早产儿严重牛奶蛋白过敏1例报告并文献复习  

SEVERE COW’S MILK PROTEIN ALLERGY IN A PRETERM NEONATE:A CASE REPORT AND LITERATURE REVIEW

作　　者：李玉美[1] 张沂洁[1] 刘燕[1] 卫红利 姜红[1] LI Yumei;ZHANG Yijie;LIU Yan;WEI Hongli;JIANG Hong(Department of Neonatology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院新生儿科,山东青岛266003

出　　处：《青岛大学学报（医学版）》2022年第5期781-783,共3页Journal of Qingdao University(Medical Sciences)

基　　金：山东省中医药科技发展计划项目(2019-0403)。

摘　　要：目的总结以过敏性休克为主要表现的新生儿严重牛奶蛋白过敏(CMPA)的临床特点及诊治经验。方法回顾性分析1例严重CMPA早产儿的病史资料、临床表现、实验室检查结果及治疗转归,并进行文献复习。结果本例早产儿系剖宫产娩出,有过敏家族史,生后28 d,换用配方奶后发生过敏性休克,给予肾上腺素、生理盐水扩容及地塞米松治疗后症状缓解;病儿血清牛奶蛋白特异性免疫球蛋白E(IgE)阳性,嗜酸性粒细胞反应性增多。予食物回避,换用氨基酸配方奶喂养后未再出现过敏。结论早产儿IgE介导的严重CMPA鲜有报道,现尚无统一诊断标准,且缺乏可靠的检测方法。有高风险家族史新生儿应注意早期识别、诊断,及时干预,重视对严重CMPA婴儿的急救。Objective To summarize the clinical characteristics and diagnosis and treatment of neonatal severe cow’s milk protein allergy(CMPA)characterized by anaphylactic shock.Methods We reviewed a case of severe CMPA in a preterm infant,analyzing the medical history,clinical manifestations,laboratory examination results,and treatment outcome,and also performed a literature review.Results This premature infant was delivered through cesarean section,with a family history of allergy.The infant developed anaphylactic shock after switching to formula milk 28 d after birth.The symptoms were relieved after treatment with epinephrine,dexamethasone,and volume expansion with normal saline.The serum cow’s milk protein-specific immunoglobulin E(IgE)was positive.A reactive increase in the level of eosinophils was observed.No allergic reaction occurred after food avoidance by changing to an amino acid-based formula.Conclusion IgE-mediated severe CMPA in premature infants has rarely been reported,lacking standard diagnostic criteria and reliable detection methods.Attention should be focused on newborns with a high-risk family history to facilitate early recognition,diagnosis,and intervention and deliver first aid to those with severe CMPA.

关 键 词：乳类过敏反应 乳蛋白质类 婴儿 早产 病例报告 

分 类 号：R722.6[医药卫生—儿科] R593.1[医药卫生—临床医学]