特应性皮炎患儿食物致敏危险因素分析：一项单中心横断面研究

doi:10.7499/j.issn.1008-8830.2202098

摘要
图/表
参考文献(28)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (560 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的分析特应性皮炎（atopic dermatitis，AD）患儿食物致敏的危险因素，以及食物致敏对生活质量及临床体征的影响。方法回顾性收集241例AD患儿人口学特征、发病年龄、病情严重度、生活质量、体格检查、食物过敏原检查、血清总IgE和嗜酸性粒细胞计数等资料。根据过敏原检测结果分为食物致敏组（n=127）和无食物致敏组（n=114）。采用多因素logistic回归分析评估AD患儿食物致敏的危险因素。结果 AD患儿食物致敏率为52.7%（127/241）。多因素logistic回归分析显示食物致敏危险因素为：秋季/冬季出生、AD发病年龄<12个月、重度AD、总IgE>150 IU/mL（P<0.05）。与无食物致敏组比较，食物致敏组生活质量较差（P=0.008），非特异性手足皮炎及掌纹症发生率较高（P<0.05）。与单种食物致敏组相比，多种食物致敏组AD病情较重，纯母乳喂养及总IgE>150 IU/mL者占比较高（P<0.05）。结论秋季/冬季出生、AD发病年龄<12个月、严重AD，或总IgE>150 IU/mL的AD患儿更易发生食物致敏。食物致敏AD患儿生活质量更差，更易出现非特异性手足皮炎及掌纹症。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王丹
	吴雪歌
	阎诗
	周甜甜
	黄亚娇
	李洁
	罗晓燕

关键词 ：特应性皮炎, 食物致敏, 危险因素, 生活质量, 临床体征, 儿童

Abstract：Objective To study the risk factors for food sensitization and the influence of food sensitization on quality of life and clinical signs in children with atopic dermatitis (AD). Methods A retrospective analysis was performed on the medical data of 241 children with AD, including demographic features, age of onset, severity of AD, quality of life, physical examination results, skin prick test (SPT) results, serum total IgE levels, and eosinophil count. According to the results of SPT, the children were divided into a food sensitization group (n=127) and a non-food sensitization group (n=114). The multivariate logistic regression analysis was used to identify the risk factors for food sensitization in children with AD. Results The prevalence rate of food sensitization was 52.7% (127/241) in the children with AD. The multivariate logistic regression analysis showed that birth in autumn or winter, age of onset of AD<12 months, severe AD, and total IgE>150 IU/mL were risk factors for food sensitization (P<0.05). Compared with the non-food sensitization group, the food sensitization group had a significantly poorer quality of life (P=0.008) and significantly higher prevalence rates of non-specific hand/foot dermatitis and palmar hyperlinearity (P<0.05). Compared with the single food sensitization group, the multiple food sensitization group had more severe AD and a significantly higher proportion of children with exclusive breastfeeding or total IgE>150 IU/mL (P<0.05). Conclusions The AD children born in autumn or winter, or those with early onset (<12 months), severe AD or total IgE>150 IU/mL have a higher risk of food sensitization. The AD children with food sensitization have a poorer quality of life and are more likely to develop non-specific hand/foot dermatitis and palmar hyperlinearity.

Key words： Atopic dermatitis Food sensitization Risk factor Quality of life Clinical sign Child

收稿日期: 2022-02-23

基金资助:重庆市卫健委中青年医学高端人才项目（2019GDRC010）。

通讯作者: 罗晓燕，女，主任医师。Email：luoxycq@hotmail.com。 E-mail: luoxycq@hotmail.com

作者简介: 王丹，女，硕士研究；

引用本文:

王丹,吴雪歌,阎诗等. 特应性皮炎患儿食物致敏危险因素分析：一项单中心横断面研究[J]. 中国当代儿科杂志, 2022, 24(8): 887-893.

