Abstract: Objective To determine the prevalence of soybean allergy in IgE-associated cow's milk allergic children in Shanghai. Methods All 441 patients consulting the Children's Hospital of Fudan University in 2009 were included in this study.The experimental group consisted of 224 patients with personal history suggestive of food allergy with specific IgE to cow's milk protein and the control group consisted of 217 patients with non allergic disease.The patients in control group didn't have history of cow milk allergy and their specific IgE to cow's milk protein was negative.Serum-specific IgE to soya protein were measured in all patients and differences of IgE level between soybean and milk,differences of Soybean allergy in different age and gender groups were analyzed separately.The allergy rate of soybean between the experimental group and the control group was also analyzed to explore the cross allergy phenomenon between milk and soybean. Results In IgE-associated CMA cohort,33 patients(14.7%) had soybean allergy.There was no correlation of specific IgE levels between soybean and cow's milk.And the prevalence of soybean allergy decreased with age.In the control group,13 patients(6%) had soybean allergy and similarly the allergy rate of soybean also decreased with age in this group.There was no cross allergic phenomenon between the milk and soybean after age one. Conclusions In Shanghai,very few young children of IgE-associated CMA(especially of age >1 year) had soybean allergy.Therefore,soybean formula may be alternative for the majority of children with IgE-associated CMA.However,milk and soybean still had certain cross allergy in babies of less than 1 year old,therefore close monitoring for cross allergy reaction is necessary in this age group.

Key words: allergy, soybean, milk allergy, child

摘要： 目的 研究上海地区IgE 相关牛奶过敏的儿童中大豆过敏的发生情况,以了解牛奶过敏与否和大豆过敏是否存在联系。方法 共有441名于2009年在复旦附属儿科医院就诊的儿童进入研究,该研究分为实验组与对照组,实验组共有224名,因IgE 相关牛奶过敏就诊,其牛奶IgE结果均为阳性,年龄最小4个月,最大4岁;对照组为217名同期因非过敏疾病于该院就诊的患儿,且既往无牛奶过敏史,其牛奶IgE结果为阴性,其中年龄最小3个月,最大4岁。检测所有对象的血清特异性大豆蛋白IgE水平,进而分析大豆与牛奶的特异性IgE水平有无相关性;各年龄组大豆过敏情况,有无性别差异;以及实验组与对照组的大豆过敏率有无统计学差异。结果 在实验组所有牛奶过敏的患儿中,33例(14.7%)检测出了大豆过敏,其中仅1例IgE水平>100 kU/L(极强阳性),其他阳性结果的平均值为1.74 kU/L,平均水平较低。大豆与牛奶的特异性IgE水平无相关性(P=-0.01)。对照组中大豆过敏为13例,占6%。两组大豆过敏的发生率均随着年龄增长明显下降,两组大豆过敏率均无性别差异。实验组与对照组的大豆过敏率在1岁内有统计学差异,随年龄增长,1岁后无统计学差异,即说明1岁后牛奶与大豆无交叉过敏现象。 结论 上海地区的IgE 相关牛奶过敏的儿童中大豆过敏占很小一部分(尤其是>1岁的儿童),对大部分牛奶过敏的患儿来说,大豆配方奶及其他大豆制品是可以选择的。但是小于1岁婴儿,牛奶与大豆仍存在一定的交叉过敏,所以该年龄阶段牛奶过敏的患儿喂养大豆配方奶粉时应严密监测有无过敏反应发生。

关键词: 过敏, 大豆, 牛奶过敏, 儿童