研究目的： 本研究主要目的在了解食物過敏原對兒童過敏性鼻炎和氣喘的相關性。 研究方法及資料： 本研究策略採用前瞻性研究(case-controlled prospective study)工具。收錄了138位兒童參與此研究，而且所有兒童都經過血清檢查專一性IgE抗體 (serum specific IgE test)，檢測出對特定食物過敏原致敏。這138位兒童中分成二群：(一) 87位只患有過敏性鼻炎及（二）另外51位則同時有氣喘和過敏性鼻炎。所有兒童皆接受理學檢查，檢測血清中IgE總量(total IgE levels)及專一性Ig E (specific Ig E)含量、並進行兒童鼻結膜炎生活品質問卷(Pediatric Rhinoconjunctivitis Quality of Life Questionnaires, PRQLQ)之填寫。而過敏性鼻炎的兒童，則另外接受鼻阻力檢查(nasal Peak Expiratory Flow Rate, nPEFR)。同時有氣喘和過敏性鼻炎的兒童，則多接受肺功能檢查(lung function test)和氣喘控制檢查(asthma control test, ACT)。分析方法以SPSS for windows 22.0版套裝軟體進行「無母數分析」。 研究結果： 在第一群只具過敏性鼻炎的87位兒童中，發現有48位同時對食物和吸入性過敏原過敏，剩餘的39位只對吸入性過敏原過敏。對食物和吸入性過敏原同時過敏的兒童比只對吸入性過敏原過敏的兒童其鼻阻力檢查值較低(p<0.05) 且血清中IgE總量較高(p<0.05)，統計上具有顯著意義。另外一群51位同時有氣喘和過敏性鼻炎的兒童中，則有24位同時對食物和吸入性過敏原過敏，剩餘的27位只對吸入性過敏原過敏。同時對食物和吸入性過敏原致敏的兒童比只對吸入性過敏原致敏的兒童血清中IgE總量較高(p<0.05)。對食物和吸入性過敏原二者同時過敏的兒童比單純只對吸入性過敏原過敏的兒童有較高的肺功能值和氣喘控制測驗分數。 結論與建議： 食物和吸入性過敏原二者同時過敏的兒童會出現較嚴重的臨床症狀和血清中Ig E總量也較高，食物過敏原過敏與兒童過敏性鼻炎應具有一定相關性，為了佐證以上結論。未來，我們應該要執行較長期,較大型,較完整地研究。
Background: Sensitisation to allergen has long been known to relate to childhood allergic disease. In general, food allergens are associated with atopic dermatitis and inhalant allergens are associated with allergic rhinitis and/or asthma. Several studies revealed that polysensitised individuals have more severe atopic disease, whereas individuals with cosensitized to food and inhalant allergen were under-researched. Objective: To realize the relationship between sensitization to food allergen and childhood allergic rhinitis and asthma. Design: This was a prospective case-controlled study. Methods: We included 138 participants with sensitized to allergen as assessed by serum-specific IgE. 87 of 138 participants had allergic rhinitis and 51 participants with both allergic rhinitis and asthma. All participants underwent a physical examination, measurement serum total IgE values and requested to complete the Pediatric Rhinoconjunctivitis Quality of Life Questionnaires (PRQLQ). Besides, nasal peak expiratory flow rate (nPEFR) was performed by allergic rhinitis participants, lung function test and asthma control test (ACT) were performed by both asthma and allergic rhinitis participants. Results: 48 of 87 allergic rhinitis participants with sensitized to food and inhalant allergens (AR food group), 39 of 87 allergic rhinitis participants with sensitized to inhalant allergen alone (AR inhalant group). AR food group significantly lower nPEFR values and higher total IgE values (p<0.05) compared with the other group. 24 of 51 both asthma and allergic rhinitis participants with sensitized to food and inhalant allergens (asthma and AR food group), 27 of 51 both asthma and allergic rhinitis participants with sensitized to inhalant allergen alone (asthma and AR inhalant group). Asthma and AR food group significantly higher total IgE values (p<0.05) compared with the other group and it was higher than the AR food group. Asthma and AR food group also had higher lung function test values and asthma control test (ACT) scores than the other group. Conclusion: This study evidences that children with sensitized to both food and inhalant allergens have more severe clinical symptoms and abnormal laboratory findings. Sensitisation to food allergen was more related to pediatric allergic rhinitis. We may need larger, longer and extended study to assess the conclusion.
