摘要
目的分析婴儿牛奶蛋白过敏(CMPA)的临床特点,为早期识别和管理疾病提供依据。方法选取2022年1月1日至2023年12月30日于中山市人民医院儿科临床诊断为CMPA的164例婴儿为研究对象,收集、分析其临床资料并进行临床随访(时间截止至2024年6月30日)。结果164例患儿中,人工喂养94例(57.3%),纯母乳喂养24例(14.6%),混合喂养46例(28.0%),有家族过敏史87例(53.0%)。发病年龄1~<6个月144例(87.8%);临床表现累及最多的是消化系统125例(76.2%),其次是皮肤系统102例(62.2%),营养不良15例(9.1%);67例(40.9%)患儿存在两个及以上系统的症状。外周血嗜酸性粒细胞百分比(EO%)较正常值升高84例(51.2%),血小板计数(PLT)较正常值升高96例(58.5%),血清牛奶蛋白特异性免疫球蛋白E(sIgE)阳性85例(51.8%)。所有病例给予饮食回避和低敏配方奶粉替代治疗后,临床症状均得到改善或消失,后续随访15例营养不良患儿中有13例营养状况得到纠正,2例营养状况尚未完全纠正,其余患儿生长发育均正常。有49例(29.9%)患儿在辅食添加过程中出现不良反应。结论儿科医生应提高对CMPA的认识,综合规范的CMPA管理能够改善疾病的预后,保障患儿的正常生长发育。
Objective To analyze the clinical characteristics of infant with cow's milk protein allergy(CMPA),and to provide evidence for early identification and management of diseases.Methods A total of 164 infants who were clinically diagnosed with CMPA in the pediatrics department of Zhongshan City People's Hospital from January 1,2022 to December 30,2023 were selected as the research objects.The infants'clinical data were collected and analyzed and clinical follow-up was performed(up to June 30,2024).Results Among the 164 children,94(57.3%)were artificially fed,24(14.6%)were exclusively breastfed,46(28.0%)were mixedly fed,and 87(53.0%)had a family history of allergies.There were 144 cases(87.8%)with onset age of 1~<6 months;the most common clinical manifestations were the digestive system(125 cases,76.2%),followed by the skin system(102 cases,62.2%),and there were 15 cases(9.1%)of malnutrition;67 cases(40.9%)had symptoms of two or more systems.Peripheral blood percentage of eosinophils(EO%)was higher than normal in 84 cases(51.2%),platelet count(PLT)was higher than normal in 96 cases(58.5%),and serum milk protein specific immunoglobulin E(sIgE)was positive in 85 cases(51.8%).After all cases were given diet avoidance and low-sensitivity formula milk powder replacement therapy,the clinical symptoms improved or disappeared.In the follow-up of 15 children with malnutrition,13 cases of nutritional status were corrected,2 cases of nutritional status had not been completely corrected,and the rest of the children had normal growth and development.49 cases(29.9%)had adverse reactions in the process of complementary feeding.Conclusion Pediatricians should improve their understanding of CMPA.Comprehensive and standardized CMPA management can improve the prognosis of the disease and ensure the normal growth and development of children.
作者
潘聪
付四毛
杨祝玲
毛静媛
刘美玲
阮静维
朱蔼欣
PAN Cong;FU Simao;YANG Zhuling;MAO Jingyuan;LIU Meiling;RUAN Jingwei;ZHU Aixin(Pediatrics Department,Zhongshan City People's Hospital,Zhongshan 528403,China)
出处
《临床医学研究与实践》
2025年第23期58-61,共4页
Clinical Research and Practice
基金
广东省中山市科学技术局2022年度第一批社会公益与基础研究项目(医疗卫生一般项目)(No.2022B1009)。
关键词
婴儿
牛奶蛋白过敏
生长发育
辅食添加
infant
cow's milk protein allergy
growth and development
complementary feeding
