Solinas C, Corpino M, Maccioni R, Pelosi U
Children and Mother Care Department, Paediatrics Unit, S. Barbara Hospital, Iglesias.
J Matern Fetal Neonatal Med. 2010 Oct;23 Suppl 3:76-9. doi: 10.3109/14767058.2010.512103.
Cow's milk protein allergy (CMPA) affects 2-7.5% of children; persistence in adulthood is uncommon since a tolerance develops in 51% of cases within 2 years and 80% within 3-4 years. CMPA is an immunological reaction to one or more milk proteins: α-lactalbumin, ß-lactoglobulin, casein, IgE or non-IgE associated, responsible of immediate or late onset symptoms. The suspicion of CMPA is based on detailed family and medical history, skin test, patch test, laboratory test, an elimination diet and food challenge. The general treatment for CMPA is dietary: elimination of cow's milk protein and introduction of extensively hydrolyzed whey or casein formula, amino acid formula, and soy formula. Extensively hydrolyzed whey or casein formula is recommended as first choice for infants in mild or moderate reactions, amino acid formula in severe CMPA and in cases with poor response to extensively hydrolysed whey or casein formula.
牛奶蛋白过敏(CMPA)影响2%至7.5%的儿童;在成年期持续存在的情况并不常见,因为51%的病例在2年内产生耐受性,80%在3至4年内产生耐受性。CMPA是对一种或多种牛奶蛋白的免疫反应:α-乳白蛋白、β-乳球蛋白、酪蛋白、IgE或非IgE相关,可导致立即或延迟出现症状。对CMPA的怀疑基于详细的家族史和病史、皮肤试验、斑贴试验、实验室检查、排除饮食和食物激发试验。CMPA的一般治疗方法是饮食治疗:消除牛奶蛋白,并引入深度水解乳清或酪蛋白配方奶粉、氨基酸配方奶粉和大豆配方奶粉。对于轻度或中度反应的婴儿,建议首选深度水解乳清或酪蛋白配方奶粉;对于严重的CMPA以及对深度水解乳清或酪蛋白配方奶粉反应不佳的情况,则使用氨基酸配方奶粉。