特应性皮炎常见食物过敏原特应性斑贴试验研究

目的了解常见食物过敏原特应性斑贴试验(atopy patch test,APT)结果与特应性皮炎发病及临床表型的关系。方法对79例特应性皮炎患者进行常见食物过敏原斑贴试验,并与皮肤点刺试验和特异性IgE(sIgE)检测结果以及临床表型相关性进行分析。结果 5种食物过敏原中,牛奶APT阳性率最高(24.3%),小麦阳性率最低(16.0%),各种食物APT阳性率均高于相应的皮肤点刺试验(SPT)及sIgE阳性率。各种食物过敏原APT、SPT和sIgE 3种诊断试验结果一致性比较差(Kappa值均0.75)。儿童(≤14岁)患者各种食物过敏原APT阳性率均高于青少年成人(14岁),但是仅有牛奶(P0.01)和大豆(P0.05)APT阳性率的差异有统计学意义。鸡蛋白、牛奶和大豆APT阳性率与特应性皮炎病情严重度评分呈一致的升高趋势,但是只有鸡蛋白阳性率升高趋势有统计学意义(P0.05),小麦和海虾APT阳性率与病情严重度评分无相关性。结论在特应性皮炎患者特别是儿童患者中,食物过敏原特应性斑贴试验可作为辅助诊断食物过敏的方法之一。     

特应性斑贴试验在诊断特应性皮炎患儿鸡蛋、牛奶过敏中的价值

目的 探讨特应性斑贴试验（APT）在诊断特应性皮炎（AD）患儿食物过敏中的价值。方法 以中国儿童最常见的过敏食物--鸡蛋、牛奶为抗原,同时采用APT和皮肤点刺试验（SPT）对68例AD患儿进行鸡蛋和牛奶变应原的诊断性检测,并以开放性食物激发试验验证。结果 本组68例AD患儿中,经食物激发试验证实鸡蛋过敏58例（85.3%）,牛奶过敏40例（58.8%）,两者同时过敏34例（50.0%）。98例阳性食物激发试验47例表现为迟发反应,10例为速发反应,41例为混合反应。APT诊断鸡蛋（牛奶）过敏的敏感性、特异性、阳性预测值、阴性预测值和与食物激发试验的一致率分别为96.6%（67.5%）、 90.0%（82.1%）、98.2%（84.4%）、81.8%（63.9%）和95.6%（73.5%）,而SPT为37.9%（30.0%）、100.0%（89.3%）、100.0%（80.0%）、21.7%（47.2%）和47.1%（54.4%）。APT诊断迟发反应的阳性率显著高于SPT（P < 0.01）。APT、SPT联合与APT单独应用在诊断鸡蛋和牛奶过敏的差异无统计学意义（并联诊断与APT单独诊断敏感性比较：鸡蛋χ2 = 0.509,牛奶χ2 = 0.549,P > 0.05;串联诊断与APT单独诊断特异性比较：鸡蛋P = 1.000,牛奶χ2 = 3.514,P > 0.05）。结论 APT对以迟发反应为主要临床表现的食物过敏的诊断价值显著优于SPT。联合APT和SPT较之单独应用APT并不能提高诊断AD鸡蛋/牛奶过敏的效能。     

特应性斑贴试验在诊断特应性皮炎患儿鸡蛋、牛奶过敏中的价值

目的 探讨特应性斑贴试验(APT)在诊断特应性皮炎(AD)患儿食物过敏中的价值.方法 以中国儿童最常见的过敏食物--鸡蛋、牛奶为抗原,同时采用APT和皮肤点刺试验(SPT)对68例AD患儿进行鸡蛋和牛奶变应原的诊断性检测,并以开放性食物激发试验验证.结果 本组68例AD患儿中,经食物激发试验证实鸡蛋过敏58例(85.3%),牛奶过敏40例(58.8%),两者同时过敏34例(50.0%).98例阳性食物激发试验47例表现为迟发反应,10例为速发反应,41例为混合反应.APT诊断鸡蛋(牛奶)过敏的敏感性、特异性、阳性预测值、阴性预测值和与食物激发试验的一致率分别为96.6%(67.5%)、90.0%(82.1%)、98.2%(84.4%)、81.8%(63.9%)和95.6%(73.5%),而SPT为37.9%(30.0%)、100.0%(89.3%)、100.0%(80.0%)、21.7%(47.2%)和47.1%(54.4%).APT诊断迟发反应的阳性率显著高于SPT(P<0.01). APT、SPT联合与APT单独应用在诊断鸡蛋和牛奶过敏的差异无统计学意义(并联诊断与APT单独诊断敏感性比较:鸡蛋x2=0.509,牛奶x2=0.549,P>0.05;串联诊断与APT单独诊断特异性比较:鸡蛋P=1.000,牛奶x2=3.514,P>0.05).结论 APT对以迟发反应为主要临床表现的食物过敏的诊断价值显著优于SPT.联合APT和SPT较之单独应用APT并不能提高诊断AD鸡蛋/牛奶过敏的效能.     

