144例婴幼儿牛奶蛋白过敏的临床分析

Clinical analysis of 144 cases of milk protein allergy in infants and children

目的分析婴幼儿牛奶蛋白过敏患儿临床特征,为早期诊断和有效治疗婴幼儿牛奶蛋白过敏提供科学依据。方法回顾性调查河南省儿童医院消化内科2020年11月1日-2022年5月1日住院的婴幼儿牛奶蛋白过敏144例病例,对婴儿婴幼儿牛奶蛋白过敏临床特征进行描述性分析,分析婴幼儿牛奶蛋白过敏患儿的临床特征。结果144例患儿中完全人工喂养者62例,纯母乳喂养64例,混合喂养18例。患儿以腹泻、便血为主要症状,母亲规避致敏高蛋白致敏食物或更换为氨基酸配方奶粉喂养后症状多明显缓解。结论牛奶蛋白过敏的患儿愈后良好,但很难诊断。本病患儿无特异性的临床表现,通过详细的病史及一般检查,当食物过敏被高度怀疑时,回避可疑过敏食物可能改善临床表现,如果诊断仍不明确或疗效较差,则需要进一步筛查食物过敏原,以确定明确致敏原,如仍不能明确诊断,需进一步行电子结肠镜检查及肠黏膜组织病理学检查协助诊断。治疗本病通过采用食物回避的方法,效果明显,早期诊断有利减少抗生素的滥用,减轻家庭经济负担,有利于对婴儿的早期营养提供指导,促进健康发育。

Objective To analyze the clinical characteristics of infants and children with milk protein allergy,and to provide a scientific basis for early diagnosis and effective treatment of infants and children with milk protein allergy.Methods A retrospective survey of 144 cases of infants with milk protein allergy hospitalized from November 1,2020 to May 1,2022 in the Department of Gastroenterology of Henan Children’s Hospital was conducted.The clinical characteristics of infants with milk protein allergy and young children were analyzed.Results Among the 144 children,62 were exclusively artificially fed,64 were exclusively breastfed,and 18 were mixed-fed.The children had diarrhea and blood in the stool as the main symptoms,and the symptoms were mostly relieved significantly after the mothers avoided allergic high-protein allergenic foods or changed to amino acid formula feeding.Conclusion The clinical history of milk protein allergy in infants and children is good,but the diagnosis is difficult.Through detailed history and general examination,if food allergy is highly suspected,avoidance of suspected allergic food can be used.If the diagnosis is still unclear or the efficacy is poor,further food allergen screening should be performed to clarify the allergen,and further e-colonoscopy and histopathological examination of intestinal mucosa should be performed to help the diagnosis if the diagnosis is still not confirmed.The effect of food avoidance is obvious,so early diagnosis is beneficial to reduce the abuse of antibiotics,reduce the economic burden of families,and facilitate early nutritional guidance for infants to promote healthy development.