Objective: To investigate sensitization rate of cow's milk in children, and explore its clinical features. Methods: This study enrolled a total of 818 patients under 18 years old with suspected food allergy who were admitted to the Allergy department in Beijing Shijitan Hospital during June 2018 to November 2020. The ImmunoCAP fluorescent enzyme-linked immunoassay system was used to quantify cow milk-specific immunoglobulin E (sIgE). Mild sensitization to cow's milk was defined as Radio-Allergo-Sorbent-Test (RAST) class 1, moderate sensitization was defined as class 2-3 and severe sensitization was class 4-6. Statistical methods such as χ2 test, independent sample t-test, one-way analysis of variance, and Spearman correlation analysis were used to retrospectively clarify differences of cow's milk sensitization rate between ages of children and elaborate its clinical features. Results: Overall sensitization rate of cow's milk reached 25.7% (210/818). Positive rate of cow milk sensitization (39.2%), cow milk sIgE levels [0.93 (0.52, 2.62)] kU/L, and moderate to severe sensitization rate (23.5%) were highest in infants aged between 0-3 years old. The sensitization rate and severity of sensitization declined with age. Most common clinical manifestation of cow milk sensitization was skin symptoms (50.0%), followed by respiratory symptoms (38.9%) and gastrointestinal symptoms (36.1%). Skin symptoms were the most common manifestation in 0-3 year-old group (47.3%), and respiratory symptoms were more common in 4-6 and 7-18 year-old groups (58.7%, 56.0%). Multiple-sensitization rate of patients with moderate to severe cow milk sensitization was 74.1%, most of which (70.4%) were co-sensitized by other food allergens, and 31.5% were co-sensitized by inhaled allergens. Conclusions: In population with age under 18 years old, infants aged between 0-3 years old suffered highest cow milk sensitization rate and increased sensitization severity. Then the severity decreased with age increasing. Patients with cow milk sensitization manifested skin symptoms most.
目的： 调查儿童及青少年人群牛奶过敏原致敏阳性率，探讨牛奶致敏的年龄、疾病分布特征和致敏特点。 方法： 回顾性研究。本研究共纳入2018年6月至2020年11月就诊于北京世纪坛医院变态反应科门诊的818例疑诊食物过敏的未成年患者。采用ImmunoCAP荧光酶联免疫法对患者血清进行牛奶sIgE检测，定义sIgE 1级为轻度致敏，2~3级为中度致敏，4~6级为重度致敏。并采用χ²检验、独立样本t检验、单因素方差分析、Spearman相关性分析等统计学方法对牛奶致敏患者的年龄分布、临床症状及多重致敏特征进行回顾性分析。 结果： 纳入研究的患者中，牛奶致敏率为25.7%（210/818）。0~3岁组婴幼儿患者牛奶致敏率为39.2%、牛奶sIgE水平［0.93（0.52，2.62）kU/L］、中重度致敏患者比例23.5%，均高于其他年龄组。牛奶致敏率及致敏程度随年龄增长呈逐渐下降趋势。牛奶致敏以皮肤过敏症状最常见（50.0%），其次是呼吸道（38.9%）和胃肠道症状（36.1%）。0~3岁组以皮肤症状最常见（47.3%），4~6岁和7~18岁组以呼吸系统症状多见（58.7%，56.0%）。中重度牛奶致敏患者的多重致敏率达74.1%，其中70.4%合并其他食物过敏原致敏，31.5%合并其他吸入性过敏原致敏。 结论： 18岁以下人群中，婴幼儿患者牛奶致敏率高、致敏程度严重，随年龄增长逐渐减轻。牛奶致敏患者以皮肤过敏症状最常见。.