食物过敏的诊断和治疗  

Diagnosis and Treatment of Food Allergy

作　　者：王良录[1] 王子熹[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院变态反应科,北京100730

出　　处：《医学与哲学（B）》2015年第7期27-30,共4页Medicine & Philosophy(B)

摘　　要：食物变态反应是临床上最常见、最重要的变态反应疾病之一。其发病机制主要为IgE介导的Ⅰ型变态反应,Ⅱ、Ⅲ、Ⅳ型亦均可涉及。临床表现可分为速发型和迟发型两型,其中速发型常见。临床上可同时累及多个器官或系统,其中胃肠道及皮肤最易受累,重者可出现严重过敏反应甚至休克造成死亡。其诊断较难明确,应根据病史、皮肤试验、特异性IgE检测结果综合分析明确诊断。双盲安慰剂对照食物激发试验是目前公认的食物变态反应诊断的金标准。应注意与食物中毒、食物特异质、食物耐受不良及进食富含血管活性胺类食物引起的胃肠道及中枢神经系统症状相鉴别。在治疗上,最佳治疗方法是禁食致敏食物,误食时应及时对症处理。Food allergy （FA） is one of the most common and important allergic diseases. The mechanisms of FA are primarily associated with the immunoglobulin E （IgE）-mediated type I allergic reaction, but also with all the other three types of allergy. Clinical manifestations can be divided into 2 types： the rapid onset and the late onset, and the rapid onset type are more common. Many organs and systems can be involved in FA, of which the cutaneous and gastrointestinal symptoms are most common, and anaphylaxis might be life-threatening. The definite diagnosis of FA is very difficult; based on the integration of a detailed history, physical examination, skin prick tests and specific IgE detection results. The double-blind placebo-controlled food challenge （DBPCFC） test is accredited as the golden standard for the diagnosis of FA. Food poisoning, food intolerance, idiosyncratic reaction and symptoms induced by vasoactive amines intake should be differentiated with FA. The best treatment of FA is strictly avoidance of allergenic food（s）, and rescue medicine should be performed in case of accidental exposure.

关 键 词：食物 食物变态反应 严重过敏性反应 食物激发试验 

分 类 号：R593.1[医药卫生—内科学]