广州地区高危新生儿脐血IgE对婴幼儿过敏疾病的预警研究

目的:探索广州地区新生儿不同脐血IgE(CBIgE)水平对婴幼儿过敏疾病的预警可行性。方法:随机选取广州市妇婴医院出生的足月、自然分娩新生儿,对脐血IgE不同水平的人群,进行为期3年的观察;主要观察消化系统、皮肤和呼吸系统等组织器官的过敏反应症状和体征;使用瑞典法玛公司生产的UniCap100型测定仪,以及脐血IgE检测试剂盒,以荧光酶免疫方法测定脐血IgE的含量。结果:在观察过程中证实患有过敏性疾病41例,占23.29%(41/176)。在患病婴儿中湿疹占46.34%(19/41),牛奶过敏占21.95%(9/41),哮喘占21.95%(9/41),过敏性鼻炎占19.51%(8/41),荨麻疹占14.63%(6/41)。有家族过敏史者患病占86.67%(13/15)。患病与非患病两组新生儿CBIgE水平比较差异有统计学意义(P<0.001),不同CBIgE界值的预警结果以CBIgE 1.08 kUA/L为优,敏感性为80.49%,特异性为74.07%,准确性为75.57%。结论:脐血IgE可以预警婴幼儿过敏疾病,1.08 kUA/L界值可以作为本地区婴幼儿过敏疾病的预警指标。

Pre-warning effect of cord blood IgE level of high risk neonates on allergic diseases of infants in Guangzhou

Objective:To evaluate whether different cord blood IgE levels of neonates could be used as a predictor of allergic diseases of infants in Guangzhou.Methods:Full-term,natural labor neonates in the hospital were selected randomly,the cord blood IgE levels of the neonates were followed up for three years,and allergic responses of digestive system,respiratory system,skin and other organs were observed.The IgE level of cord blood was detected by fluoroscopic enzyme-immune method using UniCap-100 equipment and IgE testing reagent kit.Results:41 cases(23.29%) were confirmed suffering from allergic diseases,including 19 cases of eczema(46.34%),9 cases of milk allergy(21.95%),9 cases of asthma(21.95%),8 cases of allergic rhinitis(19.51%),6 cases of urticaria(14.63%).Neonates with a family history of accounted for 86.66%(13/15).There was significant difference in the level of IgE in cord blood between the group with allergic diseases and the group with non-allergic diseases(P<0.001).Compared with different CBIgE values,the best predictor value of CBIgE was 1.08 kUA/L with the sensitivity of 80.49%,the specificity of 74.07% and the efficiency of 75.57%.Conclusion:IgE level in cord blood can predict future infants' allergic diseases,the value of 1.08 kUA/L can be regarded as a good predictor index in Guangzhou.