血、腹胀及拒奶。牛奶蛋白激发试验结果阳性47例(61.8%),阴性29例(38.2%),阳性患儿中42例为迟发过敏反应,5例为速发过敏反应。与激发试验阴性组患儿比较,阳性组血清特异性IgE抗体阳性率差异无统计学意义(14.9%vs 6.9%,x^2=0.466,P>0.05)。阳性组患儿激发后中性粒细胞较激发前明显增多,差异具有统计学意义(t=2.480,P<0.05),阳性组患儿激发后白细胞总数、中性粒细胞数、血小板总数较阴性组差异均无统计学意义(t=0.500,1.395,0.296,均P>0.05)。结论牛奶蛋白过敏患儿消化道疾病主要为腹泻及血便,临床上诊断牛奶蛋白过敏症应予牛奶蛋白激发试验,而血清特异性IgE抗体不能作为其诊断依据。

Objective To investigate the application effects of milk protein challenge test find serum specific IgE antibody de- tection in children with milk protein allergic diseases. Methods 76 cases of children with milk protein allergic diseases of North Hospital of the People＇s Hospital in Urumqi City from January,2013 to December,2015 were treated with milk pro- tein challenge test. The clinical characteristics, results of milk protein challenge test and serum IgE antibody detection, and the value change of routine blood indexes were analysed and compared. Results Diarrhea and hematochezia were the most common clinical features,vomiting,hematemesis and abdominal distention were rare. 47 cases （61.8%） showed positive re- sults in milk protein challenge test, and 29 cases （38.2% ） showed negative results. 42 cases of positive children had delayed allergy,and 5 cases showed rapid allergy. Compared with the negative group, the positive rate of serum specific IgE antibody in positive group didn＇t change obviously,the difference was not statistically significant （14.9% vs 6.9 % ,χ2 = 0. 466, P〉 0.05）. The neutrophil count in positive group was higher after challenge than that of before challenge （t=2. 480,P〈0.05）. The number change of blood cell, neutrophil and platelet in positive group were no statistical differences compared with those in negative group （t= 0. 500,1. 395,0. 296, all P〉0.05）. Conclusion Diarrhea and hematochezia were the most commom disease of digestive tract in children with milk protein allergic diseases. It is necessary to perform milk protein challenge test in clinical practice,however,serum specific IgE antibody is not considered as its diangnosis basis.