哺乳期母亲饮食管理对婴儿湿疹的防治作用及其机制研究

背景　湿疹是婴儿时期最常见的过敏性皮肤炎症，药物治疗暂缓症状，仍反复发作，严重影响婴儿的生活质量和健康成长。纯母乳喂养婴儿的湿疹与母亲进食敏感食物相关。目的　探讨哺乳期母亲血清食物特异性IgG抗体水平与婴儿湿疹的关系，哺乳期母亲回避敏感食物对婴儿湿疹的防治作用及可能机制，探索非药物防治婴儿湿疹的方法。方法　2016年3月—2018年9月，采用酶联免疫吸附法（ELISA）对纯母乳喂养的142例湿疹婴儿（观察组）和35例健康婴儿（对照组）的母亲进行血清14种食物特异性IgG抗体水平测定，指导观察组哺乳期母亲依据检测结果回避相应敏感食物，对照组母亲不进行饮食指导，3个月后电话随访湿疹改善情况。结果　观察组母亲血清食物特异性IgG抗体阳性率〔95.7%（132/138）〕明显高于对照组〔82.9%（29/35）〕，二者差异有统计学意义（P<0.05）。观察组115例母亲哺乳期间有不同程度的饮食回避，湿疹缓解的总有效率为93.0%（107/115），其中完全回避饮食者湿疹缓解率为93.4%（85/91），不完全回避饮食者湿疹缓解率为91.7%（22/24）。结论　湿疹患儿的母亲血清食物特异性IgG抗体水平升高，提示母亲对相关食物敏感，哺乳期母亲回避敏感食物对婴儿湿疹有防治作用，其机制可能与IgG介导的迟发型变态反应有关。

Mechanism of Dietary Management for Lactating Mothers in the Prevention and Treatment of Infant Eczema

Background　Eczema is the most common allergic skin inflammation in infants.The symptoms of this disease can be delayed by pharmacological treatment，but it still occurs repeatedly，seriously affecting the quality of life and healthy growth of infants.Eczema in exclusively breastfed infants is associated with mothers eating sensitive food.Objective　To investigate the relationship between infant eczema and the food-specific IgG antibody level in serum of lactating mothers，effectiveness and possible mechanism of lactating mothers' avoidance of sensitive foods on preventing and treating infant eczema，and to explore non-pharmacological preventive interventions and treatments for the disease.Methods　The levels of 14 food-specific IgG antibodies in serums of lactating mothers of 142 eczema infants（observation group）and 35 healthy infants（control group）were measured by ELISA from March 2016 to September 2018.According to the personal test result，the mothers were given dietary guidance on eating a diet with a list of foods to be avoided.And the eczema improvement was followed up by telephone calls three months later.Results　The positive rate of the eczema infants group〔95.7%（132/138）〕 was higher than that of the control group〔82.9%（29/35）〕，showing a significant difference between the two groups（P<0.05）．The total effective rate of eczema remission was 93.0%（107/115），in which the remission rate of eczema was 93.4%（85/91） in the complete avoidance group and 91.7%（22/24） in the incomplete avoidance group.Conclusion　Increased food-specific IgG antibody levels in lactating mothers of infants with eczema suggests that the mothers may be sensitive to related foods.The mothers' intentional avoidance of sensitive foods can prevent and treat the infant eczema，and the mechanism may be related to IgG-mediated delayed-type hypersensitivity.