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[家长报告的食物过敏儿童的临床特征及影响因素]

[Clinical characteristics and influencing factors of children with parent-reported food allergy].

作者信息

Ma Z Y, Chen L, Xian R L, Fang H P, Wang J, Hu Y

机构信息

Department of Child Health Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders (Chongqing), Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing 400014, China.

出版信息

Zhonghua Er Ke Za Zhi. 2022 Jul 2;60(7):676-681. doi: 10.3760/cma.j.cn112140-20211215-01047.

Abstract

To analyze the clinical characteristics and influencing factors of children with parent-reported food allergy (FA), thus providing empirical evidence for facilitating the effective utilization of medical history information and promoting better health education for parents. A cross-sectional study was conducted, recruiting all 596 children under 3 years of age who underwent physical examinations from July to August 2019 at the Department of Child Health Care, Children's Hospital of Chongqing Medical University. Children were carried out with questionnaires, skin prick test, and diagnosed with FA through oral food challenge (OFC) by pediatricians. The parent-reported incidence rate, symptoms of FA, and the possible influencing factors, including demographic characteristics, family history of allergy, in-utero exposure to smoke and antibiotic use, feeding methods after birth, and residential environment were collected by questionnaire. The differences of clinical characteristics between parent-reported FA and medically diagnosed FA were analyzed by chi-square test. Logistic regression was used to analyze the factors associated with parent-reported FA. A total of 596 children (316 boys and 280 girls) were recruited for this study. The incidence rate of FA by parent-report (22.0%, 131/596) was higher than that by medical diagnosis (9.9%, 59/596) (χ²=32.46, <0.001). There were 36.6% (48/131) of children with parent-reported FA and 2.4% (11/465) of children without parent-reported FA receiving medical diagnosis of FA. Among children with parent-reported allergic symptoms, 37.5% (24/64) of those with gastrointestinal symptoms and 31.5% (23/73) of those with skin symptoms received medical diagnosis of FA, respectively. Six out of 7 children with co-presenting cutaneous and gastrointestinal symptoms were diagnosed with FA. Univariate Logistic regression analysis showed that family history of allergy (=1.83 (95% 1.22-2.73), =0.003) and damp living environments (=2.33 (95% 1.13-4.79), =0.022) were associated with higher likelihood of parent-reported FA. The incidence rate of parent-reported FA is higher than medically diagnosed FA. Clinicians should be highly suspicious of the possibility of FA in children with both cutaneous and gastrointestinal symptoms. Family history of allergy and damp living environments may increase the possibility of parent-reported FA.

摘要

分析家长报告的食物过敏(FA)儿童的临床特征及影响因素,为促进病史信息的有效利用及推动对家长更好的健康教育提供实证依据。开展了一项横断面研究,纳入2019年7月至8月在重庆医科大学附属儿童医院儿童保健科接受体检的所有596名3岁以下儿童。对儿童进行问卷调查、皮肤点刺试验,并由儿科医生通过口服食物激发试验(OFC)诊断FA。通过问卷收集家长报告的FA发病率、FA症状以及可能的影响因素,包括人口统计学特征、过敏家族史、宫内烟雾暴露和抗生素使用情况、出生后的喂养方式以及居住环境。采用卡方检验分析家长报告的FA与医学诊断的FA之间临床特征的差异。采用Logistic回归分析与家长报告的FA相关的因素。本研究共纳入596名儿童(316名男孩和280名女孩)。家长报告的FA发病率(22.0%,131/596)高于医学诊断的发病率(9.9%,59/596)(χ²=32.46,P<0.001)。家长报告有FA的儿童中有36.6%(48/131)以及家长报告无FA的儿童中有2.4%(11/465)接受了FA的医学诊断。在家长报告有过敏症状的儿童中,有胃肠道症状的儿童中有37.5%(24/64)以及有皮肤症状的儿童中有31.5%(23/73)分别接受了FA的医学诊断。7名同时有皮肤和胃肠道症状的儿童中有6名被诊断为FA。单因素Logistic回归分析显示,过敏家族史(比值比=1.83(95%置信区间1.22-2.73),P=0.003)和居住环境潮湿(比值比=2.33(95%置信区间1.13-4.79),P=0.022)与家长报告的FA可能性较高相关。家长报告的FA发病率高于医学诊断的FA。临床医生应对同时有皮肤和胃肠道症状的儿童的FA可能性高度怀疑。过敏家族史和居住环境潮湿可能增加家长报告的FA的可能性。

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