Nentwich I, Pazdírková A, Lokaj J, Szepfalusi Z, Hrstková H
Institut für klinische Immunologie und Allergologie der Masaryk-Universität, Brno, Tschechien.
Klin Padiatr. 2009 Mar-Apr;221(2):78-82. doi: 10.1055/s-2007-993204. Epub 2008 Feb 12.
Recommendations for primary prevention of allergic diseases in high-risk children include hypoallergenic infant formulas (HA) if breastfeeding is insufficient. The primary objective of our study was to investigate the atopic dermatitis (AD) preventive effect of breastfeeding and HA-nutrition in the first 2 years of life and to follow the increase in weight.
Altogether 174 newborns with a hereditary risk for atopy were enrolled in the study, 121 children were investigated at the age of 2 months, 111 at the age of 4 and 106 at the age of 6 months. A total of 45 infants were in the first half-year of life exclusively breastfed and 61 infants were mainly fed with HA.
The body weight of initially HA-fed children was 7870G (SD 949) significantly higher as the one of breastfed children (7508 G, SD 912, p=0.0571), in addition the weight increase was also significantly higher in HA-fed infants at the age of 6 months (p=0.0042). The frequency of AD as well as SCORAD score at the age of 6 to 24 months was comparable in both groups. Neither the milk-specific IgE antibodies nor the proliferation of peripheral blood mononuclear cells (PBMC) to bovine beta-Lactoglobulin (BLG) at the age of 6 months had a prognostic value for development of atopic dermatitis.
The likelihood to develop AD in the first 2 years of life was comparable in exclusively breastfed as in HA-fed infants with hereditary risk for atopy. The initially HA-fed children demonstrated at the age of 6 months higher body weight and weight increase as the exclusively breastfed infants. The efficacy of nutritional intervention on the incidence of AD in high-risk children for atopy could not be predicted by milk-specific IgE antibodies or BLG-specific proliferation of PBMC.
对于高危儿童过敏性疾病的一级预防建议包括，若母乳喂养不足则采用低敏婴儿配方奶粉（HA）。我们研究的主要目的是调查母乳喂养和HA营养在生命最初2年对特应性皮炎（AD）的预防作用，并跟踪体重增加情况。
总共174名有遗传性特应性风险的新生儿参与了本研究，121名儿童在2个月时接受调查，111名在4个月时接受调查，106名在6个月时接受调查。共有45名婴儿在生命的前半年纯母乳喂养，61名婴儿主要喂养HA。
最初喂养HA的儿童体重为7870克（标准差949），显著高于母乳喂养儿童（7508克，标准差912，p=0.0571），此外，6个月大时喂养HA的婴儿体重增加也显著更高（p=0.0042）。两组在6至24个月时AD的发生率以及SCORAD评分相当。无论是牛奶特异性IgE抗体，还是6个月大时外周血单个核细胞（PBMC）对牛β-乳球蛋白（BLG）的增殖，对特应性皮炎的发展均无预后价值。
在生命的前2年，纯母乳喂养的婴儿和有遗传性特应性风险且喂养HA的婴儿患AD 的可能性相当。最初喂养HA的儿童在6个月大时体重和体重增加高于纯母乳喂养的婴儿。牛奶特异性IgE抗体或PBMC的BLG特异性增殖无法预测营养干预对高危特应性儿童AD发病率的疗效。
