低敏配方短期干预对母乳喂养婴儿食物蛋白介导的直肠结肠炎转归的影响  

Effects of short-term intervention of hypoallergenic formulas on outcome of food protein-induced allergic proctocolitis in breastfed infants

作　　者：张纪泳[1] 曾永梅 何昊冰 李伟艳 丘晓颖 王媛媛[1] 陈柚燕 曾凡菲 ZHANG Jiyong;ZENG Yongmei;HE Haobing;LI Weiyan;QIU Xiaoying;WANG Yuanyuan;CHEN Youyan;ZENG Fanfei(Department of Pediatrics,Shenzhen Maternity and Child Healthcare Hospital,Southern Medical University,Shenzhen 518028,China)

机构地区：[1]南方医科大学深圳妇幼保健院儿科,深圳518028

出　　处：《中国临床新医学》2025年第3期257-262,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：深圳市科技计划项目(编号:JCY20220530155208019);深圳市“医疗卫生三名工程”项目(编号:SZSM202311021)。

摘　　要：目的探讨低敏配方短期干预对母乳喂养婴儿食物蛋白介导的直肠结肠炎(FPIAP)的临床症状缓解、免疫耐受及生长发育的影响。方法选择2021年1月1日至2022年8月31日在南方医科大学深圳妇幼保健院确诊为FPIAP且以母乳喂养为主的29 d~6月龄婴儿67例。根据限制饮食情况将其分为低敏配方组(暂停母乳,以氨基酸配方或深度水解配方替代2周后,逐渐恢复母乳喂养,43例)和母乳喂养组(继续喂养,但母亲回避饮食,24例)。比较两组在1个月、3个月后的临床症状缓解情况,6~8月龄时的辅食过敏率以及12月龄时的免疫耐受和生长发育情况。结果低敏配方组在干预1个月和3个月后的临床症状缓解率均显著高于母乳喂养组(90.70%vs 50.00%,97.67%vs 62.50%,P<0.05)。两组辅食过敏率比较差异无统计学意义(P>0.05)。12月龄时,低敏配方组获得免疫耐受的比例显著高于母乳喂养组(57.58%vs 20.00%,P<0.05)。两组各月龄的体重、身长、头围及增长情况未见显著差异(P>0.05)。结论低敏配方短期干预可促进症状缓解且不影响母乳喂养的恢复,不影响婴儿的远期生长发育,且对免疫耐受有益。是否采用此方法可根据患儿症状严重程度、看护人的焦虑程度等因素决定。Objective To explore the effects of short-term intervention of hypoallergenic formulas(HFs)on the relief of clinical symptoms,immune tolerance,growth and development in breastfed infants with food protein-induced allergic proctocolitis(FPIAP).Methods A total of 67 infants aged 29 days to 6 months who were diagnosed with FPIAP and were mainly breast-fed at Shenzhen Maternity and Child Healthcare Hospital,Southern Medical University from January 1,2021 to August 31,2022 were selected.According to dietary restrictions,these infants were divided into hypoallergenic formula group[Breastfeeding was suspended and after 2 weeks of replacing breast milk with amino acid formula(AAF)or extensively hydrolyzed formula,breastfeeding was gradually resumed,43 cases]and breastfeeding group(Breastfeeding was continued with maternal food-avoidance diets,24 cases).The clinical symptom remission after 1 month and 3 months of the feeding,the rates of allergy to complementary foods at the age of 6 to 8 months,and immune tolerance,growth and development at the age of 12 months were compared between the two groups.Results The rates of clinical symptom remission after interventions for 1 month and 3 months in the hypoallergenic formula group were significantly higher than those in the breastfeeding group(90.70%vs 50.00%,97.67%vs 62.50%,P<0.05).There were no significant differences in the rates of allergy to complementary foods between the two groups(P>0.05).At the age of 12 months,the proportion of infants acquiring immune tolerance in the hypoallergenic formula group was significantly higher than that in the breastfeeding group(57.58%vs 20.00%,P<0.05).There were no significant differences in body weight,body length,head circumference and their growth between the two groups(P>0.05).Conclusion The short-term intervention of HFs can promote symptom relief without affecting the resumption of breastfeeding and without affecting long-term growth and development in infants and is beneficial for immune tolerance.Whether to use this method can be

关 键 词：食物蛋白介导的直肠结肠炎 母乳喂养 深度水解配方 氨基酸配方 免疫耐受 

分 类 号：R725.7[医药卫生—儿科]