1岁以下儿童食物过敏现状调查及临床特点分析

Prevalence and Clinical Characteristics of Food Allergy in Children Under 1 Year Old

目的调查1岁以下儿童食物过敏现状及临床特点。方法将2017年1月至2018年1月在三门峡市中心医院儿童保健科进行常规体检的儿童纳入研究。通过患儿家长填写调查问卷筛查可疑病例,并对可疑病例进行食物规避和食物激发试验,按激发试验结果判定是否存在食物过敏。对确定诊断病例进行皮肤点刺试验及临床特点分析。结果共发放调查问卷650份,其中26例失访,624例患儿完成整个诊断过程,病史调查有食物过敏相关临床表现92例(14.7%,92/624),经食物规避试验及食物激发试验确定诊断52例,食物过敏检出率为8.3%(52/624)。39例(75.0%,39/52)表现为胃肠道症状:呕吐或反流15例、腹泻28例、便血17例,喂养困难11例。17例表现为口唇水肿和皮疹,18例伴有湿疹,未见严重过敏反应及呼吸道症状儿童。皮肤点刺试验13例阳性,均为牛奶和(或)鸡蛋过敏。所有患儿均有不同程度的营养不良、贫血、低蛋白血症。结论本地区1岁以下儿童食物过敏检出率为8.3%,75.0%表现为胃肠道症状,存在不同程度的营养不良。

Objective To observe the prevalence and clinical characteristics of food allergy in children under 1 year old.Methods All well-infants younger than 1 year old attend routine health visits at the Department of Primary Child Care from January 2017 to January 2018.The suspicious cases were detected by the questionnaire filled out by the parents of the children,and the food aversion and food stimulation test were carried out on the suspicious cases,and the food allergy was determined according to the result of the result of the stimulation test.The skin prick test and clinical characteristics of the confirmed cases were analyzed.Results Totally 650 children were recruited by the consent of their parents,26 cases were lost to follow-up,and 624 children completed the whole diagnosis process.Ninety-two cases(14.7%,92/624)were diagnosed with food-related clinical manifestations through medical history investigation,and 52 cases were confirmed by food elimination test and oral foot challenge test.The detection rate of food allergy was 8.3%(52/624).Thirty-nine patients(75.0%,39/52)presented gastrointestinal symptoms:vomiting or reflux in 15 cases,diarrhea in 28 cases,hematochetum in 17 cases,feeding difficulties in 11 case.Seventeen patients presented with lip edema and rash,18 with eczema,and no severe allergic reactions or respiratory symptoms were observed in children.Skin prick test was performed in 13 patients,all of whom were allergic to milk and/or eggs.All the children had varying degrees of malnutrition,anemia,and hypoproteinemia.Conclusion The prevalence of food allergy in children under the age of 1 year in this area was 8.3%,75.0% presented gastrointestinal symptoms,and the children had different degrees of malnutrition.