临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (12): 936-.doi: 10.3969/j.issn.1000-3606.2019.12.015

• 综合报道 • 上一篇    下一篇

早期预测食物过敏高风险儿童方法探讨

柏平萍,邢梦娟,胡燕   

  1. 重庆医科大学附属儿童医院儿童保健科 儿童发育疾病研究教育部重点实验室 国家儿童健康与 疾病临床医学研究中心 儿童发育重大疾病国家国际科技合作基地 儿童营养与健康重庆市 重点实验室(重庆 400014)
  • 发布日期:2020-02-03
  • 通讯作者: 胡燕 电子信箱:hy420@126.com

Discussion on early prediction of high risk of food allergy in children

BAI Pingping, XING Mengjuan, HU Yan   

  1. Department of Child Health Care; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Child Health and Nutrition; Children's Hospital of Chongqing Medical University, Chongqing 400014, China
  • Published:2020-02-03

摘要: 目的 探讨联合多种危险因素获得的过敏风险评分预测食物过敏高风险儿童的价值。方法 采用问卷调查方 式获得≤3岁婴幼儿的过敏危险因素信息,以多元logistic逐步回归分析婴幼儿食物过敏危险因素,计算各危险因素对食物过 敏的阳性预测值,依据回归方程计算过敏风险评分,通过ROC曲线评价过敏风险评分在筛查食物过敏高风险儿童中的价值。 结果 获得78例确诊为食物过敏及156例非过敏性疾病的≤3岁婴幼儿的回顾性调查信息。其中过敏性疾病家族史、剖宫 产、孕期使用抗生素或解热镇痛药、孕期吸烟或接触吸烟环境、孕期接触杀虫剂或驱蚊剂、家中饲养宠物均是婴幼儿发生食 物过敏的危险因素(P<0.05)。 过敏家族史预测食物过敏的阳性预测值为63.2%,ROC曲线下面积(AUC)为0.696(95%CI: 0.620~0.771)。 当联合多因素获得的过敏风险评分≥2.85时,其预测食物过敏的AUC为0.804(95%CI:0.746~0.863),灵 敏度为0.526,特异度为0.910,尤登指数为0.436。结论 多危险因素联合指标筛查食物过敏高风险儿童的预测价值高于过 敏家族史。

关键词: 食物过敏; 高风险儿童; 阳性预测值; 过敏风险评分

Abstract:  Objective To explore the value of allergy risk score obtained by combining multiple risk factors in predicting high risk of food allergy in children. Methods Questionnaire survey was performed to obtain information of allergic risk factors in infants under 3 years old. Multivariate logistic stepwise regression analysis was used to analyze the risk factors of food allergy in infants. The positive predictive value of each risk factor for food allergy was calculated. Allergy risk score was calculated based on regression equation. The value of allergy risk score in screening children having high risk of food allergy was evaluated by ROC curve. Results The information was retrospectively obtained from 78 infants diagnosed with food allergy and 156 infants under 3 years old with nonallergic diseases. Family history of allergic diseases, cesarean section, use of antibiotics or antipyretic analgesics during pregnancy, smoking or exposure to smoking environment during pregnancy, exposure to insecticides or mosquito repellents during pregnancy, and pets at home are all risk factors for food allergy in infants and young children (all P<0.05). The positive predictive value of family history of food allergy was 63.2%, and the area under ROC curve (AUC) was 0.696 (95% CI: 0.620~0.771). When the allergy risk score obtained by combining multiple factors was more than 2.85, the AUC for predicting food allergy was 0.804 (95% CI: 0.746~0.863), with a sensitivity of 0.526, a specificity of 0.910 and a Youden index of 0.436. Conclusion The predictive value of multi-risk factors combination is higher for screening high-risk children of food allergy than that of family history of allergy.

Key words:  food allergy; high-risk children; positive predictive value; allergy risk score