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[神经性皮炎与食物过敏。检测方法的临床相关性]

[Neurodermatitis and food allergy. Clinical relevance of testing procedures].

作者信息

Stiening H, Szczepanski R, von Mühlendahl K E, Kalveram C

机构信息

Kinderhospital Osnabrück, Münster.

出版信息

Monatsschr Kinderheilkd. 1990 Dec;138(12):803-7.

PMID:2087240
Abstract

In 132 children with neurodermitis, we measured specific IgG and IgE antibodies against components of cow's milk, soy milk, and egg. In addition we performed epidermal tests by rubbing the nutrients onto the intact skin. The results were compared to the effect of complete omission of milk, egg, and soy during four weeks and with the outcome of subsequent reexposition. We used standardized scales to evaluate the neurodermitis and the skin reactions and for the clinical response to the oral challenge. The best prediction for the outcome of the oral challenge was obtained by the epidermal test which had to be done with whole milk, soy milk and egg white; there was no further advantage in testing egg yolk or soy oil. IgE antibodies followed next in their predictive value. No further precision was gained by the combination of epidermal testing with IgE results, by the measurement of IgE antibodies to the constituents of cow's milk, of IgG antibodies, and of the platelet count during oral challenging. Positive reactions to oral administration after four weeks' omission of allergenic food were relatively frequent in the age group below three years, but rare in school children and adolescents.

摘要

在132名神经性皮炎患儿中,我们检测了他们针对牛奶、豆奶和鸡蛋成分的特异性IgG和IgE抗体。此外,我们还通过将这些营养物质涂抹在完整皮肤上进行了表皮试验。将结果与四周内完全不摄入牛奶、鸡蛋和大豆的效果以及随后再次接触后的结果进行了比较。我们使用标准化量表来评估神经性皮炎、皮肤反应以及对口服激发试验的临床反应。通过用全脂牛奶、豆奶和蛋清进行表皮试验,对口服激发试验结果的预测效果最佳;检测蛋黄或豆油并无进一步优势。IgE抗体的预测价值次之。将表皮试验结果与IgE结果相结合、检测针对牛奶成分的IgE抗体、检测IgG抗体以及在口服激发试验期间检测血小板计数,均无法进一步提高预测的准确性。在三岁以下年龄组中,在遗漏致敏食物四周后口服给药出现阳性反应的情况相对常见,但在学龄儿童和青少年中则很少见。

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