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为母乳喂养婴儿引入过敏性食物的随机试验
Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants


Michael R. Perkin ... 其他 • 2016.05.05

摘要


背景

目前尚不确定应在何时为母乳喂养的婴儿引入过敏性食物。我们评估了早期引入过敏性食物能否预防食物过敏。

 

方法

我们从一般人群中纳入了1,303例全母乳喂养的3月龄婴儿,并将他们随机分配到早期引入6种过敏性食物组(花生、熟鸡蛋、牛奶、芝麻、白鱼肉和小麦,早期引入组),或全母乳喂养至约6月龄组(即英国目前推荐的方法,标准引入组)。主要结局是在1~3岁对6种食物中的至少一种产生过敏。

 

结果

意向性治疗分析发现,标准引入组中至少1种试验食物引起过敏的发生率为7.1%(42/595),早期引入组中为5.6%(32/567)(P=0.32)。符合方案分析表明,早期引入组中食物过敏的整体患病率(2.4% vs. 7.3%,P=0.01)、花生过敏的患病率(0 vs. 2.5%,P=0.003)和鸡蛋过敏的患病率(1.4% vs. 5.5%,P=0.009)都显著低于标准引入组;但牛奶、芝麻、鱼肉和小麦的过敏情况没有显著组间差异。每周摄入2g花生蛋白或卵清蛋白的参与者和摄入量较低的参与者相比,前者中这两种食物过敏的患病率显著下降。早期引入这6种食物虽不容易实现,但并未产生危险。

 

结论

本试验的意向性治疗分析未发现早期引入过敏性食物具有预防过敏的作用。进一步分析提出了早期引入多种过敏性食物对食物过敏的预防作用是否具有剂量依赖性这一问题(研究由英国食品标准局[Food Standards Agency]等资助,EAT在Current Controlled Trials的注册号为ISRCTN14254740)。





作者信息

Michael R. Perkin, Ph.D., Kirsty Logan, Ph.D., Anna Tseng, R.D., Bunmi Raji, R.D., Salma Ayis, Ph.D., Janet Peacock, Ph.D., Helen Brough, Ph.D., Tom Marrs, B.M., B.S., Suzana Radulovic, M.D., Joanna Craven, M.P.H., Carsten Flohr, Ph.D., and Gideon Lack, M.B., B.Ch. for the EAT Study Team*
From the Population Health Research Institute, St. George’s, University of London (M.R.P.), the Department of Paediatric Allergy, Division of Asthma, Allergy, and Lung Biology, King’s College London and Guy’s and St. Thomas’ NHS Foundation Trust (M.R.P., K.L., A.T., B.R., H.B., T.M., S.R., J.C., G.L.), the Division of Health and Social Care Research, King’s College London (S.A., J.P.), and the St. John’s Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London and Guy’s and St. Thomas’ NHS Foundation Trust (C.F.) — all in London. Address reprint requests to Dr. Lack at the Children’s Allergy Unit, St. Thomas’ Hospital, Westminster Bridge Rd., London SE1 7EH, United Kingdom, or at gideon.lack@kcl.ac.uk. *A complete list of members of the Enquiring about Tolerance (EAT) Study Team is provided in the Supplementary Appendix, available at NEJM.org.

 

参考文献

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