婴儿牛奶蛋白过敏症的临床特点及随访管理  

Clinical features and follow up management of infant cow milk protein allergy

作　　者：邓镜业[1] 张和春[1] 张凤梨 DENG Jingye;ZHANG Hechun;ZHANG Fengli(Department of Pediatrics,Jiangmen Municipal Central Hospital,Jiangmen,Guangdong 529030,China;Department of Neurology,Jiangmen Municipal Central Hospital,Jiangmen,Guangdong 529030,China)

机构地区：[1]江门市中心医院儿科,广东529030 [2]江门市中心医院神经内科,广东529030

出　　处：《现代医药卫生》2019年第16期2434-2437,共4页Journal of Modern Medicine & Health

基　　金：广东省江门市科技计划项目(江科〔2016〕98号-092)

摘　　要：目的研究婴儿牛奶蛋白过敏症(CMPA)的临床特点,评估规范治疗对患儿反复呼吸道感染的预防效果。方法回顾性分析2015年1月至2016年12月该院确诊的86例CMPA患儿的临床资料,按患者依从性分为规范管理组56例(男30例,女26例)和不规范管理组30例(男16例,女14例),全部患儿均随访至2岁,分析患儿临床症状的特点及规范化管理对疗效的影响,以及对反复呼吸道感染的预防作用。结果婴儿CMPA临床表现多样,可单一或同时出现皮肤(皮疹)、消化系统(呕吐、便血、腹泻、便秘等)等症状,其中68例(79.1%)合并出现2种及以上过敏症状。随着治疗及随访时间的延长,治疗有效率逐渐提高。至随访结束时规范管理组患儿总有效率[98.2%(55/56)]、显效率[92.9%(52/56)]均明显高于不规范管理组[分别为83.3%(25/30)、56.7%(17/30)],1岁后反复呼吸道感染发生率明显低于非规范管理组,差异均有统计学意义(P<0.05)。结论CMPA患儿临床表现多样,以饮食回避为主的综合防治措施可有效缓解患儿临床症状。CMPA患儿的规范管理可降低反复呼吸道感染发生率。Objective To study the clinical characteristics of infant cow milk protein allergy(CMPA)and to evaluate the preventive effect of standardized treatment on recurrent respiratory tract infection in children.Methods The clinical data in 86 cases of CMPA diagnosed in this hospital from January 2015 to December 2016 were retrospectively analyzed.According to the patient compliance,the cases were divided into the normative management group(56 cases,30 males and 26 females)and the non-normative management group(30 cases,16 males and 14 females).All the children cases were followed up until 2 years old.The characteristics of clinical symptoms and the influence of standardized management on the curative effect and its preventive effect on recurrent respiratory tract infection were analyzed.Results The clinical manifestations of infant CMPA were various,which could singly or simultaneously appear the symptoms of skin(rash),digestive system(vomiting,hematochezia,diarrhea,constipation,etc.),among them 68 cases(79.1%)jointly appear two or more allergic symptoms.With the extension of treatment and follow-up period,the therapeutic effective rate was increased gradually.Until the end of follow up,the total effective rate in the standardized treatment group was 98.2%(55/56),the significantly effective rate was 92.9%(52/56),which were significantly higher than those in normative management group[83.3%(25/30)and 56.7%(17/23)],the occurrence rate of recurrent respiratory tract infection after 1 year old in the standardized management group was significantly lower than that in the non-standardized management group,and the differences were statistically significant(P<0.05).Conclusion The clinical manifestations of infant CMPA are diversity.The comprehensive prevention and treatment measures based on the dietary avoidance can effectively relieve the clinical symptoms of children patients.The standardized management of CMPA children patients can reduce the incidence of recurrent respiratory tract infections.

关 键 词：乳类过敏反应 蛋白 婴儿 呼吸道感染 随访研究 

分 类 号：R725[医药卫生—儿科]