CRP在婴儿食物蛋白诱导性小肠结肠炎综合征与直肠结肠炎变化的对比性分析

Comparative analysis of CRP changes with food protein-induced enterocolitis syndrome and proctocolitis in infants

目的比较食物蛋白诱导性小肠结肠炎综合征(FPIES)与直肠结肠炎(FPIP)患儿的C反应蛋白(CRP)水平等指标的变化趋势。方法选取2019年9月~2021年9月期间于新生儿科门诊就诊的食物过敏导致的胃肠道疾病婴儿112例,依照诊断指南的临床表现,其中50例归为FPIES组,62例归为FPIP组,同时将全体患儿按照是否有发热分为发热组与非发热组。记录并分析两组患儿的CRP、血常规、抗生素使用情况等情况与变化趋势。结果FPIES组血清CRP升高、发热的患儿比例显著高于FPIP组,发热组CRP上升幅度和使用抗生素比例明显高于非发热组,差异均有统计学意义(P<0.01)。经治疗后FPIES组与FPIP组的CRP水平均迅速降至正常,差异无统计学意义(P>0.05)。结论FPIES与FPIP患儿中都有CRP升高的现象,FPIES相较于FPIP升高的比例和程度更加明显,同时FPIES更容易出现发热症状。通过回避致敏食物后CRP数值在短时间内降至正常,检测CRP水平对诊断FPIES与FPIP有重要参考价值。

Objective To comparison of trends in C-reactive protein(CRP)levels in children with food protein-induced enterocolitis syndrome(FPIES)and proctocolitis(FPIP).Methods One hundred and twelve infants with gastrointestinal disorders due to food allergy who attended the neonatal outpatient clinic between September 2019 and September 2021 were selected.Fifty cases were classified as FPIES group and 62 cases as FPIP group according to the clinical manifestations of the diagnostic guidelines,while all children were divided into febrile and non-febrile groups according to the presence or absence of fever.The CRP,routine blood test and antibiotic use of the children in both groups were recorded and analyzed with the trend of changes.Results The proportion of children with elevated serum CRP and fever was significantly higher in the FPIES group than in the FPIP group,and the rise in CRP and the proportion of antibiotics used were significantly higher in the febrile group than in the non-febrile group,and the differences were statistically significant(P<0.01).The CRP levels in both the FPIES and FPIP groups decreased rapidly to normal after treatment,and the differences were not statistically significant(P>0.05).Conclusion CRP is elevated in both children with FPIES and FPIP,and the proportion and degree of elevation is more pronounced in FPIES than in FPIP,FPIES is also more prone to febrile symptoms.By avoiding allergenic foods,CRP values decreased to normal within a short period of time,and the detection of CRP levels is an important reference for the diagnosis of FPIES and FPIP.