牛奶蛋白过敏致婴幼儿过敏性肠炎患儿粪便及外周血嗜酸性粒细胞、血小板计数表达变化及临床意义  

Changes and clinical significance of eosinophils and platelet counts in faeces and peripheral blood of infants with allergic enteritis induced by cow′s milk protein allergy

作　　者：宋祖贤 诸葛远莉[1] 张琦[1] 夏小兰 SONG Zuxian;ZHUGE Yuanli;ZHANG Qi;XIA Xiaolan(Nanjing Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing,Jiangsu 210016,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院,江苏南京210016

出　　处：《国际检验医学杂志》2023年第7期848-851,856,共5页International Journal of Laboratory Medicine

基　　金：南京市科技发展项目(201803037)。

摘　　要：目的探讨牛奶蛋白过敏(CMPA)致婴幼儿过敏性肠炎患儿粪便及外周血嗜酸性粒细胞(EOS)、血小板(PLT)计数治疗前后变化及意义。方法选取2017-2020年于该院门诊诊治的87例CMPA致婴幼儿过敏性肠炎患儿作为过敏性肠炎组,均回避牛奶4周;另选取同期就诊的同一年龄段普通腹泻患儿60例作为非过敏性肠炎组,同期同一年龄段健康儿童60例作为健康对照组,检测3组外周血血红蛋白水平及白细胞、EOS、PLT计数及粪便EOS计数,采用受试者工作特征(ROC)曲线分析其对CMPA致婴幼儿过敏性肠炎的诊断价值。结果3组外周血白细胞计数、血红蛋白水平比较差异无统计学意义(P>0.05);过敏性肠炎组外周血EOS、PLT计数分别为均明显高于非过敏性肠炎组、健康对照组(P<0.05),过敏性肠炎组粪便EOS计数高于非过敏性肠炎组(P<0.05),而健康对照组粪便中未见EOS(P<0.05)。过敏性肠炎组治疗后外周血EOS、PLT计数和粪便EOS计数均低于治疗前(P<0.05)。ROC曲线分析结果显示,外周血EOS、PLT计数和粪便EOS计数单独诊断过敏性肠炎的曲线下面积(AUC)分别为0.750、0.668、0.843,均低于3项指标联合诊断的AUC(P<0.05)。结论CMPA致过敏性肠炎患儿外周血EOS、PLT计数及粪便EOS计数均处于较高水平,回避牛奶4周后上述指标明显降低,且外周血EOS、PLT计数及粪便EOS计数联合检测对于临床上诊断CMPA致婴幼儿过敏性肠炎具有较好的应用价值。Objective To explore the changes and significance of eosinophils(EOS)and platelet(PLT)counts in faeces and peripheral blood of infants with allergic enteritis induced by cow′s milk protein allergy(CMPA)before and after treatment.Methods A total of 87 infants with allergic enteritis induced by cow′s milk protein allergy admitted to outpatient of the hospital from 2017to 2020 were enrolled as allergic enteritis group,all were not given cow′s milk for 4 weeks.A total of 60 infants with common diarrhea and 60 healthy infants during the same period in the same age group were enrolled as non-allergic enteritis group and healthy control group,respectively.The levels of peripheral blood hemoglobin,white blood cells,EOS,PLT counts and fecal EOS count in the three groups were detected.And their diagnostic value for CMPA induced allergic enteritis was analyzed by receiver operating characteristic(ROC)curve.Results The differences in levels of peripheral blood white blood cell count and hemoglobin level among the three groups were not statistically significant(P>0.05).The peripheral blood EOS and PLT counts in allergic enteritis group were significantly higher than those in non-allergic enteritis group and healthy control group(P<0.05),and fecal EOS count was higher than that in non-allergic enteritis group(P<0.05).There was no fecal EOS in healthy control group(P<0.05).After treatment,peripheral blood EOS,PLT counts and fecal EOS count in allergic enteritis group were lower than those before treatment(P<0.05).The results of ROC curve analysis showed that area under the curve(AUC)of peripheral blood EOS,PLT counts and fecal EOS count alone for the diagnosis of allergic enteritis was 0.750,0.668 and 0.843,which were lower than that of combined detection(P<0.05).Conclusion The peripheral blood EOS,PLT counts and fecal EOS count are relatively high in children with CMPA-induced allergic enteritis.The above indexes significantly reduce after avoiding milk for 4 weeks.The combined detection of peripheral blood EOS,PLT count

关 键 词：牛奶蛋白过敏 过敏性肠炎 婴幼儿 嗜酸性粒细胞计数 血小板计数 粪便 

分 类 号：R446.1[医药卫生—诊断学]