Nakamura C T, Ferdman R M, Keens T G, Davidson Ward S L
Division of Pediatric Pulmonology, Childrens Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Chest. 2000 Oct;118(4):1000-3. doi: 10.1378/chest.118.4.1000.
Determining the incidence of latex allergy in children receiving home mechanical ventilation.
The prevalence of latex allergy in the general population ranges from 0.1 to 1.0%. However, in patients with spina bifida and other chronic medical conditions associated with repeated exposure to latex, the prevalence may be as high as 60%. Children receiving home mechanical ventilation are frequently exposed to latex products. Therefore, we hypothesized that these children would be at increased risk for latex allergy.
Fifty-seven children receiving home mechanical ventilation (31 boys, 26 girls; mean [+/- SD] age, 7.8+/-6.6 years; range, 0.3 to 23.2 years) were enrolled. A radioallergosorbent test (RAST) for latex was administered and serum IgE levels were obtained in all patients.
Seventeen patients (29.8%) were found to have a positive RAST for latex. Patients with latex allergy had required mechanical ventilation for an average of 6.1+/-4.1 years vs. 5.5+/-5.4 years (p = 0.69; not significant) in those without latex allergy. Eleven of 17 patients (64.7%) had elevated serum IgE levels in the group with latex allergy vs only 14 of 40 patients (35.0%) in the group with a negative latex RAST (p = 0.04; odds ratio, 3.4).
We conclude that there is a high incidence of latex allergy in children requiring home mechanical ventilation. We speculate that screening all children receiving home mechanical ventilation may lead to the identification of patients with previously undiagnosed latex allergy and the prevention of untoward reactions from exposure to latex.
确定接受家庭机械通气的儿童中乳胶过敏的发生率。
普通人群中乳胶过敏的患病率为0.1%至1.0%。然而，在患有脊柱裂和其他与反复接触乳胶相关的慢性疾病的患者中，患病率可能高达60%。接受家庭机械通气的儿童经常接触乳胶产品。因此，我们推测这些儿童乳胶过敏的风险会增加。
纳入57名接受家庭机械通气的儿童（31名男孩，26名女孩；平均[±标准差]年龄为7.8±6.6岁；范围为0.3至23.2岁）。对所有患者进行乳胶的放射变应原吸附试验（RAST）并检测血清IgE水平。
发现17名患者（29.8%）乳胶RAST呈阳性。乳胶过敏患者平均需要机械通气6.1±4.1年，而无乳胶过敏患者为5.5±5.4年（p = 0.69；无显著差异）。乳胶过敏组17名患者中有11名（64.7%）血清IgE水平升高，而乳胶RAST阴性组40名患者中只有14名（35.0%）升高（p = 0.04；比值比为3.4）。
我们得出结论，需要家庭机械通气的儿童中乳胶过敏的发生率很高。我们推测，对所有接受家庭机械通气的儿童进行筛查可能会发现先前未被诊断出乳胶过敏的患者，并预防因接触乳胶而产生的不良反应。
