Buck D, Michael T, Wahn U, Niggemann B
Department of Pediatric Pneumology and Immunology, Children's Hospital Charité of Humboldt University, Berlin, Germany.
Pediatr Allergy Immunol. 2000 May;11(2):111-5. doi: 10.1034/j.1399-3038.2000.00039.x.
Patients with spina bifida represent the highest-risk group for developing hypersensitivity to latex. Recognized risk factors for these patients are repeated surgery and an atopic disposition. Our aim was to study the influence of a ventricular shunt as an independent risk factor. One hundred and sixty-one patients with spina bifida (median age 10 years) were investigated for the presence of a shunting device and the number, type and date of previous surgical interventions. Additionally, skin-prick tests and provocation tests were performed in order to classify sensitized and symptomatic latex-allergic individuals. Eighty-eight patients (54.7%) were sensitized; 55 (34.2%) were provocation-positive. Patients with a shunt system had undergone a significantly higher number of surgical procedures (p < 0.0001) and showed significantly higher levels of immunoglobulin E (IgE)-antibodies to latex (p < 0.0001) than patients without a shunting device. The total number of operations correlated significantly with the level of IgE-antibodies to latex in serum (p < 0.0001), whereas the number of shunt operations in patients with a ventricular shunt did not significantly correlate with the degree of sensitization. In conclusion, patients with spina bifida who have a ventricular shunt are at particularly high risk because they undergo a significantly higher number of operations than patients without a ventricular shunt. However, the ventricular shunt does not seem to be an independent risk factor. Furthermore, this study emphasizes that individuals at high risk, such as patients with spina bifida, should be handled latex-free from the very beginning of life.
脊柱裂患者是发生乳胶过敏的高危人群。这些患者公认的风险因素是反复手术和特应性体质。我们的目的是研究脑室分流作为一个独立风险因素的影响。对161例脊柱裂患者（中位年龄10岁）进行了调查，了解其是否存在分流装置以及既往手术干预的次数、类型和日期。此外，还进行了皮肤点刺试验和激发试验，以对致敏和有症状的乳胶过敏个体进行分类。88例患者（54.7%）致敏；55例（34.2%）激发试验呈阳性。与没有分流装置的患者相比，有分流系统的患者接受的手术次数明显更多（p < 0.0001），并且对乳胶的免疫球蛋白E（IgE）抗体水平明显更高（p < 0.0001）。手术总次数与血清中乳胶IgE抗体水平显著相关（p < 0.0001），而有脑室分流的患者的分流手术次数与致敏程度无显著相关性。总之，有脑室分流的脊柱裂患者风险特别高，因为他们接受的手术次数比没有脑室分流的患者明显更多。然而，脑室分流似乎不是一个独立的风险因素。此外，本研究强调，高危个体，如脊柱裂患者，从生命一开始就应避免接触乳胶。
