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[婴儿期食物过敏的预后]

[Prognoses of food allergy in infancy].

作者信息

Wang Nian-rong, Li Hai-qi

机构信息

Department of Child Health Care, Children's Hospital Affiliated to Chongqing Medical University, Chongqing 400014, China.

出版信息

Zhonghua Er Ke Za Zhi. 2005 Oct;43(10):777-81.

Abstract

OBJECTIVE

Food allergy as one of social health problems has gained more attention of people. However, few reports on prognosis of food allergy, the relation between infant food allergy and other allergic diseases, and factors affecting prognoses of infant food allergy in China. The present study was designed to investigate the evolution of infancy food allergy and to explore predicting factors of the tolerance to these foods and factors of other allergic diseases to provide a clue for managing children with food allergy reasonably and to improve their prognoses.

METHODS

Totally 119 children with food allergy during infancy, who were diagnosed in the Department of Primary Child Care, Children's Hospital, Chongqing University of Medical Sciences from January 2000 to June 2003, were studied retrospectively by analyzing the follow-up data before March 2004. The occurrence of food tolerance and other allergic diseases were counted. Kaplan-Meier methods were used to calculate the cumulative tolerance probability. And the predicting factors of persistent food allergy and influential factors of other allergic diseases were analyzed by unconditional Logistic regression models.

RESULTS

The cumulative tolerance probabilities of cow's milk and egg were 42% and 31% one year after diagnosis respectively, 63% and 62% 2 years later, 77% and 80% 3 years later, and 100% after 4 years. And the severity of skin prick test reactions to cow's milk and egg was the predicting factor for persisting hypersensitivity to cow's milk and egg (OR = 2.535, 95% CI: 1.159-5.543; OR = 2.654, 95% CI: 1.302-5.410, P < 0.05). Thirteen cases presented with hypersensitivity to other foods (15.6 +/- 6.1) months after the diagnosis was confirmed, and the risk factor was the long-lasting hypersensitivity to egg (OR = 6.109, 95% CI: 1.818-20.527, P < 0.05). After 4 cases and 15 cases were diagnosed as allergic rhinitis and asthma, respectively, (16.8 +/- 8.3) months after diagnoses and the risk factors were the long-lasting hypersensitivity to egg and the respiratory symptoms (OR = 3.596, 95% CI: 1.429-9.045; OR = 4.235, 95% CI: 1.152-15.563, P < 0.05).

CONCLUSION

At least 75% of children with egg or cow's milk allergy could develop tolerance to egg or cow's milk within 3 years after diagnoses; 10.9%, 12.6% and 3.4% of children with food allergy suffered from other food allergy, asthma and allergic rhinitis. Strengthening the screening and management of children at high risk for persistent food allergy will contribute to improvement of the prognoses of food allergy.

摘要

目的

食物过敏作为一个社会健康问题已受到人们更多关注。然而,关于食物过敏预后、婴儿食物过敏与其他过敏性疾病的关系以及影响婴儿食物过敏预后因素的报道在中国较少。本研究旨在探讨婴儿食物过敏的演变过程,探索食物耐受的预测因素以及其他过敏性疾病的相关因素,为合理管理食物过敏儿童并改善其预后提供线索。

方法

对2000年1月至2003年6月在重庆医科大学附属儿童医院儿童保健科确诊的119例婴儿期食物过敏患儿进行回顾性研究,分析2004年3月前的随访资料。统计食物耐受和其他过敏性疾病的发生情况。采用Kaplan-Meier法计算累积耐受概率。通过非条件Logistic回归模型分析持续性食物过敏的预测因素及其他过敏性疾病的影响因素。

结果

牛奶和鸡蛋过敏诊断后1年的累积耐受概率分别为42%和31%,2年后为63%和62%,3年后为77%和80%,4年后为100%。牛奶和鸡蛋皮肤点刺试验反应的严重程度是牛奶和鸡蛋持续过敏的预测因素(OR = 2.535,95%CI:1.159 - 5.543;OR = 2.654,95%CI:1.302 - 5.410,P < 0.05)。确诊后13例患儿(15.6 ± 6.1)个月出现对其他食物过敏,危险因素为对鸡蛋的长期过敏(OR = 6.109,95%CI:1.818 - 20.527,P < 0.05)。分别有4例和15例患儿在诊断后(16.8 ± 8.3)个月被诊断为过敏性鼻炎和哮喘,危险因素为对鸡蛋的长期过敏和呼吸道症状(OR = 3.596,95%CI:1.429 - 9.045;OR = 4.235,95%CI:1.152 - 15.563,P < 0.05)。

结论

至少75%的牛奶或鸡蛋过敏患儿在诊断后3年内可对牛奶或鸡蛋产生耐受;10.9%、12.6%和3.4%的食物过敏患儿患有其他食物过敏、哮喘和过敏性鼻炎。加强对持续性食物过敏高危儿童的筛查和管理将有助于改善食物过敏的预后。

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