钙卫蛋白对儿童非IgE介导的牛奶蛋白过敏的诊断价值

Diagnostic value of calprotectin in children with non-IgE-mediated cow's milk protein allergy

摘要

目的 探讨粪便钙卫蛋白(FC)在早期识别非IgE介导的牛奶蛋白过敏(non-IgE-CMPA)中的诊断价值。方法 选取2023年5月至2024年11月空军军医大学第二附属医院门诊可疑non-IgE-CMPA患儿65例,其中确诊为non-IgE-CMPA 30例;非牛奶蛋白过敏35例.比较两组患儿的FC水平,并记录各组患儿性别、年龄、母亲分娩史、母亲过敏史等情况.采用多因素Logistic回归分析non-IgE-CMPA的影响因素;受试者工作特征(ROC)曲线分析FC对non-IgE-CMPA的诊断价值。结果 两组粪便钙卫蛋白水平比较,差异有统计学意义(t=4.624,P<0.001);患儿剖宫产分娩出生(OR=6.206,95%CI:1.377~27.981)、母亲有过敏史(OR=5.732,95%CI:1.147~28.640)是non-IgE-CMPA的独立危险因素(P<0.05);FC诊断non-IgE-CMPA的曲线下面积为0.792,当FC取截断值为62.56ng/mL时,灵敏度为73.3%,特异度为85.7%。结论 FC检测在早期识别non-IgE-CMPA可能有一定的诊断价值,且检测费用低,操作简单,适合儿科门诊推广.

Abstract

Objective To investigate the diagnostic value of fecal calprotectin (FC) in the early identification of non-IgE-mediated cow's milk protein allergy (non-IgE-CMPA). Methods From May 2023 to November 2024, 65 children with suspected non-IgE-CMPA were enrolled in the outpatient clinic of the Second Affiliated Hospital of the Air Force Medical University, of which 30 were diagnosed with non-IgE-CMPA. There were 35 cases of non-cow's milk protein allergy. The FC levels of the two groups were compared, and the gender, age, maternal delivery history, and maternal allergy history of the children in each group were recorded. Multivariate logistic regression was used to analyze the influencing factors of non-IgE-CMPA. The receiver operating characteristic (ROC) curve analyzed the diagnostic value of FC for non-IgE-CMPA. Results There was a statistically significant difference in fecal calprotectin levels between the two groups (t=4.624, P<0.001), the children were born by cesarean section (OR=6.206, 95%CI: 1.377-27.981), and the mother had a history of allergies (OR=5.732, 95%CI: 1.147-28.640) was an independent risk factor for non-IgE-CMPA (P<0.05), the area under the curve of FC in the diagnosis of non-IgE-CMPA was 0.792, and the sensitivity and specificity were 73.3% and 85.7% when the cut-off value of FC was 62.56ng/mL. Conclusion FC detection may have certain diagnostic value in the early identification of non-IgE-CMPA, and the detection cost is low, the operation is simple, and it is suitable for pediatric outpatient promotion.

关键词

牛奶蛋白过敏 / 非IgE介导的过敏 / 粪便钙卫蛋白 / 儿童

Key words

milk protein allergy / non-IgE mediated allergy / fecal calprotectin / children

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基金资助

国家自然科学基金(82173627)