以消化道症状首诊的不同月龄牛奶蛋白过敏婴儿临床分析  

The clinical analysis of infants with cow’s milk protein allergy at different age first diagnosed with digestive tract symptoms

作　　者：周杏[1] 廖旺 罗威耀 刘志刚[1] ZHOU Xing;LIAO Wang;LUO Wei-yao;LIU Zhi-gang(Department of pediatrics,Foshan maternal and child health hospital affiliated to Southern medical university,Guangdong Province,Foshan 528000,China)

机构地区：[1]南方医科大学附属佛山妇幼保健院儿科,528000

出　　处：《现代消化及介入诊疗》2020年第8期1006-1010,1014,共6页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：广东省医学科学技术研究基金项目(B2017058)。

摘　　要：目的分析以消化道症状首诊的不同月龄牛奶蛋白过敏(cow’s milk protein allergy,CMPA)婴儿的临床资料,以期为临床更有针对性的诊治提供参考。方法2018年1月至2018年12月我院儿科以消化道不适症状为首诊的CMPA患儿共67例,根据月龄不同分为3组:28天~3月龄组,4月龄~6月龄组以及7月龄~12月龄组。回顾性分析各组患儿的临床资料,并分析有无明显差异。结果67例CMPA患儿中,28天龄~3月龄组32例(47.8%),4月龄~6月龄组22例(32.8%),7月龄~12月龄组13例(19.4%)。不同月龄CMPA婴儿常见消化道症状不完全一样:28天~3月龄组以血便、哭闹、肠绞痛最为常见,其次为呕吐,便秘最为少见;4月龄~6月龄组亦以血便、哭闹、肠绞痛最为常见,但便秘出现比例较前组增高;7月龄~12月龄组以血便最为常见,其次为便秘、哭闹、肠绞痛。各组在哭闹、肠绞痛方面比较差异有统计学意义(P<0.05),余消化道症状比较差异无统计学意义(P>0.05)。湿疹、荨麻疹等皮肤过敏症状可出现在各月龄组,比较差异无统计学意义(P>0.05)。各组在喘息、流涕、咳嗽等呼吸道症状比较差异有统计学意义(P<0.05)。各组CMPA在血白细胞计数升高比例、嗜酸性粒细胞升高比例、血红蛋白下降比例、大便镜检红细胞阳性率、大便潜血阳性率以及牛奶相关症状评分(cow’s milk-related symptom scores,CoMiSS)等实验室检查比较均差异无统计学意义(P>0.05)。结论不同月龄段CMPA患儿的临床表现无特异性,但月龄越小临床比例越高,月龄越小消化道受累症状越明显,随着月龄增长,呼吸道受累症状渐表现显著。Objective To analyze the clinical data of cow’s milk protein allergy(CMPA)infants of different age who were first diagnosed with digestive tract symptoms,and to provide reference for more targeted clinical diagnosis and treatment.Methods A total of 67 children with CMPA who were first diagnosed with digestive tract discomfort in the pediatric department of our hospital from January 2018 to December 2018 were collected and divided into 3 groups according to their age:28 days to 3 months,4 months to 6 months,and 7 months to 12 months.The clinical data of children in each group were analyzed retrospectively and any significant differences were analyzed too.Results Among the 67 children with CMPA,32(47.8%)were in the 28 days to 3 months group,22(32.8%)were in the 4 months to 6 months group,and 13(19.4%)were in the 7 months to 12 months group.The common symptoms of digestive tract discomfort in infants with CMPA at different age are not exactly the same:blood stool,crying and colic were the most common symptoms,followed by vomiting,and constipation was the least common symptom in the 28 days to 3 months group;blood stool,crying and colic were also the most common symptoms in the 4 months to 6 months group,but the incidence of constipation was higher than that in the previous group;blood stool was the most common,followed by constipation,crying and colic in the 7 months to12 months group.There were statistically significant differences in crying and colic in each group(P<0.05),and no statistically significant differences in the remaining gastrointestinal symptoms(P>0.05).Skin allergy symptoms such as eczema and urticaria appeared in each month age group,and the difference was not statistically significant(P>0.05).The differences in respiratory symptoms such as wheezing,runny nose and cough were statistically significant in each group(P<0.05).There were no statistically significant differences in CMPA among all groups in laboratory examinations including increased proportion of leukocyte count,increased proportion of

关 键 词：牛奶蛋白过敏 婴儿 临床表现 实验室检查 

分 类 号：R725.7[医药卫生—儿科] R57[医药卫生—临床医学]