Ostblom E, Egmar A-C, Gardulf A, Lilja G, Wickman M
Department of Pediatrics, Sachs' Children's Hospital, Huddinge, Stockholm, Sweden.
Allergy. 2008 Feb;63(2):211-8. doi: 10.1111/j.1398-9995.2007.01559.x.
There are only a few studies on the impact of food hypersensitivity (FHS) in children on health-related quality of life (HRQL). The present study was designed to examine this impact in a population-based birth cohort (BAMSE).
A nested case-control study was performed within the cohort. The parents of 1378 nine-year-old children filled out a generic questionnaire with 13 subscales (Child Health Questionnaire Parental Form 28 - CHQ-PF28) supplemented with disease-specific questions concerning FHS. There were 212 children with report of FHS. Another 221 children with allergic diseases but not FHS were examined for comparison. Furthermore, the impact of pronounced symptoms of FHS and of increasing levels of food-specific IgE antibodies on HRQL was also analysed.
The children with FHS exhibited significantly lower scores on the subscales physical functioning, role/social limitations - physical and general health in the generic instrument. Furthermore, children with food-related symptoms from the lower airways were scored lower on Self Esteem, Parental Impact - time and Family Cohesion. Sensitization per se did not alter these patterns, but high levels of food-specific IgE-antibodies affected mental health and general health negatively. A physician's diagnosis of food allergy did not affect any of the subscales negatively.
Parents reported that FHS exerts a negative impact on the HRQL of 9-year-old children, in particular in children with symptoms from the lower airways or if the FHS is associated with high levels of food-specific IgE-antibodies. Healthcare-givers must put major effort into improving and maintaining the HRQL of these children.
关于儿童食物过敏(FHS)对健康相关生活质量(HRQL)影响的研究较少。本研究旨在对一个基于人群的出生队列(BAMSE)进行此项影响的研究。
在该队列中进行了一项巢式病例对照研究。1378名九岁儿童的父母填写了一份包含13个分量表的通用问卷(儿童健康问卷家长版28 - CHQ - PF28),并补充了有关食物过敏的疾病特异性问题。有212名儿童报告有食物过敏。另外选取221名患有过敏性疾病但无食物过敏的儿童作为对照。此外,还分析了食物过敏的明显症状以及食物特异性IgE抗体水平升高对健康相关生活质量的影响。
患有食物过敏的儿童在通用量表的身体功能、角色/社会限制 - 身体和总体健康等分量表上得分显著较低。此外,下呼吸道出现与食物相关症状的儿童在自尊、父母影响 - 时间和家庭凝聚力方面得分较低。致敏本身并未改变这些模式,但高水平的食物特异性IgE抗体会对心理健康和总体健康产生负面影响。医生对食物过敏的诊断对任何分量表均无负面影响。
父母报告称,食物过敏对9岁儿童的健康相关生活质量有负面影响,尤其是下呼吸道出现症状的儿童或食物过敏与高水平食物特异性IgE抗体相关的儿童。医疗保健人员必须大力努力改善和维持这些儿童的健康相关生活质量。