Arai Y, Sano Y, Ito K, Iwasaki E, Mukouyama T, Baba M
Department of Allergy and Respiratory Medicine, Doai Medical Hospital.
Arerugi. 1998 Jul;47(7):658-66.
The aim of this study was to investigate in adult asthmatics, which kinds of food allergen can cause a positive reaction by skin scratch test and cause symptoms when administered as a food challenge.
Three thousand one hundred and two adult asthmatic patients were submitted to skin scratch tests with housedust mite. Japanese cedar extracts and 33 types of food. Sixty one adult asthmatic patients with a history of immediate, adverse reactions after food ingestion underwent open food challenge.
Six hundred and twenty five of 3102 subjects (20.1%) had a positive test to one or more food allergens. The commonest food allergens were shrimp (27.7%), crab (27.7%), yeast (23.8%) and buckwheat (15.8%). The positive tests of shrimp, egg and cow's milk were highest in patients under 20 years and decreased with age, however the test rates of crab and soybean were not influenced by age. Positive food challenge responses occurred in 30/60 subjects (50%). The foods, which most of ten provoked a reaction, were buckwheat, shrimp, crab and bread.
Skin scratch test results in adult asthmatics were different from those in atopic children where the commonest foods with positive tests were egg, cow's milk and soybean. Except for patients with a previous life-threatening reaction. Food allergy should be diagnosed by food challenge where a patient's history of adverse reaction to food, positive skin test and RAST strongly support specific food reactivity.
本研究旨在调查成年哮喘患者中,哪些食物过敏原通过皮肤划痕试验可引起阳性反应,并在进行食物激发试验时引发症状。
3102例成年哮喘患者接受了尘螨、日本雪松提取物及33种食物的皮肤划痕试验。61例有食物摄入后速发不良反应史的成年哮喘患者接受了开放性食物激发试验。
3102例受试者中有625例(20.1%)对一种或多种食物过敏原试验呈阳性。最常见的食物过敏原是虾(27.7%)、蟹(27.7%)、酵母(23.8%)和荞麦(15.8%)。20岁以下患者中虾、鸡蛋和牛奶的阳性试验率最高,且随年龄增长而降低,然而蟹和大豆的试验率不受年龄影响。60例受试者中有30例(50%)食物激发试验反应呈阳性。最常引发反应的食物是荞麦、虾、蟹和面包。
成年哮喘患者的皮肤划痕试验结果与特应性儿童不同,特应性儿童中试验呈阳性的最常见食物是鸡蛋、牛奶和大豆。除了既往有危及生命反应的患者外,食物过敏应通过食物激发试验来诊断,即患者有食物不良反应史、皮肤试验阳性及放射变应原吸附试验强烈支持特定食物反应性。