诊断和管理常见的食物过敏:一个系统的审查
Jennifer J Schneider Chafen1, Sydne J Newberry, Marc A Riedl
1VA Palo Alto Healthcare System, Palo Alto, California, USA. jjschnei@stanford.edu
JAMA
|May 13, 2010
概括
诊断食物过敏缺乏一致的标准,影响了患病率和管理层的理解. 为了有效的食物过敏诊断和治疗策略,需要更多的研究.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 临床医学 临床医学
- 公共卫生 公共卫生
背景情况:
- 全球对食物过敏的兴趣日益增长,与有关患病率和最佳诊断/管理策略的缺乏共识形成鲜明对比.
- 现有研究提出了关于食物过敏患病率和有效干预措施的各种发现.
研究的目的:
- 系统地审查有关食物过敏的流行,诊断,管理和预防的现有证据.
- 发现当前对食物过敏的理解和证据基础上的差距.
主要方法:
- 在主要医疗数据库 (PubMed,Cochrane) 进行了全面的电子搜索,查找1988年1月至2009年9月期间发表的英语文章.
- 包括诊断研究与潜在的人口和食品挑战作为标准标准,系统性审查和随机对照试验 (RCT).
- 使用已确定的标准 (AMSTAR,QUADAS,Jadad) 评估所包含研究的质量.
主要成果:
- 据估计,食物过敏的患病率在人口的1-2%至10%之间,增长趋势不确定.
- 皮肤刺痛测试和血清食品特异性IgE没有显示出对食物挑战的诊断的统计优势.
- 消除饮食是主要疗法,但缺乏可靠的研究;免疫疗法显示出希望,但需要更多的数据;水解配方可能会预防高风险婴儿的牛奶过敏,但定义没有标准化.
结论:
- 诊断标准显著缺乏统一性,这阻碍了对食物过敏患病率的可靠评估和有效的管理策略.
- 用标准化诊断标准进行进一步的研究对于推进食物过敏领域至关重要.
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