食物過敏國小學童的特異過敏原分析

Assessment of Specific Allergens among Elementary School Children with Food Allergy

10.6200/TCMJ.2012.9.4.03

吳幸霖(Hsin-Lin Wu)；溫港生(Kong-Sang Wan)；許良豪(Liang-Hao Hsu)；邱婷芳(Ting-Fang Chiu)；楊文理(Win-Nei Yang)；吳子聰(Tzee-Chung Wu)；吳克恭(Keh-Gong Wu)；黃碧桃(Be-Tau Hwang)

過敏原 ； 食物過敏 ； 特異性IgE ； allergen ； food allergy ； specific IgE

北市醫學雜誌

9卷4期（2012 / 12 / 01）

329 - 338

繁體中文

目的：為了研究台灣學童食物過敏原的種類及與空氣過敏原之間的關係， 我們檢驗了88位6-12歲在臨床上具食物過敏病史的學童，測定其特異性IgE抗體以進行過敏體質篩檢。方法：取學童的血清3-5ml用Fluorescence enzyme immuno-assay（FEIA）的方式來分析。結果：在88位有食物過敏病史的學童當中，有7人（8%）對過敏原呈陰性，其餘81人（92%）則呈現陽性反應，其中32人（39.5%）只測出對空氣過敏原呈陽性。包括32人（100%）對屋塵蟎過敏，31人（96.9%）對粉塵蟎過敏，28人（87.5%）對五爪蟎過敏，11人（34.4%）對德國蟑螂過敏。另49人（60.5%）驗出對食物過敏原過敏，其中有47人（95.9%）同時對食物及空氣過敏原呈陽性。對食物過敏原呈陽性中，蛋白過敏者26人（53.1%），蝦子過敏者23人（46.9%），牛奶過敏者15人（30.6%），酪蛋白過敏者10人（20.4%），乳蛋白過敏者9人（18.4%），乳球蛋白過敏者4人（8.2%），奇異果過敏者4人（8.2%），芒果過敏者4人（8.2%）。結論：有食物過敏病史學童中，49人（60.5%）對特異性食物過敏原呈陽性，最常見的食物過敏為蛋白、蝦子及牛奶等。具食物過敏原陽性反應的學童，有95.9%的學童同時合併對空氣過敏原呈陽性反應，而在對空氣過敏原呈陽性的學童中，有59.5%同時對食物過敏原呈陽性反應。就呼吸道過敏原與食物過敏原之相關性而言，勝算比（odds ratio）是5.14。因此，本研究提供了一個觀念，即是針對學齡期食物過敏的兒童，在臨床上不能忽視其合併呼吸道過敏原的情形。

Objectives: To evaluate the types of food allergens and their relationship with aeroallergens. Total IgE and specific IgEs against various allergens were detected in primary schoolchildren who were suspected clinically of suffering from a food allergy. Methods: The participants' total allergen level and specific IgE levels were tested by a radioabsorbent method using the Pharmacia ImmunoCAP-250. Results: Among the 88 children tested who were suspected of a history of food allergy, seven (8.0%) children were found to have a total IgE level of less than 0.35 PAu/L, which indicated that they were negative for allergy. Another 32 (36.3%) of the children tested were only positive for specific IgE antibodies against aeroallergens, including 32 individuals who were positive for Dermatophagoides pteronyssinus (100 %), 31 individuals who were positive for Dermatophagoides farinae (96.9%), 28 individuals who were positive for Blomia tropicalis (87.5%), and 11 individuals who were positive for German cockroach (34.4%). The remaining 49 individuals (60.5%) were found to have specific IgE antibodies against various foods. Forty-seven of these children (95.9%) were found to have specific IgE antibodies against both aeroallergens and food allergens. The food allergens included egg white for 26 children (53.1%), shrimp for 23 children (46.9%), cow's milk for 15 children (30.6%), casein for 10 children (20.4%), alpha lactoalbumin for 9 children (18.4%), kiwi fruit for 8 children (16.2%), beta lactoglobulin for 4 children (8.2%), and mango for 4 children (8.2%). Conclusion: Among primary schoolchildren with clinical features associated with food allergies, 60.5% had positive specific IgE antibodies against various food allergens. The most common allergens were found to be egg white, shrimp and cow's milk. Most of the children (95.9%) with positive specific IgE antibodies against foods allergens were also positive for specific IgE against various aeroallergens. In contrast, only 59.5% of children with positive for specific IgE antibodies against various aeroallergens were positive for specific IgE antibodies against foods allergens.