Umeda Satoshi, Kawahara Hisayoshi, Yoneda Akihiro, Tazuke Yuko, Tani Gakuto, Ishii Tomohiro, Goda Taro, Hirano Katsuhisa, Ikeda Kayo, Ida Shinobu, Nakayama Masahiro, Kubota Akio, Fukuzawa Masahiro
Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho Izumi, Osaka, 594-1101, Japan,
Pediatr Surg Int. 2013 Nov;29(11):1159-63. doi: 10.1007/s00383-013-3379-4.
To investigate the impact of cow's milk allergy (CMA) on infants with Hirschsprung's disease (HD).
Twenty-four patients, who developed gastrointestinal symptoms before the age of 60 days and underwent surgery for HD in the period between January 2003 and December 2012, were enrolled in this study. They were divided into two groups based on CMA-related findings: stimulation index of lymphocyte stimulation test >300 % and the presence of eosinophilic infiltration in the resected colon. Ten patients were determined specimen as not having CMA (Group A), because they did not satisfy any of the criteria. The remaining 14 were determined as having possible CMA (Group B), because they satisfied either or both findings. Patient background characteristics, pre- and postoperative clinical history, and laboratory data were compared between Groups A and B.
Pre- and postoperative enterocolitis did not occur in Group A patients. Postoperative enterocolitis was more frequent in Group B than in Group A (p = 0.04). Other clinical and laboratory data did not show significant difference between the two groups.
CMA is a possible risk factor for postoperative enterocolitis in patients with HD.
探讨牛奶过敏（CMA）对患有先天性巨结肠（HD）的婴儿的影响。
本研究纳入了24例在60日龄前出现胃肠道症状并于2003年1月至2012年12月期间接受HD手术的患者。根据与CMA相关的检查结果将他们分为两组：淋巴细胞刺激试验的刺激指数>300%以及切除结肠中存在嗜酸性粒细胞浸润。10例患者因不符合任何标准而被判定标本无CMA（A组）。其余14例因符合一项或两项检查结果而被判定可能患有CMA（B组）。比较A组和B组患者的背景特征、术前和术后临床病史以及实验室数据。
A组患者术前和术后均未发生小肠结肠炎。B组术后小肠结肠炎的发生率高于A组（p = 0.04）。两组的其他临床和实验室数据无显著差异。
CMA是HD患者术后小肠结肠炎的一个可能危险因素。