特应性斑贴试验在诊断特应性皮炎患儿鸡蛋、牛奶过敏中的价值

目的 探讨特应性斑贴试验(APT)在诊断特应性皮炎(AD)患儿食物过敏中的价值.方法 以中国儿童最常见的过敏食物--鸡蛋、牛奶为抗原,同时采用APT和皮肤点刺试验(SPT)对68例AD患儿进行鸡蛋和牛奶变应原的诊断性检测,并以开放性食物激发试验验证.结果 本组68例AD患儿中,经食物激发试验证实鸡蛋过敏58例(85.3%),牛奶过敏40例(58.8%),两者同时过敏34例(50.0%).98例阳性食物激发试验47例表现为迟发反应,10例为速发反应,41例为混合反应.APT诊断鸡蛋(牛奶)过敏的敏感性、特异性、阳性预测值、阴性预测值和与食物激发试验的一致率分别为96.6%(67.5%)、90.0%(82.1%)、98.2%(84.4%)、81.8%(63.9%)和95.6%(73.5%),而SPT为37.9%(30.0%)、100.0%(89.3%)、100.0%(80.0%)、21.7%(47.2%)和47.1%(54.4%).APT诊断迟发反应的阳性率显著高于SPT(P<0.01). APT、SPT联合与APT单独应用在诊断鸡蛋和牛奶过敏的差异无统计学意义(并联诊断与APT单独诊断敏感性比较:鸡蛋x2=0.509,牛奶x2=0.549,P>0.05;串联诊断与APT单独诊断特异性比较:鸡蛋P=1.000,牛奶x2=3.514,P>0.05).结论 APT对以迟发反应为主要临床表现的食物过敏的诊断价值显著优于SPT.联合APT和SPT较之单独应用APT并不能提高诊断AD鸡蛋/牛奶过敏的效能.     

特应性皮炎患者过敏原两种检测方法的相关性

目的探讨皮肤点刺试验和血清变应原特异性IgE检测的相关性。方法同时采用皮肤点刺试验(SPT)和德国MEDIwlss敏筛过敏原检测系统检测60例特应性皮炎(AD)患者的过敏原,并对检测结果进行比较。结果皮肤点刺试验和血清变应原特异性IgE的阳性率分别为3.89%(140/3600)和7.42%(89/1200),后者明显高于前者,差异有统计学意义(P=0.000),且这两种检测方法不相关(P=0.207)。结论皮肤点刺试验和血清变应原特异性IgE检测特应性皮炎过敏原不相关,必要时可同时进行这两种方法检测,并结合病史判断病情。     

慢性荨麻疹患者粉尘螨变应原皮肤点刺反应与自体血清皮肤反应的关系

目的 探讨自体血清的自身反应和粉尘螨诱发的变态反应在慢性荨麻疹（CU）发病中的作用和相关性。方法 对831例CU患者同时进行自体血清皮肤试验（ASST）及粉尘螨皮肤点刺实验（SPT）,对ASST与粉尘螨变应原阳性之间的相关性进行分析。结果 831例CU患者ASST和粉尘螨的总阳性率分别为51.74%和64.62%,ASST阳性组和阴性组粉尘螨SPT阳性率分别为56.52%和73.86%,两组差异有统计学意义（P < 0.05）。ASST阳性组中ASST阳性程度和粉尘螨SPT阳性程度呈负相关性（P < 0.05）。结论 自体血清皮肤反应和粉尘螨变应原诱发的变态反应均在慢性荨麻疹的发病机制中呈负相关,对CU患者同时进行变应原和ASST检测有助于临床分型和治疗。     

