成年哮喘患者食物化学不耐受的评估

Assessment of food chemical intolerance in adult asthmatic subjects.

作者信息

Hodge L, Yan K Y, Loblay R L

机构信息

Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

出版信息

Thorax. 1996 Aug;51(8):805-9. doi: 10.1136/thx.51.8.805.

DOI:10.1136/thx.51.8.805

PMID:8795668

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC472547/

Abstract

BACKGROUND

Identification of food chemical intolerance in asthmatic subjects can be reliably assessed by changes in the forced expiratory volume in one second (FEV1) in response to double blind, placebo controlled challenges on a strict elimination diet. However, this method is cumbersome and time consuming. A study was undertaken to determine whether changes in bronchial responsiveness to histamine following food chemical challenge without an elimination diet might be a faster, more convenient method.

METHODS

Eleven adult asthmatic subjects were challenged twice with metabisulphite, aspirin, monosodium glutamate, artificial food colours, sodium nitrite/ nitrate, 0.5% citric acid solution (placebo), and sucrose (placebo) on separate days. During the first set of challenges subjects consumed a normal diet. Bronchial responsiveness to histamine was assessed 90 minutes after each challenge. A greater than twofold increase in bronchial responsiveness was considered positive. For one month prior to and during the second set of challenges subjects followed a strict elimination diet and FEV1 was monitored during and for two hours after each challenge. A fall in FEV1 of 20% or more was considered positive.

RESULTS

Of the 77 food chemical challenges performed on an unmodified diet, 20 were positive (six placebo responses). In two subjects it was not possible to perform a histamine test after one of the chemical challenges because of poor spirometric function. Of the 77 food chemical challenges performed on an elimination diet, 11 were positive (no placebo responses). Excluding the two challenges in which there were no corresponding histamine tests, only on two occasions did the positive responses in both methods coincide, giving the unmodified diet method a sensitivity of 22%.

CONCLUSIONS

Strict dietary elimination and measurement of FEV1 after double blind food chemical challenge remains the most reliable method for the detection of food chemical intolerance in asthmatic subjects.

摘要

背景

通过在严格的排除饮食基础上进行双盲、安慰剂对照激发试验，观察一秒用力呼气量（FEV1）的变化，能够可靠地评估哮喘患者对食物化学物质不耐受情况。然而，这种方法繁琐且耗时。因此开展了一项研究，以确定在不进行排除饮食的情况下，食物化学物质激发试验后支气管对组胺反应性的变化是否是一种更快、更便捷的方法。

方法

11名成年哮喘患者在不同日期分别接受两次偏亚硫酸氢盐、阿司匹林、味精、人工食用色素、亚硝酸钠/硝酸盐、0.5%柠檬酸溶液（安慰剂）和蔗糖（安慰剂）激发试验。在第一轮激发试验期间，受试者食用正常饮食。每次激发试验后90分钟评估支气管对组胺的反应性。支气管反应性增加两倍以上被视为阳性。在第二轮激发试验前一个月及试验期间，受试者遵循严格的排除饮食，每次激发试验期间及之后两小时监测FEV1。FEV1下降20%或更多被视为阳性。

结果

在未改变饮食的情况下进行的77次食物化学物质激发试验中，20次呈阳性（6次为安慰剂反应）。两名受试者在一次化学物质激发试验后，由于肺功能检查结果不佳，无法进行组胺试验。在排除饮食情况下进行的77次食物化学物质激发试验中，11次呈阳性（无安慰剂反应）。排除两次无相应组胺试验的激发试验，两种方法仅在两次出现阳性反应一致的情况，未改变饮食方法的灵敏度为22%。