脐血嗜酸性粒细胞阳离子蛋白与早期婴儿特应性皮炎相关性的前瞻性研究

摘要

目的 探讨脐血嗜酸性粒细胞阳离子蛋白(ECP)、脐血特异性IgE(sIgE)与父母特应质、婴儿特应性皮炎和食物皮肤点刺试验阳性率之间的相关性,为婴儿早期过敏性疾病的发生风险提供前瞻性检测指标.方法 选择2009年6月至2010年3月期间分娩的健康新生儿及其母亲,调查父母特应质情况.收集并检测脐血中ECP、鸡蛋和牛奶sIgE的含量.随访婴儿,记录出生后6周、3个月、6个月时的特应性皮炎发生情况,并在婴儿出生后3、6个月时实施食物皮肤点刺试验.结果 调查并随访146例婴儿及其母亲.父母为特应质与非特应质的婴儿比较,其脐血ECP含量差异无统计学意义(P ＞ 0.05).新生儿脐血中鸡蛋、牛奶sIgE均为阴性.按脐血中ECP含量是否＞ 10 μg/L将婴儿分为2组,婴儿出生后6周、3个月、6个月时,特应性皮炎发病率在ECP增高婴儿中均高于正常者(P ＜ 0.01).脐血ECP含量与婴儿3、6个月时的食物皮肤点刺试验阳性率无相关性(P ＞ 0.05).结论 父母特应质对脐血ECP水平无影响.新生儿脐血中鸡蛋、牛奶sIgE均为阴性,故孕末期回避饮食依据不足.脐血ECP增高与婴儿早期特应性皮炎发生有显著相关性,而脐血ECP含量与婴儿3、6个月时的食物皮肤点刺试验阳性无相关性.%Objective To evaluate the relationship between ECP level in cord blood and parents' atopy, infant atopic dermatitis and positive skin prick tests. Methods One hundred and froty-six healthy pregnant women from Jun 2009 to Mar 2010 were enrolled in this study. Parents' atopy was evaluated by questionnaires. The ECP level, egg and milk specific IgE were measured in cord blood during laboring. All the cases were divided into two groups according to ECP level (higher than 10 μg/L or not) in cord blood. The morbidity of atopic dermatitis was investigated at 6 weeks, 3 months and 6 months after birth, and food skin prick tests were observed at 3 and 6 months after birth. Results No significant difference was observed between parents' atopy and ECP level in cord blood (P > 0.05). The egg and milk specific IgE were negative in 146 cord blood samples. The morbidity of atopic dermatitis in elevated ECP group was higher than that of normal ECP group at 6 weeks, 3 months and 6 months after birth (P < 0.01). No significant difference was observed between the ECP level in cord blood and positive rate of food skin prick test at 3 and 6 months after birth (P > 0.05). Conclusions The ECP level in cord blood has no relationship with parents' atopy. The egg and milk specific IgE are negative in com blood, thus food avoidance is unnecessary during late pregnancy. Significant correlation exists between ECP level and atopic dermatitis at 6 weeks, 3 months and 6 months after birth. The ECP level in cord blood has no relationship with positive rate of food skin prick tests at 3 or 6 months after birth.