食物過敏可觸發危及生命的氣喘


  June 12, 2003 - 根據一份病例對照的研究指出,食物過敏可觸發危及生命的氣喘,這項研究論文將發表在七月份的Journal of Allergy and Clinical Immunology (JACI),研究中指出,一半因氣喘而住院的兒童有食物過敏,特別是對花生過敏,而對照組只有10% 有食物過敏。
  
  英國倫敦聖瑪莉醫院的Gideon Lack, MD表示,這項研究強調對氣喘兒童進行詳儘過敏調查的重要性,這樣兒科醫生才可以確定有嚴重反應危險的兒童以及某些有嚴重氣喘兒童的潛在病因。
  
  研究人員對兩組病人做了比較,一組是19例住進兒童加護病房的病人,他們因為氣喘發作呼吸衰竭而依靠呼吸機人工呼吸,另外一組是38例比較輕微的氣喘病人,評估包括呼吸計量,對食物過敏的skin prick或者RAST測試,以及氣喘發作前二十四小時食物過敏原暴露情況的問卷調查。
  
  研究中,危及生命的危險因素包括食物過敏 (勝算比 [OR], 8.58; 95% 信賴區間 [CI], 1.85 - 39.71),多次過敏診斷紀錄(OR, 4.42; 95% CI, 1.17 - 16.7),氣喘出現年齡早 (OR, 6.48; 95% CI, 1.36 - 30.85)以及頻繁住院史(OR, 14.2; 95% CI, 1.77 - 113.59)。
  
  回歸分析顯示,危及生命氣喘的唯一獨立危險因素是因氣喘頻繁住院史(OR, 9.85; 95% CI, 1.04 - 93.27) 和食物過敏 (OR, 5.89; 95% CI, 1.06 - 32.61),其中一半因氣喘而住院的兒童有食物過敏,特別是對花生過敏,而對照組只有10% 兒童有食物過敏,研究人員認為食物過敏可觸發危及生命的氣喘,Dr. Lack說,對這組病人更多的加護治療可降低與氣喘相關的發病率和死亡率。
  

Food Allergies May Trigger Lif

By Laurie Barclay, MD
Medscape Medical News

June 12, 2003 — Food allergies may trigger life-threatening asthma attacks, according to results of a case-controlled study published in the July issue of the Journal of Allergy and Clinical Immunology (JACI) and released early on the JACI Web site. Half of children hospitalized for asthma had food allergies, especially to peanuts, compared with 10% of controls.

"This study stresses the importance of detailed allergy investigations in asthmatic children," senior author Gideon Lack, MD, from St. Mary's Hospital in London, U.K., says in a news release. "This should allow pediatricians to identify a group of children at risk for severe reactions and the potential cause for severe asthma in certain children."

The investigators compared a group of 19 children admitted to a pediatric intensive care unit and dependent on ventilators because of respiratory failure after an asthma attack with a group of 38 children with milder asthma. Evaluation included spirometry, skin prick or RAST testing for food allergy, and a questionnaire reviewing exposure to food allergens 24 hours before the asthma attack.

Risk factors for life-threatening asthma were food allergy (odds ratio [OR], 8.58; 95% confidence interval [CI], 1.85 - 39.71), multiple allergic diagnoses (OR, 4.42; 95% CI, 1.17 - 16.7), early onset of asthma (OR, 6.48; 95% CI, 1.36 - 30.85), and frequent hospital admissions (OR, 14.2; 95% CI, 1.77 - 113.59).

Regression analysis revealed that the only independent risk factors for life-threatening asthma were frequent hospital admissions with asthma (OR, 9.85; 95% CI, 1.04 - 93.27) and food allergy (OR, 5.89; 95% CI, 1.06 - 32.61).

Half of the children with life-threatening asthma had food allergies, especially to peanuts, compared with 10% of the children in the control group. The investigators suggest that life-threatening asthma attacks may therefore be triggered by food allergies.

"More intensive management of this group may decrease the morbidity and mortality associated with their asthma," Dr. Lack says.

J Allergy Clin Immunol. 2003;112:1-7

Reviewed by Gary D. Vogin, MD

    
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