脐血主要过敏相关指标所反映的生命早期致敏状况研究  

A study of hypersensitivity in early life revealed by cord blood immunological indices

作　　者：唐海婷[1] 邵洁[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院妇产科,上海200025

出　　处：《临床儿科杂志》2013年第6期538-542,共5页Journal of Clinical Pediatrics

摘　　要：目的探讨生命早期的致敏状况。方法选取2009年6月至2010年3月在本院产科登记检查并分娩的健康孕妇146例,及其配偶和婴儿。通过父母问卷调查和父母过敏原皮肤点刺试验确定父母特应质情况,根据父母特应质情况分组。分娩时检测脐血总IgE,鸡蛋、牛奶特异性IgE,ECP及母体总IgE含量,随访婴儿6周、3个月、6个月特应性皮炎的发生情况。结果在146例孕妇所产婴儿中,父母双方至少一方特应质组67例,双方均为非特应质79例。脐血总IgE、ECP平均值及阳性率在父母特应质组中均较非特应质组高,但差异无统计学意义。脐血总IgE与母亲总Ig无相关性。婴儿生后6周、3个月、6个月特应性皮炎的发生率在脐血总IgE、ECP增高组中较高,差异有统计学意义(P<0.05)。脐血中可检测到极微量的鸡蛋、牛奶特异性IgE,且与父母特应质无相关性。结论胎儿在母体子宫内可被食物抗原致敏。脐血总IgE、特异性IgE、ECP或可作为宫内致敏的指标,其与父母特应质、母亲IgE水平无相关性,脐血IgE、ECP与婴儿早期特应性皮炎的发生有一定的相关性。Objectives To evaluate the allergic status of the fetus. Methods One hundred and forty-six healthy pregnant women registered in our hospital from Jun 2009 to Mar 2010 were enrolled in this study. Parental atopy history was evalu-ated by questionnaire, and all parents were divides into four groups. The ECP level, total IgE, egg and milk specific IgE were measured in cord blood. Maternal serum IgE were measured and the infant atopic dermatitis at ages 6 weeks, 3 months and 6 months were followed up. Results Among the 146 pregnant women and their spouses, 67 of them were present with the features of atopy in at least one of the parent, and 79 of them were not. The positive rates and the average levels of cord serum IgE, ECP in atopy-positive group were higher than those in the negative group, but difference was not significant （P〉0.05）. The cord serum IgE had no significant correlation with maternal total IgE （P〉0.05）. The morbidity of infant atopic dermatitis in elevated ECP and IgE group were higher at ages 6 weeks, 3 months and 6 months （P〈0.05）. Egg and milk specific IgE could be detected in cord blood, but the detection rate was very low. Conclusions The fetus can be sensitized by food allergen in ma-ternal uterus. Total IgE, special IgE and ECP in cord blood could be taken as indices of fetal sensitization in maternal uterus. They are not influenced by parental atopy history and maternal serum IgE. Significant correlation exists between levels ECP and IgE in cord blood and infant atopic dermatitis.

关 键 词：脐血 免疫球蛋白E 特异性IGE 嗜酸性粒细胞阳离子蛋白 特应性皮炎 

分 类 号：R725.6[医药卫生—儿科]