目的 通过对牛奶激发试验与血清特异性抗体的比较,明确牛奶激发试验诊断婴幼儿牛奶蛋白过敏的临床意义。方法 收治苏州大学附属儿童医院2015年2-11月共57例疑似牛奶蛋白过敏的婴幼儿住院进行牛奶激发试验,并进行血常规检测,采用酶联免疫方法(ELISA)进行血清总IgE抗体、血清特异性牛奶蛋白IgE检测;采用免疫印迹法进行特异性牛奶蛋白IgG检测,比较和分析与激发结果的关系。结果 57例婴幼儿中牛奶激发试验阳性者占40.4%(23/34)。比较阳性组与阴性组的白细胞数、嗜酸性粒细胞比率、中性粒细胞比率、血小板计数变化,差异均无统计学意义(P＞0.05);仅有阳性组激发后中性粒细胞比率较激发前增高,差异有统计学意义(P=0.02);阳性组与阴性组的血清总IgE、特异性牛奶蛋白IgE及特异性牛奶蛋白IgG检测结果比较,差异无统计学意义(P＞0.05)。结论 对疑似牛奶蛋白过敏婴幼儿行血清总IgE及血清特异性牛奶蛋白IgE检测的临床意义不大,不推荐特异性牛奶蛋白IgG用于诊断牛奶蛋白过敏。应提倡牛奶激发试验应用于临床诊断婴幼儿牛奶蛋白过敏。
Abstract
Objective To compare the results of cow's milk challenge test and serum specific antibody detection,and to evaluate the value of cow's milk challenge test on cow's milk allergy. Methods A total of 57 infants with suspected cow's milk allergy received cow's milk challenges in Children's Hospital of Soochow University from February,2015 to November,2015.Blood routine,serum total IgE antibody,serum milk protein specific IgE and serum milk protein specific IgG were tested using enzyme-linked immune method (ELISA) and western blotting.The blood changes of cow's milk challenges positive group were and negative group were compared.The relationship among serum total IgE antibody,serum milk protein specific IgE,serum milk protein specific IgG and the results of the cow's milk challenge were analyzed. Results A total of 57 cases of children with challenges induced positive results in 23 cases (40.4%),while negative results in 34 cases(59.6%).The changes in the count of white blood cell,neutrophil ratio,eosinophils ratio and platelet were studied,however.there were no statistical difierences between the challenge failed group and the passed ones.It was interesting that the neutrophil ratio was higher than before among children who passed the challenge.There was no significant difference in total IgE,serum cow's milk protein IgE and IgG between challenge positive group and negative group. Conclusions The detection of total serum IgE and serum milk protein IgE in infants with suspected cow's milk allergy is of little significance,so testing for IgG against cow's milk is not recommended as a diagnostic tool.It is important and necessary to perform cow's milk protein challenge in diagnosis of infant cow's milk allergy.
关键词
牛奶蛋白过敏 /
血清特异性抗体 /
牛奶激发试验 /
婴幼儿
Key words
cow&apos /
s milk protein allergy /
serum specific antibody /
cow&apos /
s milk challenge /
infant
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