慢性荨麻疹患者变应原检测及自体血清试验临床分析

目的:探讨慢性荨麻疹患者变应原检测和自体血清皮肤试验的临床意义。方法:皮肤点刺试验(SPT)检测30种变应原皮试液(包括吸入性和食物性),以生理盐水作阴性对照,以组胺作阳性对照,注射于前臂屈侧,20-30分钟后观察结果。自体血清试验(ASST)以自体血清注射于一侧前臂,另一侧注射生理盐水作阴性对照,30分钟后观察结果。结果:787例慢性荨麻疹患者中SPT有550例阳性(69.89%),6种以上变应原阳性332例(42.19%),吸入组阳性516例(65.57%)明显高于食物组309例(39.26%);ASST阳性为244例(31.00%),SPT阴性组ASST阳性率明显高于SPT阳性组。结论:SPT可以帮助我们寻找引起慢性荨麻疹的相关变应原。ASST阳性表明患者血清中存在自身抗体,可以作为自身免疫性荨麻疹的筛选试验。     

456例湿疹患儿变应原体外检测结果分析

目的观察湿疹患儿血清总IgE水平,分析不同年龄组变应原变化规律。方法选择门诊7岁以内湿疹患儿456例,抽取静脉血,收集血清。采用全自动体外变应原检测系统进行变应原特异性IgE检测。结果456例患儿中,血清变应原特异性IgE升高者为376例,总阳性率为82.5%。其中1～2岁组、3～4岁组易发生食物过敏,5～7岁组易发生吸入性过敏,阳性率分别是84.5%、57.1%和51.9%。结论湿疹患儿血清总IgE水平普遍增高;最易引起患儿过敏的变应原为牛奶、牛肉、羊肉;不同年龄组患儿变应原似有差异,可能与食谱发生改变有关。     

湿疹患者食物变应原检测及临床应用意义

目的探讨食物变应原检测的临床意义,指导食物过敏湿疹患者合理调整饮食结构。方法采用皮肤点刺试验(SPT)检测湿疹患者对13种食物性变应原皮试液的反应,以生理盐水作阴性对照,注射于前臂屈侧,20～30min后观察结果,筛选出食物变应原阳性患者,将其分成随机分为两组,分别采用饮食控制联合药物治疗与单纯药物治疗,观察治疗后21d疗效和3个月后的复发率。结果242例湿疹患者中食物过敏阳性者72例(29.75%),21d后随访治疗组总有效率(91.67%)和对照组(88.89%)无统计学意义,3个月后治疗组复发率(25%)明显低于对照组(76.92%)。结论SPT有助于我们寻找引起湿疹的部分食物变应原,指导调整饮食结构,制订长期、合理的饮食控制方案,可在一定程度上降低湿疹的复发率。     

皮肤点刺试验检测慢性荨麻疹变应原的临床意义

目的探讨皮肤点刺试验检测慢性荨麻疹变应原的临床意义。方法用20种不同的变应原进行皮肤点刺试验,生理盐水为阴性对照,组胺为阳性对照。结果292例慢性荨麻疹患者中,有210例为阳性反应,阳性率为71.92%,单个变应原中,以吸入性粉尘螨的阳性率为最高,达63.69%。结论皮肤点刺试验特异性高,为慢性荨麻疹患者寻找可能的变应原提供依据,并力求避免接触,以提高患者的生活质量。     

816例皮肤点刺试验过敏原结果分析

目的 探讨特应性皮炎、慢性荨麻疹、慢性湿疹常见过敏原的可能致病情况.方法 用标准变应原液在前臂屈侧皮肤进行皮肤点刺试验,分别用0.1%组胺和0.9%氯化钠液作阳性和阴性对照,统计分析采用x2检验.结果 尘螨(屋尘螨+粉尘螨)的阳性率最高,达50.0%～78.6%,其次为动物毛,达7.1%～21.4%,霉菌的阳性率也较高,达7.1%～14.3%,并且这3种变应原在3种疾病间的阳性率差异均有统计学意义(P＜0.01),以特异性皮炎的阳性率最高.食物组过敏原中虾的阳性率(6.6%～14.3%)最高,但在3种疾病间的阳性率差异无统计学意义(P＞0.05);金枪鱼在慢性荨麻疹中的阳性率(9.5%)较高,鸡蛋、牛奶、芹菜在特异性皮炎中的阳性率(7.1%～14.3%)较高,这4种变应原在3种疾病间的阳性率差异均有统计学意义(P＜0.05).结论 吸入组过敏原是慢性过敏性皮肤病的常见过敏原,尘螨为首要过敏原,以特异性皮炎的阳性率为最高.     

