EFFECT OF ALLERGEN AVOIDANCE ON DEVELOPMENT OF ALLERGIC DISORDERS IN INFANCY
EFFECT OF ALLERGEN AVOIDANCE ON DEVELOPMENT OF ALLERGIC DISORDERS IN INFANCY
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DOI：
10.1016/0140-6736(92)91260-f
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发表时间：
1992-06-20
期刊：
影响因子：
168.9
通讯作者：
HIDE, DW
中科院分区：
文献类型：
--
作者：
ARSHAD, SH;MATTHEWS, S;HIDE, DW
有很多证据表明，过敏性疾病的发展可能与早期接触过敏原有关，包括母乳中的过敏原。我们曾试图找出是否避免食物和吸入过敏原在婴儿期预防过敏性疾病的发展在高危婴儿在产前随机对照研究120名婴儿家族史的特应性和高（>0.5 kU/I）脐带血总IgE浓度随机分配到预防和对照组。在预防组（n=58），哺乳期母亲避免过敏性食物（牛奶、鸡蛋、鱼和坚果），避免给婴儿喂食这些食物以及大豆、小麦和橙子，直到12个月大;婴儿的卧室和起居室每3个月用杀螨粉末和泡沫处理一次，用酶联免疫吸附法测定粉尘中屋尘螨抗原（Dermatophagoides pteronyssinus antigen，Der p I）的含量。在对照组（n=62），母亲和婴儿的饮食是不受限制的，没有杀螨治疗，并在出生时和9个月的Der p I浓度进行了测量。一位不知道分组的儿科过敏专家在10-12个月时检查了婴儿的过敏性疾病。通过Logistic回归分析计算各种因素的比值比，并控制其他混杂变量。在12个月时，25例（40%）对照组婴儿和8例（13%）预防组婴儿发生过敏性疾病（比值比6.34，95%置信区间2.0-20.1）。对照组12个月时哮喘（4.13，1.1 -15.5）和湿疹（3.6，1.0 -12.5）的患病率也显著较高。父母吸烟是12个月时总过敏症的一个重要危险因素，无论是父母中只有一方吸烟（3.97，1.2 -13.6）还是父母双方都吸烟（4.72，1.2 -18.2）。减少婴儿在食物和室内灰尘中的过敏原暴露，可降低出生后头几年过敏性疾病的发生率。被动吸烟是一个重要的风险因素，应在任何预防方案中加以解决。
There is much evidence that the development of allergic disorders may be related to early exposure of allergens, including those in breastmilk. We have tried to find out whether avoidance of food and inhaled allergens in infancy protects against the development of allergic disorders in high-risk infants.In a prenatally randomised, controlled study 120 infants with family history of atopy and high (>0.5 kU/I) cord-blood concentrations of total IgE were allocated randomly to prophylactic and control groups. In the prophylactic group (n=58), lactating mothers avoided allergenic foods (milk, egg, fish, and nuts) and avoided feeding their infants these foods and soya, wheat, and orange up to the age of 12 months; the infants' bedrooms and living rooms were treated with an acaricidal powder and foam every 3 months, and concentrations of Dermatophagoides pteronyssinus antigen (Der p I) in dust samples were measured by enzyme-linked immunosorbent assay. In the control group (n=62), the diet of mothers and infants was unrestricted; no acaricidal treatment was done and Der p I concentrations were measured at birth and at 9 months. A paediatric allergy specialist unaware of group assignment examined the infants for allergic disorders at 10-12 months. Odds ratios were calculated by logistic regression analysis for various factors with control for other confounding variables. At 12 months, allergic disorders had developed in 25 (40%) control infants and in 8 (13%) of the prophylactic group (odds ratio 6.34, 95% confidence intervals 2.0-20.1 ). The prevalences at 12 months of asthma (4.13,1.1-15.5) and eczema (3.6,1.0-12.5) were also significantly greater in the control group. Parental smoking was a significant risk factor for total allergy at 12 months whether only one parent smoked (3.97,1.2-13.6) or both parents smoked (4.72,1.2-18.2).Reduced exposure of infants to allergens in food and in housedust lowered the frequency of allergic disorders in the first years of life. Passive smoking is an important risk factor that should be addressed in any prophylactic programme.