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以深度水解配方管理牛乳蛋白过敏:法国前瞻性非干预研究结果(EVA 研究)。

Managing Cow's Milk Protein Allergy with an Extensively Hydrolyzed Formula: Results from a Prospective, Non-Interventional Study in France (EVA Study).

机构信息

Paediatric Nutrition and Gastroenterology Department, Trousseau Hospital (APHP), 75 012 Paris, France.

Independent Researcher, 33 200 Bordeaux, France.

出版信息

Nutrients. 2022 Mar 12;14(6):1203. doi: 10.3390/nu14061203.

DOI:10.3390/nu14061203
PMID:35334859
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8952694/
Abstract

Symptoms related cow’s milk proteins allergy (CMPA) usually improve between two to four weeks following an elimination diet, firstly with extensively hydrolyzed formulas (eHF). The aim of the EVA study was to observe the evolution of CMPA-related symptoms in real life after initiation of a whey-based extensively hydrolyzed formula (w-eHF, Althéra®, Nestlé Health Science, Switzerland). This cross-sectional prospective non-interventional study was carried out alongside paediatricians in private practice in France between June 2019 and June 2020. Infants aged 0−3 years presenting with confirmed diagnosis or clinical symptoms suggesting CMPA were enrolled. Data were collected at enrolment (baseline visit) and three to five weeks later (follow-up visit). Symptoms were assessed using the Cow’s Milk-related Symptom Score (CoMiSS®). The per protocol population included 135 infants. The average number of symptoms per infant significantly decreased under the study formula (from 2.81 to 1.36, p < 0.001) and the proportions of infants with any CMPA related symptoms decreased. Daily crying and regurgitation showed the largest decline, respectively −44.4% and −31.85% (p < 0.001). These results describe the early management of symptoms suspected to be related to CMPA in routine practice that was rarely described in the literature. The number and severity of symptoms decreased most of the cases after commencing the study formula.

摘要

与牛乳蛋白过敏(CMPA)相关的症状通常在消除饮食后 2 至 4 周内改善,首先是广泛水解配方(eHF)。EVA 研究的目的是观察在开始使用乳清基广泛水解配方(w-eHF,Althéra®,雀巢健康科学,瑞士)后,现实生活中 CMPA 相关症状的演变。这项横断面前瞻性非干预性研究于 2019 年 6 月至 2020 年 6 月在法国的私人执业儿科医生中进行。招募了 0-3 岁确诊或有 CMPA 临床症状的婴儿。在入组时(基线访视)和 3-5 周后(随访访视)收集数据。使用牛乳相关症状评分(CoMiSS®)评估症状。符合方案人群包括 135 名婴儿。在研究配方下,婴儿的平均症状数显著减少(从 2.81 降至 1.36,p<0.001),且有任何 CMPA 相关症状的婴儿比例降低。每日哭闹和反流的降幅最大,分别为-44.4%和-31.85%(p<0.001)。这些结果描述了在常规实践中疑似与 CMPA 相关症状的早期管理,这在文献中很少描述。在开始研究配方后,大多数情况下症状的数量和严重程度都有所减轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/e00097d5a446/nutrients-14-01203-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/9360cbb9510a/nutrients-14-01203-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/322a704536c4/nutrients-14-01203-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/8ea1c7032c91/nutrients-14-01203-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/1ab27396ec5a/nutrients-14-01203-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/e00097d5a446/nutrients-14-01203-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/9360cbb9510a/nutrients-14-01203-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/322a704536c4/nutrients-14-01203-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/8ea1c7032c91/nutrients-14-01203-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/1ab27396ec5a/nutrients-14-01203-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8925/8952694/e00097d5a446/nutrients-14-01203-g005.jpg

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本文引用的文献

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2
Current Trends in Tolerance Induction in Cow's Milk Allergy: From Passive to Proactive Strategies.牛奶过敏诱导耐受的当前趋势:从被动策略到主动策略
Front Pediatr. 2019 Sep 18;7:372. doi: 10.3389/fped.2019.00372. eCollection 2019.
3
Testing the Cow's Milk-Related Symptom Score (CoMiSS) for the Response to a Cow's Milk-Free Diet in Infants: A Prospective Study.
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