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哮喘学龄前儿童发生 IgE 介导的食物过敏的危险因素。

Risk Factors for the Development of IgE-Mediated Food Allergy in Preschool Children with Asthma.

机构信息

Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

出版信息

J Trop Pediatr. 2022 Feb 3;68(2). doi: 10.1093/tropej/fmac008.

Abstract

BACKGROUND

Food allergy is a component of the atopic march and may have effects on asthma. This study aimed to evaluate the risk factors for confirmed immunoglobulin E-mediated food allergies and their impact on the clinical picture in preschool children with asthma.

METHODS

Clinical history and allergic assessment results were obtained from medical records and analyzed retrospectively. Preschool children with asthma were included in the study and the characteristics of food allergy and asthma were evaluated. The patients were grouped as those with food allergy (Group I, n = 60) and those without (Group II, n = 98).

RESULTS

In patients with food allergy and asthma, the number of episodes requiring systemic steroids in the last year (p = 0.002), atopic dermatitis (p = 0.001), parental atopic disease (p = 0.009) and aeroallergen sensitivity rates (p < 0.001) was higher than patients without food allergies. The use of medium or high doses of inhaled steroids to achieve asthma control was more frequent in patients with food allergies (p = 0.014). Parental history of atopic disease [p = 0.007, odds ratio (OR): 3.27, 95% confidence interval (CI) 1.37-7.77)], atopic dermatitis (p = 0.017, OR: 2.80, 95% CI: 1.19-6.57), starting complementary food after 6 months (p = 0.004, OR: 3.9, 95% CI: 1.5-10.0) and having aeroallergen sensitivity (p < 0.001, OR: 6.01, 95% CI: 2.21-16.29) were identified as significant risk factors for food allergy.

CONCLUSION

Asthmatic preschool children with food allergies are more likely to have a parental atopic disease, atopic dermatitis, aeroallergen sensitivity and starting complementary food after 6 months. These patients experience more asthma attacks and need higher doses of steroids.

摘要

背景

食物过敏是特应性进行曲的一个组成部分,可能对哮喘有影响。本研究旨在评估特应性哮喘学龄前儿童中已确诊的免疫球蛋白 E 介导的食物过敏的危险因素及其对临床症状的影响。

方法

从病历中获取临床病史和过敏评估结果,并进行回顾性分析。将哮喘的学龄前儿童纳入研究,并评估食物过敏和哮喘的特征。将患者分为食物过敏组(I 组,n=60)和无食物过敏组(II 组,n=98)。

结果

在有食物过敏和哮喘的患者中,过去一年需要全身使用类固醇的发作次数(p=0.002)、特应性皮炎(p=0.001)、父母的特应性疾病(p=0.009)和变应原敏感性率(p<0.001)均高于无食物过敏的患者。需要使用中高剂量吸入性类固醇来控制哮喘的患者在有食物过敏的患者中更为常见(p=0.014)。父母有特应性疾病史(p=0.007,比值比(OR):3.27,95%置信区间(CI):1.37-7.77))、特应性皮炎(p=0.017,OR:2.80,95% CI:1.19-6.57))、6 个月后开始添加补充食物(p=0.004,OR:3.9,95% CI:1.5-10.0))和有变应原敏感性(p<0.001,OR:6.01,95% CI:2.21-16.29))被确定为食物过敏的显著危险因素。

结论

有食物过敏的特应性哮喘学龄前儿童更有可能存在父母的特应性疾病、特应性皮炎、变应原敏感性和 6 个月后开始添加补充食物。这些患者的哮喘发作更频繁,需要更高剂量的类固醇。

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