牛奶蛋白过敏致婴儿下消化道出血60例临床分析

Clinical analysis of 60 cases of infants with lower gastrointestinal bleeding caused by cow's milk protein allergy

目的对牛奶蛋白过敏导致的婴儿下消化道出血进行临床资料分析,为早期诊断和有效治疗提供依据。方法回顾性分析2014年1月-2016年5月深圳市儿童医院60例牛奶蛋白过敏导致婴儿下消化道出血的临床资料。结果牛奶蛋白过敏致1~6月婴儿下消化道出血最多41例(68.33%),不同性别患儿年龄分布差异无统计学意义(χ2=1.371,P=0.242),人工喂养多见25例(41.67%);临床表现突然大便带鲜血或血丝46例(76.67%);实验检查IgG抗体增高48例(80%);电子肠镜检查:发现多发性结节增生(81.33%);病理检查表现慢性非特异性炎症,固有层嗜酸性粒细胞增多;回避牛奶蛋白治疗后,患儿治愈率情况:2周后治愈率比1周后治愈率明显增多,差异有统计学意义(P<0.05);4周后治愈率比2周治愈率两者比较,差异无统计学意义(P>0.05)。结论牛奶蛋白过敏致婴儿下消化道出血,以1~6月人工喂养患者多见,IgG抗体升高可能参与了其机制,回避牛奶蛋白2-4周后未见缓解,需要考虑嗜酸粒细胞结肠炎引起可能。

Objective To investigate the clinical analysis of lower gastrointestinal bleeding caused by cow＇s milk protein allergy in infants,and to provide a basis for early diagnosis and effective treatment of lower gastrointestinal bleeding caused by cow＇s milk protein allergy in. infants. Method The elinieai data of 60 irlfants with lower gastrointestinal bleeding caused by cow＇s milk protein allergy in Shenzhen Children＇s Hospital from May 2016 to January 2014 were analyzed retrospectively. Results Most cow＇s milk protein allergy caused lower gastrointestinal bleeding was in infants with the age of 1 6 months（68.33 % ）, with no significant gender difference in age distribution（ 2 = 1.371, P = 0. 242）, 25 cases of formulafeeding infants （41.67%）;Clinical manifestation was blood in stool suddenly in 46 cases （76.67%）;Experimental examination of IgG antibody increased in 48 cases （80%） ;Electronic eolonoseopy revealed multiple nodular hyperplasia （81.330%）; Pathological examination showed chronic nonspecific inflammation,and the intrinsic layer of eosinophils increased; After avoid milk protein treatment ： cure rate 2 weeks＂ was significantly increased than that of one-week. The difference was statistically significant （P〈0.05） ;Between 4 weeks and two weeks＇ cure rate, the difference was not statistically significant （P〉0.05）. Conclusions Milk protein allergy caused lower gastrointestinal bleeding, mainly are infants with the age of 1 - 6 months with formula-feeding infants,elevated IgG antibody maybe involve in the pathogenesis of infant lower gastrointestinal bleeding caused by cow＇s milk protein allergy. Avoidance of milk protein of 2-4 weeks, the lower gastrointestinal bleeding can not be alleviated,patients need to consider the cause of eosinophilic colitis.