Cremer R, Hoppe A, Kleine-Diepenbruck U, Bläker F
Children's Hospital, Pediatric Clinic, Cologne, Germany.
Pediatr Allergy Immunol. 1998 Feb;9(1):40-3. doi: 10.1111/j.1399-3038.1998.tb00299.x.
The course of latex sensitization is rarely documented, and only a few reports about the influence of prophylaxis in the occupational environment have been published concerning health care workers. Therefore we did a follow-up study in the high risk group of patients with spina bifida and evaluated the efficacy of latex prophylaxis. For this purpose we measured IgE antibodies (FEIA) against latex and inhalative allergens in the sera of 67 patients with spina bifida and reevaluated them 0.6 to 4.1 years later, having instructed the patients about prophylactic measures and established a latex-free environment for surgery of all spina bifida patients in our hospital. 37% of the patients did not develop latex antibodies during the follow-up period, 27% showed decreasing levels of antibodies (12% to non-detectable levels), 19% had an increase in latex sensitization (6% newly sensitized), and 9% showed no change in levels of latex antibodies. From our data it may be concluded that surgery without strict latex prophylaxis is the main cause of new sensitization and worsening of preexisting latex antibody levels. Mild sensitization can be reduced by prophylactic measurements to non-detectable antibody levels. With consistent prophylaxis, even symptomatic patients can be operated without risk of allergic complications or increasing antibodies.
乳胶致敏的病程鲜有文献记载，关于职业环境中预防措施对医护人员影响的报道也仅有几篇。因此，我们对脊柱裂患者这一高危群体进行了一项随访研究，并评估了乳胶预防措施的效果。为此，我们检测了67例脊柱裂患者血清中针对乳胶和吸入性过敏原的IgE抗体（荧光酶免疫分析），并在0.6至4.1年后对他们进行了重新评估。在此期间，我们向患者介绍了预防措施，并为我院所有脊柱裂患者的手术建立了无乳胶环境。在随访期间，37%的患者未产生乳胶抗体，27%的患者抗体水平下降（12%降至检测不到的水平），19%的患者乳胶致敏情况加重（6%为新致敏），9%的患者乳胶抗体水平无变化。从我们的数据可以得出结论，不采取严格乳胶预防措施的手术是新致敏和现有乳胶抗体水平恶化的主要原因。通过预防措施，轻度致敏可降至检测不到的抗体水平。通过持续的预防措施，即使是有症状的患者也可以进行手术，而不会有过敏并发症或抗体增加的风险。