WANG Dan,WU Xue-Ge,YAN Shi et al. Risk factors for food sensitization in children with atopic dermatitis: a single-center cross-sectional study[J]. CJCP, 2022, 24(8): 887-893.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2202098 或 http://www.zgddek.com/CN/Y2022/V24/I8/887

	Drucker AM, Wang AR, Li WQ, et al. The burden of atopic dermatitis: summary of a report for the national eczema association[J]. J Invest Dermatol, 2017, 137(1): 26-30. PMID: 27616422. DOI: 10.1016/j.jid.2016.07.012.
	Bylund S, Kobyletzki LB, Svalstedt M, et al. Prevalence and incidence of atopic dermatitis: a systematic review[J]. Acta Derm Venereol, 2020, 100(12): adv00160. PMID: 32412646. DOI: 10.2340/00015555-3510.
	3 Yuenyongviwat A, Koosakulchai V, Treepaiboon Y, et al. Risk factors of food sensitization in young children with atopic dermatitis[J]. Asian Pac J Allergy Immunol, 2021. Epub ahead of print. PMID: 33386793. DOI: 10.12932/AP-250820-0946.
	Robison RG, Singh AM. Controversies in allergy: food testing and dietary avoidance in atopic dermatitis[J]. J Allergy Clin Immunol Pract, 2019, 7(1): 35-39. PMID: 30501976. PMCID: PMC6312729. DOI: 10.1016/j.jaip.2018.11.006.
	5 中国医师协会皮肤科医师分会儿童皮肤病专业委员会, 中华医学会皮肤性病学分会儿童学组, 中华医学会儿科学分会皮肤性病学组. 儿童特应性皮炎相关食物过敏诊断与管理专家共识[J]. 中华皮肤科杂志, 2019, 52(10): 711-716. DOI: 10.35541/cjd.20190586.
	Tham EH, Rajakulendran M, Lee BW, et al. Epicutaneous sensitization to food allergens in atopic dermatitis: what do we know?[J]. Pediatr Allergy Immunol, 2020, 31(1): 7-18. PMID: 31541586. DOI: 10.1111/pai.13127.
	Tran MM, Lefebvre DL, Dharma C, et al. Predicting the atopic march: results from the Canadian Healthy Infant Longitudinal Development Study[J]. J Allergy Clin Immunol, 2018, 141(2): 601-607.e8. PMID: 29153857. DOI: 10.1016/j.jaci.2017.08.024.
	Hill DJ, Hosking CS, de Benedictis FM, et al. Confirmation of the association between high levels of immunoglobulin E food sensitization and eczema in infancy: an international study[J]. Clin Exp Allergy, 2008, 38(1): 161-168. PMID: 18028467. DOI: 10.1111/j.1365-2222.2007.02861.x.
	Boccardi D, D'Auria E, Turati F, et al. Disease severity and quality of life in children with atopic dermatitis: PO-SCORAD in clinical practice[J]. Minerva Pediatr, 2017, 69(5): 373-380. PMID: 26200523. DOI: 10.23736/S0026-4946.16.04294-8.
	Fukuie T, Yasuoka R, Fujiyama T, et al. Palmar hyperlinearity in early childhood atopic dermatitis is associated with filaggrin mutation and sensitization to egg[J]. Pediatr Dermatol, 2019, 36(2): 213-218. PMID: 30810250. DOI: 10.1111/pde.13752.
	Brar KK, Calatroni A, Berdyshev E, et al. Hyperlinear palms as a clinical finding in peanut allergy[J]. J Allergy Clin Immunol Pract, 2020, 8(8): 2823-2825. PMID: 32376483. PMCID: PMC7483281. DOI: 10.1016/j.jaip.2020.04.056.
	De D, Kanwar AJ, Handa S. Comparative efficacy of Hanifin and Rajka's criteria and the UK working party's diagnostic criteria in diagnosis of atopic dermatitis in a hospital setting in North India[J]. J Eur Acad Dermatol Venereol, 2006, 20(7): 853-859. PMID: 16898910. DOI:10.1111/j.1468-3083.2006.01664.x.
	Peters RL, Krawiec M, Koplin JJ, et al. Update on food allergy[J]. Pediatr Allergy Immunol, 2021, 32(4): 647-657. PMID: 33370488. PMCID: PMC8247869. DOI: 10.1111/pai.13443.
