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以胃肠道症状为主的婴儿牛奶蛋白过敏临床特征:280例分析

[Clinical features of cow's milk protein allergy in infants presenting mainly with gastrointestinal symptoms: an analysis of 280 cases].

作者信息

Yang Qing-Hua, Zheng Bing-Sheng, Zhou Shao-Ming, Dai Dong-Ling

机构信息

Department of Gastroenterology, Shenzhen Children's Hospital, Shantou University Medical College, Shenzhen, Guangdong 518036, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2019 Mar;21(3):271-276. doi: 10.7499/j.issn.1008-8830.2019.03.016.

Abstract

OBJECTIVE

To investigate the epidemiological and clinical features of cow's milk protein allergy (CMPA) in infants presenting mainly with gastrointestinal symptoms.

METHODS

A retrospective analysis was performed for the clinical data of 280 hospitalized infants, who were diagnosed with CMPA presenting mainly with gastrointestinal symptoms.

RESULTS

Among the 280 infants, 203 infants(72.5%) were aged of less than 6 months. Major manifestations included diarrhea in 171 infants (61.1%), hematochezia in 149 infants (53.2%), vomiting in 71 infants (25.4%), eczema in 57 infants (20.4%), malnutrition in 42 infants (15%) and constipation in 13 infants (4.6%). Of the 280 infants, 258 (92.1%) had mild-to-moderate CMPA and 22 (7.9%) had severe CMPA. Compared with the mild-to-moderate CMPA group, the severe CMPA group had a significantly higher incidence rate of malnutrition (50.0% vs 12.0%) and a significantly lower incidence rate of hematochezia (22.7% vs 55.8%). The breastfeeding CMPA group had significantly lower incidence rates of malnutrition (10.3% vs 24.6%) and severe CMPA (4.4% vs 18.0%) than the artificial feeding CMPA group, and the artificial feeding CMPA group had a significantly lower incidence rate of hematochezia than the breastfeeding and mixed feeding CMPA groups (37.7% vs 56.6%/59.0%).

CONCLUSIONS

CMPA presenting mainly with gastrointestinal symptoms is more common in infants aged of less than 6 months. Diarrhea and hematochezia are the most common manifestations at the time of onset. Most infants have mild-to-moderate allergy. Compared with breastfeeding, artificial feeding is more likely to cause malnutrition and severe CMPA.

摘要

目的

探讨以胃肠道症状为主的婴儿牛奶蛋白过敏(CMPA)的流行病学及临床特征。

方法

对280例以胃肠道症状为主且诊断为CMPA的住院婴儿的临床资料进行回顾性分析。

结果

280例婴儿中,203例(72.5%)年龄小于6个月。主要表现为腹泻171例(61.1%)、便血149例(53.2%)、呕吐71例(25.4%)、湿疹57例(20.4%)、营养不良42例(15%)、便秘13例(4.6%)。280例婴儿中,258例(92.1%)为轻至中度CMPA,22例(7.9%)为重度CMPA。与轻至中度CMPA组相比,重度CMPA组营养不良发生率显著更高(50.0%对12.0%),便血发生率显著更低(22.7%对55.8%)。母乳喂养的CMPA组营养不良发生率(10.3%对24.6%)和重度CMPA发生率(4.4%对18.0%)显著低于人工喂养的CMPA组,且人工喂养的CMPA组便血发生率显著低于母乳喂养和混合喂养的CMPA组(37.7%对56.6%/59.0%)。

结论

以胃肠道症状为主的CMPA在6个月以下婴儿中更为常见。腹泻和便血是发病时最常见的表现。大多数婴儿为轻至中度过敏。与母乳喂养相比,人工喂养更易导致营养不良和重度CMPA。

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