The most common allergens according to skin prick test: The role of wheal diameter in clinical relevancy

The skin prick test (SPT) could be applied as a useful in vivo method for the detection of sensitization in epidemiological and diagnostic studies if the wheal size is ideally evaluated. We focused on SPT wheal size to identify sensitization pattern to common inhalant and food allergens. In this cross‐sectional study, SPT results were obtained from a total of 972 allergic patients. Common allergen extracts for SPT were selected according to the type of allergic diseases, and the geographical pattern. SPT with food allergens was performed for patients with atopic dermatitis (AD) and chronic urticaria (CU). A total of 461 male (47.4%) and 511 female (52.6%) participated in this study (median age: 31 years). The majority of individuals were affected with allergic rhinitis (AR) (n = 624) and asthma (n = 224); while 129 and 67 patients suffered from AD and CU, respectively. The most common aeroallergens were Russian thistle (52.1%) and lamb's quarter (50.7%) with the largest wheal diameter. The wheal size of lamb's quarter was significantly different between patients with asthma and AR (P<.001). In addition, a significant difference was detected in wheal diameter in response to the Russian thistle between patients with AR and AD (P = .001). Shrimp (23.6%) and Peanut (22.5%) caused the most common food sensitization in patients with AD and CU. Having in mind the most common weed pollens including the Russian thistle and lamb's quarter, preventive strategies, such as, removing unwanted weeds or preventing them from growing, avoidance, and specific immunotherapy may be crucial for better disease control.     

Skin Prick Test in Patients with Chronic Allergic Skin Disorders

Background:

Chronic allergic skin disorders are the inflammatory and proliferative conditions in which both genetic and environmental factors play important roles. Chronic idiopathic urticaria (CIU) and atopic dermatitis (AD) are among the most common chronic allergic skin disorders. These can be provoked by various food and aeroallergens. Skin prick tests (SPTs) represent the cheapest and most effective method to diagnose type I hypersensitivity. Positive skin tests with a history suggestive of clinical sensitivity strongly incriminate the allergen as a contributor to the disease process.

Aims and Objectives:

To determine the incidence of positive SPT in patients with chronic allergic skin disorders and to identify the various allergens implicated in positive SPT.

Methods:

Fifty patients of chronic allergic disorders were recruited in this study. They were evaluated by SPT with both food and aeroallergens.

Results:

In our study, SPT positivity in patients of CIU was 63.41% and in AD was 77.78%. Out of the 41 patients of CIU, the most common allergen groups showing SPT positivity were dust and pollen, each comprising 26.83% patients. SPT reaction was positive with food items (21.6%), insects (17.07%), fungus (12.20%), and Dermatophagoides farinae, that is, house dust mite (HDM) (7.32%). The allergen which showed maximum positivity was grain dust wheat (19.51%). Among nine patients of AD, maximum SPT positivity was seen with Dermatophagoides farinae, pollen Amaranthus spinosus, grain dust wheat, and cotton mill dust; each comprising 22.22% of patients.

Conclusion:

Our study showed that a significant number of patients of CIU and AD showed sensitivity to dust, pollen, insects, Dermatophagoides farinae, and fungi on SPT. Thus, it is an important tool in the diagnosis of CIU and AD.     

The natural history of sensitizations to food and aeroallergens in atopic dermatitis: a 4-year follow-Up

The natural history of atopic dermatitis (AD) is variable. Generally the dermatitis disappears during the first years of life, but it is often followed by the appearance of allergic respiratory diseases (ARDs). Our aim was to establish the risk factors for developing an ARD in children with AD. We followed up for 4 years 78 children (51 boys, 27 girls) with mild (26%), moderate (48%), and severe (26%) AD (clinical score proposed by Rajka and Langeland). In all the patients IgE serum levels were checked and skin prick tests (SPTs) were performed at the first examination. The SPTs were repeated in 68 children at the end of the study. The children with severe AD had significantly higher IgE serum levels than those with mild or moderate AD. SPTs at the first observation were positive in 47% of cases, mostly in patients with severe AD, with a prevalence of food allergens, particularly in younger patients. At the second observation, SPTs were positive in 65% of cases, including 100% of children with severe AD. Inhalants were the most common allergens. An ARD appeared in 38% of all patients: in 75% of those with severe AD and in 54% of those with a positive first SPT. Allergic screening should be carried out at an early age, especially in severe AD, since SPT positivity to food allergens, associated with severe clinical AD symptoms and a high IgE serum level, identifies those children ages 0-3 years at high risk of development of ARD.     