	Schmitt J, Langan S, Deckert S, et al. Assessment of clinical signs of atopic dermatitis: a systematic review and recommendation[J]. J Allergy Clin Immunol, 2013, 132(6): 1337-1347. PMID: 24035157. DOI: 10.1016/j.jaci.2013.07.008.
	Silverberg JI, Lei D, Yousaf M, et al. Comparison of patient-oriented eczema measure and patient-oriented scoring atopic dermatitis vs eczema area and severity index and other measures of atopic dermatitis: a validation study[J]. Ann Allergy Asthma Immunol, 2020, 125(1): 78-83. PMID: 32199977. DOI: 10.1016/j.anai.2020.03.006.
	Thomas KS, Apfelbacher CA, Chalmers JR, et al. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting[J]. Br J Dermatol, 2021, 185(1): 139-146. PMID: 33393074. PMCID: PMC8359383. DOI: 10.1111/bjd.19751.
	Matsui T, Tanaka K, Yamashita H, et al. Food allergy is linked to season of birth, sun exposure, and vitamin D deficiency[J]. Allergol Int, 2019, 68(2): 172-177. PMID: 30670337. DOI: 10.1016/j.alit.2018.12.003.
	Liu X, Arguelles L, Zhou Y, et al. Longitudinal trajectory of vitamin D status from birth to early childhood in the development of food sensitization[J]. Pediatr Res, 2013, 74(3): 321-326. PMID: 23797532. PMCID: PMC3773018. DOI: 10.1038/pr.2013.110.
	Ng JC, Yew YW. Effect of vitamin D serum levels and supplementation on atopic dermatitis: a systematic review and meta-analysis[J]. Am J Clin Dermatol, 2022, 23(3): 267-275. PMID: 35246808. DOI: 10.1007/s40257-022-00677-0.
	Umar M, Sastry KS, Al Ali F, et al. Vitamin D and the pathophysiology of inflammatory skin diseases[J]. Skin Pharmacol Physiol, 2018, 31(2): 74-86. PMID: 29306952. DOI: 10.1159/000485132.
	Tokura Y. Extrinsic and intrinsic types of atopic dermatitis[J]. J Dermatol Sci, 2010, 58(1): 1-7. PMID: 20207111. DOI: 10.1016/j.jdermsci.2010.02.008.
	Hu Y, Liu S, Liu P, et al. Clinical relevance of eosinophils, basophils, serum total IgE level, allergen-specific IgE, and clinical features in atopic dermatitis[J]. J Clin Lab Anal, 2020, 34(6): e23214. PMID: 32068307. PMCID: PMC7307373. DOI: 10.1002/jcla.23214.
	Martin MJ, Estravís M, García-Sánchez A, et al. Genetics and epigenetics of atopic dermatitis: an updated systematic review[J]. Genes (Basel), 2020, 11(4): 442. PMID: 32325630. PMCID: PMC7231115. DOI: 10.3390/genes11040442.
	Brough HA, Nadeau KC, Sindher SB, et al. Epicutaneous sensitization in the development of food allergy: what is the evidence and how can this be prevented?[J]. Allergy, 2020, 75(9): 2185-2205. PMID: 32249942. PMCID: PMC7494573. DOI: 10.1111/all.14304.
	Eigenmann PA, Beyer K, Lack G, et al. Are avoidance diets still warranted in children with atopic dermatitis?[J]. Pediatr Allergy Immunol, 2020, 31(1): 19-26. PMID: 31273833. DOI: 10.1111/pai.13104.
	Jiao L, Su CW, Cao T, et al. Maternal influences and intervention strategies on the development of food allergy in offspring[J]. Front Immunol, 2022, 13: 817062. PMID: 35281070. PMCID: PMC8904425. DOI: 10.3389/fimmu.2022.817062.
	Bradshaw LE, Haines RH, Thomas KS, et al. Clinical examination for hyperlinear palms to determine filaggrin genotype: a diagnostic test accuracy study[J]. Clin Exp Allergy, 2021, 51(11): 1421-1428. PMID: 34608691. DOI: 10.1111/cea.14025.
	Mustonen N, Siljander H, Niemel? O, et al. Allergy-related symptoms are poorly predicted by IgE and skin prick testing in early life[J]. Int Arch Allergy Immunol, 2021, 182(7): 574-584. PMID: 33550294. DOI: 10.1159/000512109.