家长对儿童食物过敏的认知水平调查

Survey on the parental awareness of pediatric food allergies

摘要

目的 了解家长对儿童食物过敏的认知水平,为儿童食物过敏的临床管理提供依据。方法 针对儿童食物过敏设计调查问卷,单选题及多选题总计37项,内容包括病因、症状识别、诊断和临床管理等.分别于2021年11月和2022年5月通过网络面向家长发放问卷二维码,回收问卷后由专人整理,进行统计分析。结果 共回收有效问卷505份.症状识别上,对湿疹、荨麻疹、呼吸困难、揉眼/揉鼻、呕吐、腹泻、粘液便、生长迟缓等症状的选择比例过半,最高达79.41%;肛周皮疹、反流、厌食选择比例偏低(33.47%~35.45%).超过半数了解常见高过敏性食物包含的具体内容,90.00%以上知道海鲜、牛奶、鸡蛋是常见过敏性食物.诱发食物过敏因素选题中,辅食添加过早、抗生素应用的选择率超45.00%,20.99%选择辅食添加过晚.食物过敏诊断中,皮肤点刺试验、血清特异性IgE和食物回避-激发试验选择率分别为54.46%、74.65%和71.49%,但仍有67.92%和35.84%选择血清特异性IgG和外周血嗜酸性粒细胞增高.饮食管理上,替代配方选择、母乳喂养的配方粉选择、辅食添加时机等的正确率过半,最高83.37%.调查对象的年龄及学历并不影响答题合格率(P>0.05),本人或家人有食物过敏性疾病的调查对象在回答常见过敏食物识别、过敏临床管理类题目时正确率较高,反向答案症状识别类题目正确率低,差异有统计学意义(χ²值介于4.48~42.80之间,P<0.05)。结论 家长对儿童食物过敏的症状识别、诊断、临床管理有较好的认知,但在如IgG检测、低敏配方时长等方面认识有待提高,应避免造成过度诊断及过度饮食限制而影响儿童的生长发育.

Abstract

Objective To investigate the parents' awareness of pediatric food allergies and to provide a basis for clinical management of food allergy in children. Methods A questionnaire designed for pediatric food allergies consisted of a total of 37 single-choice and multiple-choice questions, including etiology, symptom recognition, diagnosis and clinical management. The questionnaires were distributed to parents online using QR codes in November 2021 and May 2022. After collecting the completed questionnaires, they were organized by designated personnel for statistical analysis. Results A total of 505 valid questionnaires were collected. Regarding symptom recognition, the selection rates for symptoms such as eczema, urticaria, difficulty breathing, eye/nose rubbing, vomiting, diarrhea, mucous stool, and delayed growth exceeded half, with the highest reaching 79.41%. The selection rates such as perianal rash, reflux, and aversion to food were relatively low (33.47% to 35.45%). Over half of the respondents understood the specific contents of common highly allergenic foods, and over 90.00% knew that seafood, milk, and eggs are common allergenic foods. In the selection of factors triggering food allergies, the selection rates for early introduction of complementary foods and the use of antibiotics exceeded 45.00%, while 20.99% chose delayed introduction of complementary foods. In food allergy diagnosis, the selection rates for skin prick tests, serum-specific IgE, and food avoidance-provocation tests were 54.46%, 74.65% and 71.49%, respectively. However, 67.92% and 35.84% still chose increased serum-specific IgG and peripheral blood eosinophilia. In dietary management, the accuracy rates for choosing alternative formulas, selecting formula powders for breastfeeding, and timing of complementary food introduction exceeded half, with the highest reaching 83.37%. The age and education level of the surveyed participants did not affect the pass rates of the questionnaire (P>0.05). Respondents with a personal or family history of food allergies had higher accuracy in answering questions related to the identification of common allergenic foods and clinical management of allergies. However, their accuracy in answering questions related to symptom recognition in reverse was lower, with statistically significant differences (χ² values ranged from 4.48 to 42.80, P<0.05). Conclusion Parents have a good understanding of symptom recognition, diagnosis, and clinical management of pediatric food allergies. However, there is room for improvement in areas such as IgG testing and duration of low-allergen formulas. Excessive diagnosis and dietary restrictions should be avoided to prevent adverse effects on the growth and development of children.

关键词

食物过敏 / 儿童 / 认知 / 问卷调查

Key words

food allergy / children / cognition / questionnaire investigation

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基金资助

国家自然科学基金面上项目(82070537)