32例食物蛋白过敏与婴儿呕吐的相关性研究

Research of the relevance in 32 cases of food protein allergy and infant vomiting

【目的】检测以呕吐为主要表现的婴儿血清食物特异性IgG,以探讨牛奶不耐受与呕吐的关系。【方法】收集2008年9月-2010年2月在唐都医院儿科门诊及住院的32例3月-1岁婴儿,全部满足下例条件：1）主要症状除频繁呕吐外,部分伴腹泻、血便、湿疹、生长缓慢;2）上消化道内镜提示胃、十二指肠有粘膜病变;3）食物不耐受检测对一种或一种以上食物蛋白不耐受;4）食物归避试验或激发试验阳性;其中男20例,女12例;对研究对象进行血常规、24 h食管PH值监测、胃镜检查、食物不耐受检测、食物归避试验;【结果】食物特异性IgG检测对食物不耐受引起之婴儿呕吐的病因诊断有积极临床意义,特别注意胃镜下黏膜糜烂或十二指肠增生为主的呕吐婴儿,应考虑完善食物不耐受检测,以免延误诊断和治疗。【结论】食物蛋白过敏是引起婴儿呕吐的原因之一,尤其是对频繁呕吐患儿治疗效果不佳时应考虑食物过敏。

【Objective】 To test the specific IgG,in the serum of infant vomiting as the main manifestation,to investigate the relationship between milk intolerance and vomiting.【Methods】 To collect the infant（the age between three month to one year）,during Septermber 2008~February 2010 in the pediatric outpatient and inpatient of our hospital（32 case：20 males and 12 females）,satisfied the following conditions： 1）except of vomiting frequently,have the symptoms of diarrhea,bloody stool,eczema,growth slowly;2）can find gastric and duodenal mucosal lesions when checkout of upper gastrointestinal endoscopy;3）can find of one or more of food protein intolerance as detect food intolerance testing;4）Food Avoid test or provocation test are positive;To investigation the blood routine,24-hour esophageal PH value monitoring,endoscopy,food intolerance test,Food Avoid Test;【Results】 There were significance in diagnosis of clinical,to tetermination of specific IgG in children with vomiting,need to paying particular attention to the children which mucosal erosion or duodenal hyperplasia,should consider the food intolerance testing,to avoid misdiagnosis and treatment promptly.【Conclusions】 Food protein allergy is one of the reason could cause vomiting in infants,we should be considered the food allergies in children with vomiting frequently,especially when poor therapeutic efficacy.