摘要
目的:为了研究在诊断牛奶过敏(CMH)时应用皮肤划痕试验(SPT)和测定血清中总的或特异性免疫球蛋白E(IgE)是否能够预测在整4岁时出现牛奶(CM)耐受。研究设计:对CM有立即反应(n=95)或迟发反应(n=67)的婴儿进行前瞻性随访到整4岁。
Objectives To investigate whether the development of tolerance to cow'smilk (CM) by aged 4 years can be predicted with a skin prick test (SPT) and measurements of total or specific immunoglobulin E (IgE) in the serum, taken at the time of diagnosis of cow's milk hypersensitivity (CMH) . Study design Infants with immediate (n =95) or delayed (n = 67) challenge reactions to CM were prospectively followed to aged 4 years. CMH status was assessed annually by CM challenges. Results By aged 2, 3, and 4 years, children with delayed reactions developed tolerance to CM faster than those with immediate reactions: 64% , 92% , and 96% versus 31%, 53%, and 63%, respectively. A wheal size of < 5 mm in SPT correctly identified 83% of 124 infants who developed tolerance to CM by aged 4 years, and a wheal size of≥5 mm in SPT correctly iden- tified 71% of 39 infants with persistent CMH. Milk-specific IgE < 2 kU/L correctly identified 82% of infants who developed tolerance to CM, and milk-specific IgE ≥ 2 kU/L correctly identified 71% of infants with persistent CMH. Conclusion SPT and milk-specific IgE in the serum are useful prognostic indicators of the development of tolerance to CM in infants with CMH.
