血清IgE测定对牛奶过敏婴儿的临床意义  

Clinical significance of determination of serum IgE in infants with milk allergy

作　　者：梁敏[1] 张立文[1] 朱美华[1] 陈蕴光[2] 

机构地区：[1]广州医科大学附属第二医院儿科,广东广州510260 [2]广州医科大学附属第二医院过敏反应科,广东广州510260

出　　处：《中国当代儿科杂志》2015年第6期618-622,共5页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨牛奶蛋白特异性IgE(sIgE)对牛奶蛋白过敏症(CMPA)患儿的临床意义。方法依据sIgE检测结果将96例CMPA患儿分为IgE+组(n=26)与IgE-组(n=70),对比分析两组患儿的临床特点;予食物回避和使用深度水解蛋白粉或氨基酸粉干预16周后,比较两组患儿的干预效果。结果 CMPA患儿血清IgE阳性率为27%。IgE+组的首次发病年龄低于IgE-组(P<0.05);过敏性家族史和呼吸道症状发生率高于IgE-组(P<0.05);重度CMPA、消化道症状、体重低下、生长迟缓、贫血和低蛋白血症发生率低于IgE-组(P<0.05)。IgE+组患儿主要临床症状表现为红斑、荨麻疹、呕吐、流涕、咳嗽、喘息和阵发性哭闹,发生率高于IgE-组(P<0.05);IgE-组患儿主要临床症状表现为湿疹、便秘和腹泻,发生率高于IgE+组(P<0.05)。干预16周后,两组间各临床症状缓解率均在80%以上,且两组间各临床症状缓解率比较差异均无统计学意义(P>0.05)。结论 CMPA患儿血清IgE阳性率不高。IgE-组临床症状更不典型,多为非过敏性临床表现。早期食物回避和使用深度水解蛋白粉或氨基酸粉干预对IgE+和IgE-患儿均能获益。Objective To determine the clinical signiifcance of milk protein-speciifc IgE （sIgE） for infants with cow’s milk protein allergy （CMPA）. Methods Ninety-six infants with CMPA were divided into IgE＋group （n=26） and IgE-group （n=70） and clinical characteristics were compared between the two groups. Infants were denied allergy-inducing food and fed instead extensively hydrolyzed formulas or amino-acid formulas for 16 weeks before the two groups were compared. Results Twenty-seven percent of the infants were sIgE-seropositive. The ifrst onset age of CMPA was signiifcantly younger in the IgE＋group than in the IgE-group （P＆lt;0.05）, and the family history of allergy and respiratory symptoms were signiifcantly less common in the IgE-group than in the IgE＋group （P＆lt;0.05）. Severe CMPA, gastrointestinal symptoms, underweight, growth retardation, anemia, and hypoproteinemia were signiifcantly more common in the IgE- group than in the IgE＋ group （P＆lt;0.05）. Erythema, urticaria, vomiting, nasal discharge, cough, wheezing, and paroxysms of crying were major clinical symptoms of the IgE＋group, and their incidences were signiifcantly higher in the IgE＋group than in the IgE-group （P〈0.05）;eczema, constipation, and diarrhea were major symptoms of the IgE-group, and their incidences were signiifcantly higher in the IgE-group than in the IgE＋group （P〈0.05）. The remission rate of each symptom was as high as over 80%in the two groups after 16 weeks of intervention and there was no signiifcant difference in the remission rates between the two groups （P〈0.05）. Conclusions IgE seropositive rate is not high in infants with CMPA. Atypical signs instead of allergic symptoms are more common in the IgE seronegative infants with CMPA. Avoiding allergy-inducing food and eating extensively hydrolyzed formulas or amino-acid formulas in early age beneift infants with IgE-mediated or non-IgE-mediated CMPA.

关 键 词：牛奶蛋白过敏症 早期干预 婴儿 

分 类 号：R725.9[医药卫生—儿科]