Atopy patch test reaction to airborne allergens in the diagnosis of atopic dermatitis

The aim of the study was to evaluate the possible use of atopy patch test in the diagnosis of atopic dermatitis and to characterize an optimal standardized system for atopy patch test in terms of allergen concentrations and time of allergen exposure. The study included 36 patients with atopic dermatitis and IgE-mediated airborne allergy. Patients presented positive results of skin prick tests and serum antigen specific IgE against house dust mite allergens and/or selected grass pollen allergens. Control groups consisted either of patients with allergic rhinitis (control group 1) or healthy volunteers with no signs or symptoms of atopy (control group 2). Allergologic diagnostic workup consisted of skin prick test, serum antigen specific IgE and total IgE evaluation, atopy patch test with selected airborne allergens of different concentrations (0.1xSPT, 1xSPT and 10xSPT), time of allergen exposure (8, 24 and 48 h), and readings of the results (8, 24, 48 and 72 h). Positive results of atopy patch test with airborne allergens were obtained in 47.2% of atopic dermatitis patients and none of control subjects. Contact reaction itself and the intensity of reaction were demonstrated to correlate with allergen concentration and time of allergen exposure on atopy patch test. The dose and time response analysis showed the optimal concentration of allergens for atopy patch test to be 10xSPT, 500000 SBE/ml, and optimal evaluation time 24 and 48 h of allergen application. There was no correlation between atopy patch test results and mean serum concentrations of total or antigen specific IgE. Atopy patch test results did not correlate with localization of skin lesions, severity and extensiveness of skin inflammation. A significantly higher contact reactivity to airborne allergens was recorded in the group of atopic dermatitis patients with polyvalent allergy in comparison with atopic dermatitis patients allergic to only one aeroallergen. It is concluded that atopy patch test is the only provocation test currently available with clinical relevance for contact IgE-mediated sensitization in atopic dermatitis patients. Using petrolatum as a vehicle, allergen concentration of 500000 SBE/ml and evaluation time of 24 and 48 h of allergen application may lead to improved atopy patch test results.     

Patch test reactions in atopic patients

Patch testing was carried out in 851 atopic patients; 181 atopic dermatitis (AD) patients were additionally tested with 50% dilutions of the test substances. The occurrence of allergic and irritant reactions was frequent, being 57% and 33% for AD patients aged 28-41 years and 19-27 years, respectively. Among age-matched allergic rhinitis (AR)/allergic conjunctivitis (AC) or asthma (A) patients, the number of allergic reactions varied from 25 to 30%, and for irritant reactions was 24%. In all groups, nickel, fragrance-mix, balsam of Peru and neomycin were the commonest allergens. Contact allergy to ingredients of topical medicaments was common among AD patients and patients with severe and long-lasting dermatitis were most frequently sensitized. However, sensitivity to multiple substances was not common among those patients. The number of irritant reactions was considerable, but 50% dilution of the test substances did not solve the problem.     

儿童期特应性皮炎145例临床分析

目的探讨儿童期特应性皮炎(AD)患儿临床特征及常见特异性变应原分布。方法回顾性分析2013年7月-2014年7月在湖南省儿童医院皮肤科门诊就诊的145例儿童期AD患儿的临床资料,总结其性别比例、地域、加重季节、临床表现及血清特异性变应原分布等特征。结果 145例患儿年龄2~12岁,66.9%有过敏性疾病家族史,其中以过敏性鼻炎(40.7%)最为常见。居住在城市患儿明显高于农村,两者间比值为1.7:1;皮损加重季节以夏、秋季为主,占63.4%。根据AD评分(scoring atopic dermartitis,SCORAD)标准,中度儿童期AD患儿多见(61.4%),且男童比女童较为严重,差异有统计学意义(P<0.05)。血清特异性IgE以吸入性过敏原为主(61.5%),其中户尘螨、粉尘满、屋尘最为常见。结论儿童期AD患儿城市多于农村,常夏秋季节加重,男患儿皮损较女患儿严重,多并发过敏性鼻炎,过敏原以吸入性变应原为主。     

Clinical Availability of Component-Resolved Diagnosis Using Microarray Technology in Atopic Dermatitis

Background

Various allergens play a role in the elicitation or exacerbation of eczematous skin lesions in atopic dermatitis (AD), and much research effort has been focused on improving diagnostic tests to identify causative allergens.

