| 成智 颜美玲△ 贺丰 康美华 甘拓域.基于胃肠道表现就诊的婴儿牛奶蛋白过敏症临床分析[J].,2016,16(30):5957-5960 |
| 基于胃肠道表现就诊的婴儿牛奶蛋白过敏症临床分析 |
| Clinical Analysis of Infant Milk Allergy in Gastrointestinal Tract |
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| DOI： |
| 中文关键词: 胃肠道表现 婴儿 牛奶蛋白过敏 症状评分 误诊 |
| 英文关键词: Gastrointestinal Infant Cow milk allergy CoMiSS score Misdiagnose |
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| 中文摘要: |
| 目的：探讨以胃肠道表现为首发症状的婴儿牛奶蛋白过敏症(cow milk protein allergy,CMPA)的临床特点，以减少误诊。方
法：选择2012 年7 月至2015 年6 月我院消化门诊就诊的448 例诊断为婴儿牛奶蛋白过敏患儿，采用问卷调查法收集临床资料
和应用COMiSS 症状评分法进行症状量化评估。结果：448 例患儿中男216 例，女232 例，以0～ 6 个月发病年龄为主。不同胃肠
道首发症状就诊中腹泻50%，便血29%，反流或呕吐9%，阵发性哭闹7%，便秘5%。治疗前COMiSS 评分均值10.24± 2.60 分，饮
食回避2～4 周后评分均值为3.68± 1.17 分，均值差>6 分。调查既往诊疗中误诊病例296 例，不同胃肠道首发症状患儿的误诊率
为：腹泻组71%，便血组68%，阵发性哭闹组50%，反流或呕吐组40%，便秘组66%。既往误诊病例中抗生素使用率达62%。误诊病
例中发生营养不良112 例，非误诊病例中营养不良4 例，差异具有统计学意义（P<0.05）。结论：胃肠型婴儿牛奶蛋白过敏主要症状
为腹泻及便血。因症状缺乏特异性，临床实践中误诊发生率高。COMiSS症状评分法有助于临床医师对该病首发症状的识别和疗
效观察。 |
| 英文摘要: |
| Objective:Analysis of the clinical characteristics of infant milk protein allergy in the gastrointestinal tract as the first
symptom.Methods:FromJuly 2012 to June 2015, 448 cases in Our hospital were diagnosed as cow milk protein allergy. A questionnaire
survey was used to collect clinical data and to evaluate the symptoms of CoMiSS symptom score.Results:448 cases of male and 216
cases, female 232 cases, the age of 0 to 6 months of age. Different gastrointestinal first symptom of patients with diarrhea group 50%,
blood in the stool was 29%paroxysmal crying 7%in group and reflux or vomiting in group 9%, constipation group 5%. Before treatment,
the mean CoMiSS score was 10.24 ± 2.60. The mean value of feeding intervention was 3.68 ± 1.17. Mean difference >6. Investigation
of 296 cases of misdiagnosis in past diagnosis and treatment. Different gastrointestinal symptoms in children with the misdiagnosis rate of
diarrhea was 71%, 68% of blood in the stool group paroxysmal crying group 50%, the reflux or vomiting group (40%), constipation
group 66%. The use rate of antibiotics in the past misdiagnosed cases was 62%. 112 cases of malnutrition occurred in cases. 4 cases of
malnutrition in non misdiagnosis cases.Conclusion:Gastrointestinal type baby milk protein allergy symptoms as diarrhea and
hematochezia. Cow Milk protein proctitis is the most common cow milk protein allergy disease. Because of the lack of specificity, the
misdiagnosis rate is high in clinical practice. CoMiSS symptom score method is helpful to the clinical physicians to identify and observe
the symptoms of the disease. |
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