过敏高风险婴儿罹患过敏性疾病的多因素分析及干预  

Multivariate analysis of the risk factors for allergy and interventions in high-risk infants

作　　者：钱继红[1] 陈同辛[1] 敖黎明[1] 陈冠仪[1] 杨祖菁[2] 王留娣[3] 高美玲 吴星英[5] 陆国强[6] 顾擎东 董蔚 郑珠丽[9] 吴圣楣[1] 朱建幸[1] 

机构地区：[1]上海交通大学医学院附属新华医院儿内科,200092 [2]上海交通大学医学院附属新华医院妇产科,200092 [3]上海市浦东新区妇幼保健院产科 [4]上海市奉贤区中心医院儿科 [5]同济大学附属东方医院妇产科 [6]同济大学附属第一妇婴保健院产科 [7]崇明堡镇医院儿科 [8]上海市南翔医院儿科 [9]上海市徐汇区中心医院儿科

出　　处：《上海医学》2008年第1期1-4,共4页Shanghai Medical Journal

摘　　要：目的探讨过敏高风险婴儿发生过敏性疾病的危险因素及早期干预措施。方法对具有过敏性疾病家族史(父母一方或双方)的新生儿进行1年的随访,观察过敏性疾病的发生情况。对影响过敏性疾病发生的因素进行单因素分析后,选取有统计学意义的指标,应用logistic逐步回归模型进行统计分析。结果254名婴儿中,有114例在生后1年内出现1种或多种过敏症状。单因素分析中有12项指标具有统计学意义,7项指标入选logistic逐步回归方程,分别为母孕期过敏性疾病发作史(OR=2.523,95%CI为1.263～5.041,P<0.01)、双亲有过敏性疾病史(OR=6.116,95%CI为2.546～14.692,P<0.01)、母亲血清IgE值(OR=2.413,95%CI为1.710～3.404,P<0.01)、被动吸烟(OR=2.778,95%CI为1.402～5.502,P<0.01)、出生后6个月内添加鸡蛋(OR=2.693,95%CI为1.238～5.859,P<0.05)、纯母乳喂养(OR=0.196,95%CI为0.086～0.447,P<0.01)和部分水解配方奶(pHF)喂养(OR=0.099,95%CI为0.038～0.255,P<0.01)。结论妊娠期加强对有过敏史妇女的保护,防止过敏性疾病的复发,避免过敏高风险婴儿过早接触香烟、过早添加鸡蛋,母乳喂养及pHE喂养等综合措施可减少过敏高风险婴儿过敏性疾病的发生。Objective To identify the risk factors of allergy in high-risk infants and explore their interventions for preventing allergy development in early life. Methods A 1-year-long follow-up was conducted for 254 newborn infants with one parent or both allergic parents. The factors that significantly affected infantile allergy development, screened primarily by univariate analysis, were further examined by multivariate analysis using logistic regression. Results Out of the 254 high-risk infants, 114 developed one or multiple allergic symptoms during the one-year period after birth. Univariate analysis identified 12 significant factors related to the onset（P 〈 0.05）, of which 7 were also found significant in stepwise multivariate regression analysis（P〈0.05）. Maternal history of allergic disease onset during late pregnancy（OR = 2.523, 95% CI = 1.263 - 5.041 ）, parental history of allergic diseases（OR= 6.116, 95%CI= 2.546-14.692）, increased maternal blood IgE（OR = 2. 413, 95%CI=1. 710-3.404）, infantile smoke exposure（ OR=2. 778, 95%CI = 1.402-5.502） and intake of egg before 6 months of age（ OR=2. 693, 95%CI=1. 238-5. 859） were found to Be the risk factors of allergy development, while breast feeding（OR=0. 196, 95%CI=0. 086-0. 447） and partially hydrolyzed formula（pHF） feeding（ OR =0. 099, 95% CI = 0.038 - 0.255 ） were the protective factors. Conclusion Comprehensive measures including prevention of allergic disease onset during pregnancy, avoiding infantile smoke exposure and egg intake before 6 months of age, breast feeding, and pHF feeding help to reduce the risk of allergy development in the high-risk infants.

关 键 词：过敏 高风险婴儿 多因素分析 

分 类 号：R725.9[医药卫生—儿科]