论文部分内容阅读
目的探讨食物不耐受(FI)在小儿胃肠道疾病发病中的作用,为诊断、预防和治疗由FI引起的小儿慢性消化系统疾病提供更有效的手段。方法采用ELISA法检测182例消化系统疾病(研究组)和32例择期手术患儿及健康儿童(对照组)血清FI特异性IgG(sIgG)抗体,并根据病史、临床症状及血清sIgG检测结果剔除相应食物,观察随访患儿临床症状改善情况。结果研究组中158例有1~9种血清sIgG水平升高,总阳性率为86.81%;对照组7例血清sIgG呈阳性反应,且均为单一抗体阳性,sIgG阳性程度均为轻度,阳性率为21.88%,二组sIgG阳性率比较差异有统计学意义(P<0.01)。sIgG水平升高的消化系统疾病158例患儿中,1种sIgG升高者48例(占30.38%),2种及2种以上sIgG升高者110例(占69.62%)。优势敏感食物为牛奶、鸡蛋,sIgG升高例数分别为117例(74.05%)和105例(66.46%),其余依次为巧克力31例、大豆25例、虾21例、小麦20例、米7例、花生5例、猪肉1例。对sIgG阳性程度达+2级及以上患儿采取忌食过敏食物治疗1~3个月,并予回访。其中迁延性慢性腹泻患儿回访49例,症状明显改善45例(91.84%),症状改善4例(8.16%),总有效率100%;再发性腹痛回访21例,症状明显改善10例(47.62%),症状有改善6例(28.57%),无效5例(23.81%),总有效率76.19%;胃食管反流病回访12例,症状均明显改善,有效率100%;周期性呕吐综合征回访6例,症状有明显改善2例(33.33%),症状改善2例(33.33%),无效2例(33.33%),总有效率66.67%。结论由IgG介导的FI在某些小儿消化系统疾病特别是慢性胃肠道疾病的发病中起重要作用。检测血清食物sIgG,进而了解患儿FI情况,可为一些不明原因的小儿慢性消化系统疾病的诊断、预防及调整饮食治疗提供更客观的依据。
Objective To investigate the role of food intolerance (FI) in the pathogenesis of gastrointestinal diseases in children and provide a more effective means for diagnosis, prevention and treatment of chronic digestive diseases caused by FI in children. Methods Serum FI-specific IgG (sIgG) antibodies were detected by ELISA in 182 cases of digestive diseases (study group), 32 cases of elective surgery and healthy children (control group), and were excluded according to their medical history, clinical symptoms and serum sIgG test results The corresponding food, observe the follow-up clinical symptoms in children improved. Results The serum sIgG levels of 158 cases in the study group increased from 1 to 9, with a total positive rate of 86.81%. Serum sIgG levels were positive in 7 of the 7 patients in the study group, all of which were positive for single antibody. The positive rates of sIgG were mild and positive The rate of sIgG positive rate in the two groups was statistically significant (P <0.01). Of the 158 infants with elevated sIgG, 48 (30.38%) had one sIgG elevation, and 110 (69.62%) had two or more sIgG escalation. The predominant sensitive foods were milk, eggs, and elevated sIgG were 117 cases (74.05%) and 105 cases (66.46%) respectively, followed by 31 cases of chocolate, 25 cases of soybean, 21 cases of shrimp, 20 cases of wheat and 7 meters of rice For example, peanut in 5 cases, pork in 1 case. To sIgG positive level of +2 and above children to eat food allergy treatment for 1 to 3 months, and to visit. Among them, 49 cases were retrospectively observed in 49 children with persistent chronic diarrhea, the symptoms were significantly improved in 45 cases (91.84%), the symptoms were improved in 4 cases (8.16%) and the total effective rate was 100%. The recurrent abdominal pain was followed up in 21 cases and the symptoms were significantly improved in 10 cases 47.62%). The symptoms were improved in 6 cases (28.57%) and ineffective in 5 cases (23.81%), the total effective rate was 76.19%. Gastroesophageal reflux disease was followed up in 12 cases, the symptoms were significantly improved, the effective rate was 100% Syndromes were retrospectively reviewed in 6 cases. The symptoms were significantly improved in 2 cases (33.33%), symptoms improved in 2 cases (33.33%), ineffective in 2 cases (33.33%), and the total effective rate was 66.67%. Conclusion IgG-mediated FI plays an important role in the pathogenesis of certain gastrointestinal diseases in children, especially chronic gastrointestinal diseases. Detection of serum food sIgG, and then understand the situation of children with FI, for some unexplained chronic digestive diseases in children to diagnose, prevent and adjust diet to provide more objective evidence.