Universitair KinderZiekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Acta Paediatr. 2013 Oct;102(10):990-8. doi: 10.1111/apa.12349. Epub 2013 Aug 5.
The treatment for cow's milk protein allergy (CMPA) is a diet with an extensive hydrolysate. This study aimed to determine whether a whey (eWH) or casein hydrolysate (eCH) is the best option.
Infants with suspected CMPA were treated with an eWH or eCH, and efficacy was assessed with a symptom-based score developed by the authors. Diagnosis of CMPA was based on a positive challenge. If positive, the same eHF/eCH was continued. If negative, a standard starter and follow-up formula were given up to the age of 12 months.
An open challenge was performed on 85/116 (73%) infants suspected of CMPA on clinical grounds and was positive in 59/85 (69%). After 1 month, the symptom-based scores in both groups showed significant statistical and clinical reductions, and total and specific IgE and skin prick test results were similar. Both hydrolysates were enriched with probiotics, which were recovered in the gastrointestinal flora. The eWH-Standard Formula sequence led to better growth at the age of 1 year than the other three feeding regimens tested.
The eWH and eCH are equally effective. The symptom-based score is a useful tool to evaluate the efficacy of dietary treatment in infants with CMPA.
牛奶蛋白过敏（CMPA）的治疗方法是采用广泛水解的饮食。本研究旨在确定乳清（eWH）或酪蛋白水解物（eCH）是最佳选择。
疑似 CMPA 的婴儿接受 eWH 或 eCH 治疗，并采用作者制定的基于症状的评分来评估疗效。CMPA 的诊断基于阳性挑战。如果阳性，则继续使用相同的 eHF/eCH。如果为阴性，则给予标准起始配方和后续配方，直至 12 个月大。
对 85/116 名（73%）基于临床症状疑似 CMPA 的婴儿进行了开放性挑战，其中 59/85 名（69%）为阳性。1 个月后，两组基于症状的评分均显示出显著的统计学和临床改善，总 IgE、特异性 IgE 和皮肤点刺试验结果相似。两种水解物均添加了益生菌，这些益生菌在胃肠道菌群中得以恢复。eWH-标准配方序列在 1 岁时的生长情况优于其他三种测试的喂养方案。
eWH 和 eCH 同样有效。基于症状的评分是评估 CMPA 婴儿饮食治疗效果的有用工具。
