O. Matsyura, L. Besh, N. Lukyanenko, Oksana Kovalska, Kh.B. Slivinska-Kurchak, Yaryna Nagurna
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引用次数: 0
摘要
背景。牛奶蛋白过敏是儿科的一个热门问题。这种疾病影响2-3%的幼儿。方法。该研究包括30名被证实对牛奶蛋白过敏的儿童,并规定了牛奶排除饮食。随访36个月。通过检测牛奶的主要成分(bos8、bos5、bos4)、次要成分(bos6)以及与血清白蛋白的交叉反应(Fel d 2、caf 3)来评估其分子谱。研究小组包括46.7%的男孩。患者平均年龄14.5±3.18个月。在分析的25个因素中,我们通过逐步选择的逻辑回归方法确定了9个因素,它们共同作用影响过敏儿童对牛奶蛋白的耐受性的形成。有三个临床实例的计算预测完全耐受发展的消除饮食对牛奶蛋白过敏的儿童。结论。在消除饮食中减少耐受性发展可能性的独立预测因素已经确定:对牛奶的皮肤试验,Bos 8, Bos 5, Bos 4, Bos 6。消除饮食中耐受性发展的独立预测因素是:牛奶特异性IgE,总IgE, Fel d2, can3。通过消除疗法产生耐受性的可能性很低,建议通过特定的口服耐受性诱导对患者进行处方治疗。
DIAGNOSTIC PREDICTORS OF TOLERANCE DEVELOPMENT IN THE ELIMINATION DIET IN CHILDREN WITH COW'S MILK PROTEIN ALLERGY
Background. Cow's milk protein allergy is a topical issue in pediatrics. This disease affects 2-3% of young children. Methods. The study included 30 children with a confirmed cow’s milk protein allergy and a prescribed milk elimination diet. The children were observed for 36 months. The molecular profile was evaluated by detecting the major components of milk (Bos d 8, Bos d 5, Bos d 4), minor (Bos d 6), and cross-reactive with serum albumin (Fel d 2, Can f 3). Results. The study group included 46.7% of boys. The mean age of the subjects was 14.5±3.18 months. Nine of the 25 analyzed factors were identified in the course of our work by the method of logistic regression with progressive selection, which in combined action affect the formation of tolerance to cow's milk proteins in allergic children. There are three clinical examples of calculating the prediction of the complete tolerance development in the elimination diet in children with cow's milk protein allergy. Conclusions. Independent predictors that reduce the likelihood of the tolerance development in the elimination diet, have identified: skin test to milk, Bos d 8, Bos d 5, Bos d 4, Bos d 6. Independent predictors of the tolerance development in the elimination diet are: milk-specific IgE, total IgE, Fel d 2, Can f 3. Low probability of tolerance development by elimination therapy is a recommendation for prescribing treatment to a patient by specific oral tolerance induction.