特应性皮炎患儿食物致敏危险因素分析:一项单中心横断面研究

Risk factors for food sensitization in children with atopic dermatitis:a single-center cross-sectional study

目的分析特应性皮炎(atopic dermatitis,AD)患儿食物致敏的危险因素,以及食物致敏对生活质量及临床体征的影响。方法回顾性收集241例AD患儿人口学特征、发病年龄、病情严重度、生活质量、体格检查、食物过敏原检查、血清总IgE和嗜酸性粒细胞计数等资料。根据过敏原检测结果分为食物致敏组(n=127)和无食物致敏组(n=114)。采用多因素logistic回归分析评估AD患儿食物致敏的危险因素。结果AD患儿食物致敏率为52.7%(127/241)。多因素logistic回归分析显示食物致敏危险因素为:秋季/冬季出生、AD发病年龄<12个月、重度AD、总IgE>150 IU/mL(P<0.05)。与无食物致敏组比较,食物致敏组生活质量较差(P=0.008),非特异性手足皮炎及掌纹症发生率较高(P<0.05)。与单种食物致敏组相比,多种食物致敏组AD病情较重,纯母乳喂养及总IgE>150 IU/mL者占比较高(P<0.05)。结论秋季/冬季出生、AD发病年龄<12个月、严重AD,或总IgE>150 IU/mL的AD患儿更易发生食物致敏。食物致敏AD患儿生活质量更差,更易出现非特异性手足皮炎及掌纹症。[中国当代儿科杂志,2022,24(8):887-893]

Objective To study the risk factors for food sensitization and the influence of food sensitization on quality of life and clinical signs in children with atopic dermatitis(AD). Methods A retrospective analysis was performed on the medical data of 241 children with AD, including demographic features, age of onset, severity of AD,quality of life, physical examination results, skin prick test(SPT) results, serum total IgE levels, and eosinophil count.According to the results of SPT, the children were divided into a food sensitization group(n=127) and a non-food sensitization group(n=114). The multivariate logistic regression analysis was used to identify the risk factors for food sensitization in children with AD. Results The prevalence rate of food sensitization was 52.7%(127/241) in the children with AD. The multivariate logistic regression analysis showed that birth in autumn or winter, age of onset of AD<12 months, severe AD, and total IgE>150 IU/mL were risk factors for food sensitization(P<0.05). Compared with the non-food sensitization group, the food sensitization group had a significantly poorer quality of life(P=0.008) and significantly higher prevalence rates of non-specific hand/foot dermatitis and palmar hyperlinearity(P<0.05). Compared with the single food sensitization group, the multiple food sensitization group had more severe AD and a significantly higher proportion of children with exclusive breastfeeding or total IgE>150 IU/mL(P<0.05). Conclusions The AD children born in autumn or winter, or those with early onset(<12 months), severe AD or total IgE>150 IU/mL have a higher risk of food sensitization. The AD children with food sensitization have a poorer quality of life and are more likely to develop non-specific hand/foot dermatitis and palmar hyperlinearity.Citaion:[Chinese Journal of Contemporary Pediatrics, 2022, 24(8): 887-893]