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过敏原检测结果能否成饮食指南?

2017-08-15 15:13:10   中国青年网

我国第二个“中国过敏防治周”刚刚结束,今年的主题是“防治过敏、正确诊断、规范治疗”。北京协和医院变态反应科主任尹佳教授在北京医师协会变态反应医师分会第一届学术会议上,向医生和患者宣传普及正确诊断和治疗过敏性疾病的方法。尹佳认为,过敏没有正确的诊断,就没有正确的治疗,诊断一定要结合病史和病人的症状、体征。

问题 两检测方法不被推荐

尹佳说,过敏专科医生的职责就是要选择正确的诊断方法,找出致敏原,做出正确的病因学诊断,给患者提出避免过敏原的建议,进行特异性的免疫治疗,阻止疾病的发展,减少疾病的负担,改善病人的生活质量。在她的日常门诊病人中,很多患者都是拿着在外院做的生物共振检测和食物不耐受检测结果来寻求解决办法。目前,生物共振检测和食物不耐受检测已成为国内很普遍的过敏原检测方法,部分医生甚至把检测结果当成了诊断的“金标准”。

但是,全世界各国过敏专科学会都不推荐用这两种方法来诊断过敏性疾病(即过敏原)。作为受过专业培训的变态反应专科医生,尹佳呼吁,防治过敏性疾病,首先要选择正确的诊断方法。没有正确的诊断,就没有正确治疗的基础,用不正确的方法诊断过敏性疾病,根本就谈不上规范的治疗。

案例 检测不当影响治疗

尹佳曾接诊过一位73岁的女患者,她发作性地出现头皮及全身瘙痒,还伴有皮疹。这位患者在当地医院用生物共振方法进行过敏原检测,结果显示主要食物都是“过敏”状况,这位患者被吓坏了,找到尹佳时,她禁食了所有的海产品、所有的调料、所有的肉、所有的蛋奶类食品,基本上不吃蛋白质,就吃青菜和一些粮食。在协和医院,这位患者做了常规的特异性免疫球蛋白E(IgE)组套的检测,既包括了吸入过敏原,也包括食物过敏原。除了蒿属花粉是很微弱过敏外,其他所有的过敏原检测都是阴性的,与生物共振检测方法检出的结果相比,差距太大了。

尹佳还接诊过1个9岁的男孩,男孩出生后就经常出现皮肤瘙痒和皮疹,还经常打喷嚏、流鼻涕。今年5月,他去某医院用生物共振的方法检测,结果显示多种食物和接触物都过敏,呈现阳性的过敏原多达106种。于是,孩子这个不能吃、那个不能吃……由于营养不均衡,他的身高明显低于同龄儿童。尹佳为他做了皮内试验,结果显示他主要是吸入过敏原尘螨和霉菌过敏,特异性免疫球蛋白E的检测显示:鸡蛋和牛奶呈非常微弱的阳性,花生,大豆,芝麻呈弱阳性,尘螨强阳性6级。

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