儿童IgE相关食物过敏消化道临床特点及随访研究

Clinical characteristics of gastrointestinal symptoms and follow-up of children with IgE-related food allergy

目的探讨儿童IgE相关食物过敏的消化道临床表现特点及其预后。方法选取2012年3月至2013年11月首都医科大学附属北京儿童医院消化科174例IgE相关食物过敏患儿作为研究对象,结合过敏原IgE抗体检测结果,对致敏食物进行饮食回避,设计标准化调查问卷,对患儿的临床表现及预后进行定期随访。结果 174例过敏原特异性IgE抗体检测中,牛奶、鸡蛋为主要过敏原,分别占66.1%和27.6%,轻度敏感以牛奶为主(65.5%),中度敏感以鸡蛋白为主(5.2%)。婴儿组消化道症状以腹泻为主(51.3%),幼儿组以呕吐为主(37.5%),学龄期及青春期组以腹痛为主要表现(43.5%)。牛奶过敏以腹泻为主要表现,占20.7%。以腹泻为主要临床表现患儿在过敏原特异性IgE浓度高低、过敏原数目方面,差异无统计学意义(P>0.05)。牛奶特异性IgE 2级的患儿获得耐受的时间(7.54±5.11)个月长于牛奶特异性IgE 1级的患儿(3.50±3.53)个月,差异有统计学意义(P<0.05)。结论IgE相关的食物过敏患儿以牛奶和鸡蛋为主要的过敏原,患儿的消化道临床表现依据年龄组不同而有所差异,牛奶过敏患儿特异性IgE浓度越高越不易获得耐受。

Objective To observe the clinical characteristics and prognosis of children with IgE-related food allergy.Methods The study was enrolled 174 children with food allergy in Beijing Children Hospital between March 2012 and November 2013. All patients were given treatment of avoid allergic food and filled out the standard questionnaire and followed up. Results The s Ig E positive rates of milk and eggs were higher than other food,were 66.1% and 27.6%. Mildly sensitive to milk was 65.5%,moderately sensitive to chicken protein was 5.2%. Main clinical manifestations of children with food allergy were vary in different age groups. In the infant group, diarrhea was the main manifestation（51.3%）,and in the toddler group,vomiting was the main manifestation（37.5%）. In the school age and adolescence group,abdominal pain was the main manifestation（43.5%）. The severity of diarrhea are not connected with the types and concentration of allergens Ig E. The results of follow-up analysis showed that patients of milk s Ig E 2 level（7.54±5.1）months need more longer time to acquire tolerance than s Ig E 1 level（3.50±3.53）months. Conclusion Milk and eggs are the main allergens. The gastrointestinal symptoms of children with Ig E-related food allergy were different with age. Children with high concentration of milk specific Ig E is not easy to acquire food tolerance. The concentration of milk specific Ig E had certain predictive value for the patient＇s tolerance.