Sakai Kazunori, Sasaki Kemal, Furuta Tomoko, Sugiura Shiro, Watanabe Yukari, Kobayashi Takae, Kawabe Takashi, Morishita Masashi, Nakanishi Kumiko, Ito Komei
Department of Allergy, Aichi Children's Health and Medical Center, Obu 474-8710, Japan.
Department of Pediatrics, Okazaki City Hospital, Okazaki 444-8553, Japan.
Asia Pac Allergy. 2017 Oct;7(4):234-242. doi: 10.5415/apallergy.2017.7.4.234. Epub 2017 Oct 23.
Oral food challenge (OFC) tests are conducted in both specialized institutions and general hospitals. We aimed to compare the severity of the conditions of the patients between these 2 types of institutions in order to consider the role of such institutions in society.
We evaluated the results of OFC tests for hen's egg, cow's milk, and wheat that were conducted in a specialized institution (Aichi Children's Health and Medical Center [ACHMC], n = 835) and in 4 general hospitals (n = 327) in Aichi prefecture, Japan.
The symptoms provoked were scored using the total score (TS) of the Anaphylaxis Scoring Aichi scoring system in combination with the total ingested protein dose (Pro) before the appearance of allergic symptoms.
The total ingested dose of the challenge-positive patients in ACHMC was significantly less than that in the general hospitals ( < 0.01). The median TS of the provoked symptoms in ACHMC and the general hospitals did not differ to a statistically significant extent in the hen's egg or cow's milk challenges; however, the median TS in ACHMC was significantly lower than that in the general hospitals for the wheat challenge ( = 0.02). The median TS/Pro values in ACHMC were almost identical to the upper 25% of the TS/Pro values in the general hospitals, suggesting that the specialized institution usually managed more severe patients.
The specialized institution performed OFC tests at a lower threshold dose, but provoked similar TSs to the general hospitals. This evaluation may help in optimizing the distribution of patients to general hospitals and specialized institutions.
口服食物激发试验（OFC）在专科医院和综合医院均有开展。我们旨在比较这两类机构中患者病情的严重程度，以便考量此类机构在社会中的作用。
我们评估了在日本爱知县的一家专科医院（爱知儿童健康与医疗中心[ACHMC]，n = 835）和4家综合医院（n = 327）进行的针对鸡蛋、牛奶和小麦的OFC试验结果。
使用爱知过敏评分系统的总分（TS）结合出现过敏症状前摄入的总蛋白剂量（Pro）对激发的症状进行评分。
ACHMC中激发试验阳性患者的总摄入量显著低于综合医院（<0.01）。在鸡蛋或牛奶激发试验中，ACHMC和综合医院激发症状的TS中位数在统计学上没有显著差异；然而，在小麦激发试验中，ACHMC的TS中位数显著低于综合医院（=0.02）。ACHMC中TS/Pro值的中位数几乎与综合医院TS/Pro值的上25%相同，这表明专科医院通常诊治的患者病情更严重。
专科医院在较低的阈值剂量下进行OFC试验，但激发的TS与综合医院相似。该评估可能有助于优化患者在综合医院和专科医院之间的分配。
