摘要
目的分析牛奶蛋白过敏(CMPA)儿童基本情况,探讨个体化应用氨基酸配方粉、深度水解乳清蛋白婴儿配方粉治疗后的干预效果及转归。方法收集2009年2-12月在中国医科大学附属盛京医院儿科就诊,符合CMPA诊断的180例患儿为干预对象。在营养门诊对其喂养史、一般情况进行回顾性分析,给予牛奶回避及治疗类配方粉营养干预7 d后回访疗效,指导辅食的选择和添加,并随访3个月、6个月后配方粉喂养婴儿的变化及疗效。结果 180例患儿牛奶过敏高发年龄段为>2～4月龄组(64例,占35.5%);母乳喂养者21例(11.7%),非纯母乳喂养者159例(88.3%);有家族史者32例(17.8%);男女比为1.651。干预7 d后显效比例最高的临床症状为腹泻(61例,占83.6%)。3个月后纯氨基酸配方粉喂养76例(占46.0%),深度水解配方喂养54例(占32.7%),适度水解配方奶粉喂养为25例(占15.3%)。6个月后喂养主要是纯氨基酸配方(39例,占24.9%),其次为牛奶配方粉(36例,占22.9%)。结论母乳喂养有利于避免婴儿牛奶过敏,营养干预3个月内不宜喂养含牛奶蛋白配方奶粉,营养干预6个月后部分患儿可获牛奶耐受。牛奶过敏患儿喂养配方粉的转归各不相同,应结合患儿家庭经济能力、病情变化等个体化营养干预。
Objective To analyze the basic status and clinical manifestations of infants with cow＇s milk protein allergy（CMPA） ,and explore the intervention effect and outcome after using the individual amino acid formula and extensively hydrolyzed protein. Methods One hundred and eighty infants with the diagnosis of CMPA were selected as intervention target during Feb. to Dec. 2009 who came to see a doctor in pediatric treatment of Shengjing Hospital Affiliated to China Medical University. A retrospective analysis was carried out by the feeding history, basic status of these patients who visited nutrition clinic. Each patient received nutrition instruction of avoiding cow＇s milk and giving the formula as sequential therapy for 7 days, and was guided the choice of food supplement and adding. The feeding changes were recalled after 3 months and 6 months of nutritional intervention, respectively. Results The age of high incidence of infants with CMPA was 2 - 4 months after birth with the ratio 35.5% in all 180 patients. The ratio of breast feeding was 11.7% （21/180 cases） ,while that of non - breast feeding was 88.3% （ 159/180 cases）. Thirty - two patients（ 17.8% ） had family history. Sex ratio of male ： female was 1.65 ： 1. The main clinical symptom was diarrhea （83.6%） after 7 days. The main feeding formula after the 3 rd month was pure amino acid medicals （46.0%）, extensively hydrolyzed formula（ 32.7% ）, partially hydrolyzed formula （15.3%）. The main feeding after the 6th month was pure amino acid medicals （24.9%） ,cow＇s formula milk（22.9% ）. Conclusions Breast feeding is benefited to avoiding CMPA. The infant patients should not be fed with milk protein formula within 3 months of nutritional intervention, and some infants may become milk tolerance after 6 months of nutritional intervention. The outcome of feeding formula is different with each other. The individual nutrition intervention according to economic condition of each infant and disease changes is necessary.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第19期1486-1488,共3页
Journal of Applied Clinical Pediatrics
关键词
牛奶过敏
营养干预
氨基酸配方粉
儿童
allergy to cow＇ s milk
nutrition intervention
amino acid medicals
child
