Watson W T
Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.
Clin Rev Allergy Immunol. 1995 Winter;13(4):347-59. doi: 10.1007/BF02801844.
The diagnosis of hypersensitivity reactions to foods in infancy and childhood requires the use of clinical skills and laboratory diagnostic methods to identify suspect foods. Patients and parents occasionally may need to keep food/symptom diaries to explore the association of foods and adverse reaction. Skin testing or RAST may shorten the list of potential allergens because of their excellent negative predictive value. Except for obvious serious allergic reactions after ingestion of a single food, confirmation of the reaction may be ideally confirmed by a DBPCFC, especially if the reported symptoms are subjective in nature. Equivocal responses should be repeated. Although many in vitro and in vivo diagnostic methods have been developed to potentially improve the diagnosis of food allergy in children, no test has been able to predict the results of the DBPCFC with any greater accuracy than skin tests or RAST. The "perfect" test with excellent positive and negative predictive values has yet to be developed.
婴幼儿及儿童食物过敏反应的诊断需要运用临床技能和实验室诊断方法来确定可疑食物。患者及家长有时可能需要记录食物/症状日记，以探究食物与不良反应之间的关联。皮肤试验或放射性变应原吸附试验（RAST）因其出色的阴性预测价值，可能会缩短潜在过敏原的清单。除了摄入单一食物后出现明显严重过敏反应的情况外，反应的确认理想情况下应由双盲安慰剂对照食物激发试验（DBPCFC）来完成，尤其是当报告的症状本质上较为主观时。模棱两可的反应应重复进行。尽管已经开发出许多体外和体内诊断方法，可能会改善儿童食物过敏的诊断，但尚无任何检测方法能够比皮肤试验或RAST更准确地预测双盲安慰剂对照食物激发试验的结果。具有出色阳性和阴性预测价值的“完美”检测方法尚未研发出来。
