食物过敏与相关消化系统疾病

摘要

食物过敏是指人接触过某种食物,再次摄入时,机体对之产生异常免疫反应,出现生理功能紊乱和/或组织损伤,由此引发一系列的临床症状.目前报道,有170余种食物可导致过敏,以下几种致敏原:牛奶、鸡蛋、花生、坚果、有壳海鲜、大豆、小麦等引起90％以上的食物过敏.消化系统过敏症状的出现与致敏原的特性(包括蛋白质的家族属性、三维结构、生物活性和对消化的稳定性)和机体本身状态(遗传因素、肠道黏膜屏障功能的完整性、口服免疫耐受是否建立)有密切关系.食物过敏最常累及的是消化系统,症状呈非特异性,容易漏诊或误诊.食物过敏根据其发病机制分为IgE介导、非IgE介导及IgE和非IgE共同介导,可引起呕吐、腹泻、反流、便秘、腹痛等消化系统症状,还可导致食物蛋白介导的直肠结肠炎,食物蛋白介导的小肠结肠炎,食物蛋白介导的肠病,嗜酸性粒细胞性胃肠炎,嗜酸性粒细胞性食管炎,麦胶肠病等消化系统疾病,婴儿肠绞痛,肠易激惹综合征等功能性胃肠病也被认为与食物过敏有关.无论延误诊断还是过度诊断,均可能导致婴幼儿生长发育迟缓、贫血和低蛋白血症等.所以认识食物过敏对消化系统的影响,尽早明确诊断和治疗可有效防止营养不良发生,改善患儿生活状态.%Food allergy refers to the body's abnormal immune response to food,which induces disorder and/or injuries of human body,and thus triggers a series of manifestations.Ninety percent of food allergy is due to the following allergen:milk,eggs,peanuts,nuts,seafood,soy,wheat,etc.The symptoms of digestive system are closely associated with the nature of allergen (including protein's family nature,three dimensional structure,biological activity and stability) and the body's own status (genetic factors,integrity of intestinal mucosal barrier and oral immune tolerance).The symptoms of digestive systems are not typical,and differ by various factors like body conditions,ages,regions and allergens,so the diagnosis is difficult.Food allergy is categorized by its mechanism:IgE,non IgE,and mix.The symptoms of digestive systems include vomiting,diarrhea,reflux,constipation and abdominal pain,etc,and relative diseases include food protein-induced enteropathy,food protein-induced enterocolitis syndrome,food protein-induced enterocolitis syndrome,food protein-induced proctocolitis,celiac disease,eosinophilic gastroenteritis,eosinophilic esophagitis and infantile colic,etc.Delayed diagnosis will result in failure to thrive,anemia and hypoproteinenia.Therefore,early diagnosis and treatment can effectively prevent malnutrition and improve the children's animation.