Objective

The purpose of this study was to evaluate the diagnostic effectiveness of a newly introduced microarray-based specific immunoglobulin E detection assay, ImmunoCAP ISAC, for use in AD patients.

Methods

The serum samples of 25 AD patients were tested by using ISAC and a multiple allergen simultaneous test-enzyme immunoassay (MAST-EIA). In addition, 10 of the 25 patients underwent skin prick testing (SPT). The positive reaction rates to allergens in each test and the agreements, sensitivities, and specificities of ISAC and MAST-EIA were evaluated versus the SPT results.

Results

For ISAC versus SPT, the overall results were as follows: sensitivity, 90.0%; specificity, 98.2%; positive predictive value (PPV), 90.0%; and negative predictive value (NPV), 98.2%. The total agreement and κ value for ISAC versus SPT were 96.9% and 0.882, respectively. For MAST-EIA versus SPT, the sensitivity was 80.0%, specificity 92.7%, PPV 66.7%, and NPV 96.2%. The total agreement and κ value for MAST-EIA versus SPT were 90.8% and 0.672, respectively. The overall agreement between the ISAC and MAST-EIA results was 88%.

Conclusion

The ISAC results in AD correlated well with the SPT results, and compared favorably to the MAST-EIA results. This study demonstrates the potential of ISAC as a convenient allergic diagnostic method in AD patients.     

Can atopy patch tests with aeroallergens be an additional diagnostic criterion for atopic dermatitis?

The complex pathomechanisms underlying skin lesions in atopic dermatitis (AD) result in variations of the clinical picture and frequent diagnostic difficulties. The purpose of this study was to evaluate the usefulness of atopy patch tests (APT) for aeroallergens in the diagnosis of AD. The study involved 115 adult patients with AD and 98 healthy volunteers (the control group). APTs for cat dander allergens, birch pollen, a mixture of house dust mite species and a mixture of 5 grass pollen allergens were applied for both groups. Positive reaction to at least one test allergen was found in 53.9% patients compared to 6.2% in the control group (p<0.001). The most frequent hypersensitivity (45.2%) observed was to house dust mite allergens. Polyvalent allergy to 2-4 allergens was found in 56.5% patients. The specificity of tests exceeded 75%, whereas the sensitivity varied from 18 to 66%. CONCLUSIONS: 1. Atopy patch tests, which are characterised by considerable specificity, confirm the role of polyvalent contact hypersensitivity to aeroallergens in the development of atopic dermatitis. 2. Positive aeroallergen ATP results are observed in the majority of patients and can thus be regarded as an additional diagnostic criterion in atopic dermatitis.     

过敏专科门诊3 051例湿疹皮炎患者血清特异性IgE检测结果分析

目的分析湿疹皮炎患者血清特异性IgE检测结果。方法回顾2021年4月1日至2022年3月31日于华山医院过敏专科门诊就诊的3 051例湿疹皮炎患者, 利用Phadia过敏原检测系统检测患者的血清特异性IgE水平, 计算各项过敏原的检测阳性率, 分析湿疹皮炎患者的常见吸入性过敏原和食物过敏原。计数资料组间比较采用χ2检验。结果 3 051例湿疹皮炎患者中, 特应性皮炎1 412例, 其他湿疹/皮炎1 639例。1 629例(53%)过敏原阳性, 阳性过敏原数为(3.0 ± 1.6)个。最常见的3种吸入性过敏原分别是粉尘螨(904/1 522例, 59%)、户尘螨(891/1 513例, 59%)和链格孢霉(206/1 068例, 19%);最常见的3种食物过敏原分别是虾(251/1 432例, 18%)、鸡蛋白(165/992例, 17%)和牛奶(149/994例, 15%)。3 051例中, 25例(1%)年龄< 2岁, 571例(19%)2 ～ 12岁, 285例(9%)12 ～ 18岁, 2 170例(71%) > 18岁。在< 2岁、2 ～ 12岁患者组中, 最...