156例慢性消化系统疾病患儿食物特异性IgG检测结果分析

发布时间：2018-06-18 16:40

本文选题：儿童 + 食物不良反应　；参考：《山西医科大学》2012年硕士论文

【摘要】：目的: (1)分析慢性消化系统疾病患儿食物特异性IgG检测结果为阳性的常见食物种类。 (2)对慢性消化系统疾病患儿食物特异性IgG检测结果进行分析，并探讨食物异性IgG介导的食物不良反应与生后早期喂养方式的关系。 (3)探讨食物特异性IgG抗体检测在儿童慢性消化系统疾病中的临床价值。 (4)比较食物回避、食物回避加口服双歧杆菌制剂两种治疗方案在食物特异性IgG抗体检测阳性的慢性消化系统疾病患儿中的临床疗效的差异，探讨最佳的治疗方法。方法: (1)采用ELISA法检测156例慢性消化系统疾病患儿（病例组）和70例正常儿童（对照组）血清中14种食物特异性IgG抗体水平。 (2)分析病例组检测结果中最常见的阳性食物种类。 (3)将病例组与对照组检测结果进行比较，分析检测结果的差异是否具有统计学意义。 (4)据患儿生后4个月内的喂养方式不同将病例组食物特异性IgG抗体检测阳性的患儿分为三组（母乳喂养组、人工喂养组、混合喂养组），探讨早期喂养方式是否对食物异性IgG介导的食物不良反应有影响。 (5)将病例组134例阳性患儿分为两组，第一组71人，嘱回避相关食物，第二组63人，，嘱回避相关食物同时予以双歧活菌制剂辅助治疗，随访3月，观察4周、8周、12周时症状改善情况，研究两组间的差异是否具有统计学差异。结果: (1)156例患儿中，食物特异性IgG检测阳性所占比例为85.90%,其中仅一种食物检测阳性所占比例是35.90%；两种食物检测阳性占37.82%；两种及两种以上食物检测阳性在所研究患儿中占50%。 (2)病例组与对照组结果比较有统计学差异（P0.05）的食物为牛奶、大豆、鸡蛋。且均为病例组高于对照组。 (3)134例食物特异性IgG检测阳性患儿生后4月内的喂养方式：母乳喂养62例，占39.74%；人工喂养13例，占8.33%；混合喂养81例，51.93%。 (4)将134例食物特异性IgG检测阳性患儿分为食物回避组及食物回避同时予以双歧活菌制剂辅助治疗组，两组症状改善情况（第一组有3人失访；第二组7人失访）：4周时随访两组的症状改善有统计学差异（p0.05），为第二组症状改善优于第一组；8周、12周症状改善无明显统计学意义。结论:食物特异性IgG检测阳性的食物是经常接触的食物中的一种或两种甚至多种，以鸡蛋、牛奶为主,其发生可能与生后早期的喂养方式有关，对食物特异性IgG检测阳性患儿的治疗主要为回避相关食物，治疗的前4周在禁食的基础上予以双歧活菌制剂辅助治疗可能更有利于改善患儿症状。
[Abstract]:Objective: to analyze the food specific IgG of children with chronic digestive system disease. To explore the relationship between food adverse reactions mediated by food heterosexual IgG and early postnatal feeding. 3) to explore the clinical value of food specific IgG antibody detection in children with chronic digestive system diseases. 4) to compare food avoidance. The difference of clinical efficacy between food avoidance and oral bifidobacterium preparation in children with chronic digestive system diseases with food specific IgG antibody. Methods: Elisa was used to detect the serum levels of 14 food specific IgG antibodies in 156 children with chronic digestive system diseases (case group) and 70 normal children (control group). The positive food type seen here. 3) compare the test results between the case group and the control group. According to the feeding pattern within 4 months after birth, the children who were positive for IgG antibody were divided into three groups (breast-feeding group, artificial feeding group). In the mixed feeding group, the influence of early feeding mode on food adverse reactions mediated by food heterosexual IgG was investigated. (5) 134 cases of positive children in the case group were divided into two groups: the first group (71 cases), the second group (63 cases), the first group (71 cases), the second group (63 cases). The patients were followed up for 3 months to observe the improvement of symptoms at 4 weeks, 8 weeks and 12 weeks, and whether there was statistical difference between the two groups. Results: the proportion of food specific IgG positive was 85.90, of which only one was 35.90, and the positive rate of two kinds of food was 37.82. Two or more kinds of food test positive accounted for 50% of the children studied. 2) the results of the case group and the control group were statistically different (P0.05) the foods were milk, soybean, eggs. The feeding methods of 3134 children with positive food specific IgG were: breast feeding 62 cases (39.74%), artificial feeding 13 cases (8.33%), and the feeding methods of 3134 cases (39.74%) were higher than that of the control group. 134 children with positive food specific IgG were divided into food avoidance group and food avoidance group with bifidobacterium preparation as adjuvant treatment group. The symptoms of the two groups were improved (3 patients in the first group were not visited). There was a significant difference in symptom improvement between the two groups after 4 weeks follow-up in the second group (P < 0.05). The symptom improvement in the second group was better than that in the first group at 8 weeks and 12 weeks. There was no significant difference in the improvement of symptoms between the two groups at 8 weeks and 12 weeks. Conclusion: food specific IgG positive food is one or two or even more of the foods that are in frequent contact, mainly eggs and milk, and its occurrence may be related to the way of feeding in the early postnatal period. The treatment of food specific IgG positive children was mainly to avoid the related food, the first 4 weeks of treatment on the basis of fasting Bifidobacterium may be more conducive to improve the symptoms of children.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.7

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