不同过敏家族史婴幼儿发生食物过敏的围生期环境影响因素分析

Perinatal environmental factors for food allergy infants with different allergic family histories

目的:探讨围生期环境因素对不同过敏家族史婴幼儿发生食物致敏及过敏的影响。方法:回顾性分析进行食物过敏流行病学调查的婴幼儿问卷资料2 030份。对不同过敏家族史婴幼儿发生食物致敏及过敏的围生期环境因素进行logistic回归分析。结果:家族史阳性儿童食物致敏及过敏的检出率明显高于家族史阴性儿童(致敏:27.1%vs.15.3%,χ2=35.752,P=0.000;过敏:19.5%vs.9.7%,χ2=34.472,P=0.000);62.5%食物致敏、59.5%食物过敏婴幼儿来自过敏疾病家族史阴性的儿童。对于过敏疾病家族史阳性儿童,孕期高蛋白摄入可导致食物致敏(OR=1.618,95%CI=1.085~2.414,P=0.018)。对于家族史阴性的儿童,高出生体质量、生后头3 d最早摄入非母乳食物、孕期高蛋白摄入可增加其发生食物致敏的风险(OR=1.674,95%CI=1.115~2.515,P=0.013;OR=1.396,95%CI=1.040~1.875,P=0.026;OR=1.996,95%CI=1.495~2.664,P=0.000);高出生体质量、孕期高蛋白摄入亦是此类婴幼儿发生食物过敏的危险因素(OR=1.794,95%CI=1.104~2.916,P=0.018;OR=1.797,95%CI=1.269~2.546,P=0.001)。结论:虽然过敏性家族史阳性者更易发生食物致敏及过敏;然而,家族史阴性者更易受围生期环境因素影响。

Objective：To explore the predisposing perinatal environmental factors of food sensitization and allergy in infants with different allergic family histories. Methods：Totally 2 030 copies of questionnaires data from the epidemiological investigation of food allergy were analyzed retrospectively. Logistic regression was used to analyze the perinatal environmental risk factors of food sensitization and allergy in infants with different allergic family histories. Results：The incidence of food sensitization and allergy in positive allergic family history infants was significantly higher than that of negative family history infants（sensitization：27.1% vs. 15.3%,χ^2=35.752,P=0.000;allergy：19.5% vs. 9.7%,χ^2=34.472,P=0.000）. 62.5% of food sensitization infants and 59.5% of food allergy infants were from family without allergic history. Logistic regression analysis showed that high protein intake during pregnancy might lead to food sensi-tization（OR=1.618,95%CI=1.085 to 2.414,P=0.018）;no environmental risk factors was found for food allergy in infants with allergic family history. While,for infants without allergic family history,high birth weight,the earliest food intake during the first 3 days,high protein intake during pregnancy may increase the risk of occurrence of food sensitization,respectively（OR =1.674,95% CI =1.115 to 2.515,P=0.013;OR=1.396,95%CI=1.040 to 1.875,P=0.026;OR=1.996,95%CI=1.495 to 2.664,P=0.000）;high birth weight,high protein intake during pregnancy were the risk factors of food allergy（OR=1.794,95%CI=1.104 to 2.916,P=0.018;OR=1.797,95%CI=1.269 to 2.546,P=0.001）. Conclusion：Compared with the infants from negative allergic family history,those from positive family history are more susceptible to food sensitization and allergy. However,much attention should be paid to perinatal environment factors influencing food sensitization or allergy among infants without allergic family history. Therefore,different preventive strategies should be considered among individuals in clinic.