IgE介导食物过敏相关女童反复外阴阴道炎的随访研究
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摘要
目的:评价食物回避在血清食物特异性Ig E(s Ig E)阳性女童反复外阴阴道炎(RVV)临床转归中的作用。方法:对单纯食物s Ig E阳性78例患儿根据食物回避程度分为治疗组1(42例)及治疗组2(36例),s Ig E阴性62例为阴性组。3组均予常规治疗,治疗组增加要求食物回避,治疗组1为严格按照要求回避过敏食物患儿,治疗组2为未按照要求回避过敏食物患儿;观察1年RVV症状改善率、复发率、平均复发次数及平均复发间隔时间。结果:首次治疗后各组患儿的临床症状均有显著改善,3组间差异没有统计学意义(P>0.05),但治疗组1复发率、平均复发次数明显低于另两组(P<0.001),平均复发间隔时间也明显延迟(P<0.05)。结论:食物过敏原阳性的RVV患儿对食物回避治疗具有良好的应答效果,RVV患儿应积极进行食物过敏原的检测,对食物过敏原阳性的患儿,应积极采取食物回避的策略。
Objective: To evaluate the effectiveness of dietary antigen exclusion on clinical remission of recurrent vulvovaginitis( RVV) in girls with specific Ig E( s Ig E) positive of food allergy antigen. Methods: Seventy-eight RVV girls with s Ig E positive of food allergy antigen were divided into study group Ⅰ( G Ⅰ,n = 42) and study group Ⅱ( GⅡ,n = 36) according to the extent of dietary exclusion. The control group consisted of 62 RVV girls with s Ig E negative of food allergy antigen. Routine treatments were performed in both study and control groups. Dietary exclusion was required in both GⅠ and GⅡ. Girls in GⅠfollowed dietary exclusion strictly while girls in GⅡ did not strictly follow dietary exclusion. The rate of clinical improvement and recurrence,mean recurrent frequency and interval time within one year in all the 140 patients were observed. Results: There was significantly clinical improvement in all three groups after first therapy with no statistically significant difference( P > 0. 05). However,the recurrent rate and mean recurrent frequency in GⅠ were significantly lower than those in the other two groups( P < 0. 001). Meanwhile,recurrent interval time of patients in G Ⅰ was delayed significantly( P < 0. 05).Conclusion: Ig E-mediated food allergy related recurrent vulvovaginitis in girls responds well to dietary allergen exclusion.
Objective: To evaluate the effectiveness of dietary antigen exclusion on clinical remission of recurrent vulvovaginitis( RVV) in girls with specific Ig E( s Ig E) positive of food allergy antigen. Methods: Seventy-eight RVV girls with s Ig E positive of food allergy antigen were divided into study group Ⅰ( G Ⅰ,n = 42) and study group Ⅱ( GⅡ,n = 36) according to the extent of dietary exclusion. The control group consisted of 62 RVV girls with s Ig E negative of food allergy antigen. Routine treatments were performed in both study and control groups. Dietary exclusion was required in both GⅠ and GⅡ. Girls in GⅠfollowed dietary exclusion strictly while girls in GⅡ did not strictly follow dietary exclusion. The rate of clinical improvement and recurrence,mean recurrent frequency and interval time within one year in all the 140 patients were observed. Results: There was significantly clinical improvement in all three groups after first therapy with no statistically significant difference( P > 0. 05). However,the recurrent rate and mean recurrent frequency in GⅠ were significantly lower than those in the other two groups( P < 0. 001). Meanwhile,recurrent interval time of patients in G Ⅰ was delayed significantly( P < 0. 05).Conclusion: Ig E-mediated food allergy related recurrent vulvovaginitis in girls responds well to dietary allergen exclusion.
引文
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[7]钱华,徐荣华,鲁慧,等.1 936例儿童外阴阴道炎症状与病原体分析[J].皮肤性病诊疗学杂志,2013,20(3):169-171.
[8]林翠兰,付四毛,陈昂,等.过敏体质与女童反复外阴阴道炎的相关性研究[J].东南大学学报:医学版,2015,34(5):761-765.
[9]何君,邢艳.慢性荨麻疹患者血清中特异性Ig E和Ig G检测的临床应用[J].东南大学学报:医学版,2013,32(4):417-421.
[10]树叶,汤建萍,张丹,等.儿童变态反应性疾病过敏原3 504例调查分析[J].中国当代儿科杂志,2010,12(9):720-722.
[11]TAYLOR B N,SAAVEDRA M,FIDEL P L Jr.Local Th1/Th2 cytokine production during experimental vaginal candidiasis:potential importance of transforming growth factor-beta[J].Med Mycol,2000,38(6):419-431.
[12]LAUK K,SUZUKI H,NOVAK J,et al.Pathogenesis of Henoch-Schonlein purpura nephritis[J].Pediatr Nephrol,2010,25(1):19-26.
[2]MERKLEY K.Vulvovaginitis and vaginal discharge in the pediatric patient[J].J Emerg Nurs,2005,31(4):400-402.
[3]林翠兰,何冰洁,陈昂,等.青春期前女童外阴阴道炎4 214例临床分析[J].中国医师杂志,2014,16(5):653-656.
[4]MORAES P S,TAKETOMI E A.Allergic vulvovaginitis[J].Ann Allergy Asthma Immunol,2000,85(4):253-265.
[5]杨冬梓,石一夏.小儿与青春期妇科学[M].3版.北京:人民卫生出版社,2008:93-137.
[6]RAMIREZ-SANTOS A,PEREIRO M Jr,TORIBIO J.Recurrent vulvovaginitis:diagnostic assessment and therapeutic management[J].Actas Dermosifiliogr,2008,99(3):190-198.
[7]钱华,徐荣华,鲁慧,等.1 936例儿童外阴阴道炎症状与病原体分析[J].皮肤性病诊疗学杂志,2013,20(3):169-171.
[8]林翠兰,付四毛,陈昂,等.过敏体质与女童反复外阴阴道炎的相关性研究[J].东南大学学报:医学版,2015,34(5):761-765.
[9]何君,邢艳.慢性荨麻疹患者血清中特异性Ig E和Ig G检测的临床应用[J].东南大学学报:医学版,2013,32(4):417-421.
[10]树叶,汤建萍,张丹,等.儿童变态反应性疾病过敏原3 504例调查分析[J].中国当代儿科杂志,2010,12(9):720-722.
[11]TAYLOR B N,SAAVEDRA M,FIDEL P L Jr.Local Th1/Th2 cytokine production during experimental vaginal candidiasis:potential importance of transforming growth factor-beta[J].Med Mycol,2000,38(6):419-431.
[12]LAUK K,SUZUKI H,NOVAK J,et al.Pathogenesis of Henoch-Schonlein purpura nephritis[J].Pediatr Nephrol,2010,25(1):19-26.